Predicting alternate light absorption in areas of trauma based on degree of skin pigmentation: Not all wavelengths are equal

Scafide, Katherine N.; Downing, Nancy R.; Kutahyalioglu, Nesibe S.; Sheridan, Daniel J.; Langlois, Neil E. I.; Hayat, Matthew J.

doi:10.1016/j.forsciint.2022.111410

Cited by 3 publications

(5 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Skin color impacted bruise visibility scores in our analysis, with very light and light skin colors having highest visibility ratings across all light sources when compared to dark skin tones (Table 2). Results are consistent with our previous findings that more bruises were detected on lighter skin colors [15]. Contrary to our previous findings, 515 nm with a red filter resulted in the highest mean visibility score in the dark skin color category.…”

Section: Discussionsupporting

confidence: 90%

“…Box plots are displayed in Figure 1 observing the area of trauma using an ALS 415 nm with a yellow filter increased the visibility score 0.46 points higher than white light (95% CI: 0.43, 0.49; p < 0.001). This value approaches the clinically meaningful increase of 0.50 [15]. Similarly, 450 nm or use of an orange filter also provided a significant, though not clinically meaningful, increase in visibility (Table 2).…”

Section: Discussionmentioning

confidence: 65%

“…Consistent with prior studies, we found 415 nm wavelength with yellow filter resulted in highest visibility ratings across skin colors and resulted in a clinically meaningful increase in bruise visibility rating using standardized bruise visibility tools. Increased visibility could improve the accuracy of injury documentation, which could corroborate violence and reduce disparities for persons with dark skin colors [15]. Results demonstrate the benefit of the BVS and AVS to decrease subjectivity in the description of visualized bruises and standardize how bruises are documented [16].…”

Section: Discussionmentioning

confidence: 99%

“…An alternative light source (ALS), with its single bandwidth light emission, has the potential to overcome the challenges of white light reflection. Several studies have demonstrated that violet and blue ALS wavelengths (400–470 nm) can improve the detection of bruises over white light [11–13], even on diverse skin tones [14, 15]. Bruise detection refers to determining whether there is or is not a bruise identified at a site of known trauma.…”

Section: Introductionmentioning

confidence: 99%

“…Based on prior analyses, we hypothesized that 415 nm and 450 nm wavelength with yellow and orange filters would result in increased bruise visibility. Bruises that are more visible are easier to accurately document, which can reduce disparities for patients on whom bruises are difficult to visualize, especially persons with darker skin colors [15]. Results of this analysis can be utilized to support use of ALS in medical forensic examinations.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial

Downing,

Scafide,

Ali

et al. 2024

Journal of Forensic Sciences

Self Cite

View full text Add to dashboard Cite

Difficulty visualizing bruises resulting from interpersonal violence, especially in individuals with dark skin, contributes to disparities in access to justice. The purpose of this analysis was to compare bruise visibility of detected injuries using white light versus alternate light sources (ALS). Visibility was assessed using the 5‐point Bruise Visibility Scale (BVS) for white light and the ALS Visibility Scale (AVS) for ALS. Bruises were induced using controlled application of a paintball to the upper arm on 157 healthy adults across six skin color categories. Using a crossover design, the light source used first to assess the bruise (white light or ALS) was randomized. Each bruise was examined up to 21 times over 4 weeks using white light and 10 combinations of wavelengths (350 nanometer [nm] – 535 nm) and colored filters (yellow, orange, and red). Multilevel modeling was used to analyze the repeated measures data with a total 20,103 bruise assessments. Results revealed 415 nm with yellow filter resulted in an almost 0.5‐point increase in BVS/AVS score across all skin colors (Estimate = 0.46; 95% CI: 0.43, 0.49; p < 0.001), a clinically significant improvement in ability to visualize bruises. Conversely, 515 nm (Estimate = −0.80; 95% CI: −0.84, −0.76; p < 0.001) and 535 nm (Estimate = −0.64, 95% CI: −0.67, −0.60; p < 0.001) with red filter resulted in more than 0.5‐point decrease in BVS/AVS score. The use of ALS is supported by the data and results in improved bruise visibility during medical forensic examinations.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial

Downing,

Scafide,

Ali

et al. 2024

Journal of Forensic Sciences

Self Cite

View full text Add to dashboard Cite

show abstract

Examining the use of alternative light sources in medico-legal assessments of blunt-force trauma: a systematic review

Tyr,

Heldring,

Zilg

2024

Int J Legal Med

View full text Add to dashboard Cite

The ability to analyze blunt-force trauma is crucial for deciphering valuable clues concerning mechanisms of injury and as evidence for medico-legal investigations. The use of alternate light sources (ALS) has been studied over the past decade, and is proposed to outperform conventional white light (CWL) during bruise assessments. In response to the growing interest of the technology worldwide, a systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) to address the ability of ALS to detect and visualize bruising. From an initial 4055 records identified, ten studies met the eligibly criteria and were selected for this review. Evaluation also included a novel framework, referred to as SPICOT, to further systematically assess both scientific evidence and risk of bias in forensic literature. Analysis reveals that narrowband wavelengths within in the infrared or ultraviolet spectral ranges do not significantly outperform CWL in visualizing or detecting bruising. However, wavelengths within the visible spectrum, particularly 415 nm combined with longpass or bandpass yellow filters, are more effective. However, the majority of selected studies only address the sensitivity of ALS, and therefore, results may only be considered valid when the location of a bruise is known. Further investigation is required to understand the specificity of ALS, in particular how the use of topical cosmetic products, previous wounds/scar-tissue, tattoos, moles and freckles may affect detection. The ethical concern regarding the interpretation of enhanced visualized trauma should also be considered in prospect discussions prior to implementing ALS into routine practice. Nevertheless, this review finds that narrowband ALS within the visible spectrum demonstrates potential for improved injury documentation, outperforming CWL in the detection and visualization of bruising.

show abstract

Commentary on: Downing NR, Scafide KN, Ali Z, Hayat MJ. Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial. J Forensic Sci. 2024;69(3):880–7. https://doi.org/10.1111/1556‐4029.15481

Hauda,

Rotolo,

Riviello

et al. 2024

Journal of Forensic Sciences

View full text Add to dashboard Cite

We read with interest the article by Downing NR, et al. regarding the use of alternate light to view bruises [1]. We agree with the authors that the identification of injuries in patients who have experienced physical violence is important. As colleagues who are forensic medicine experts, we recognize the importance of visualizing bruises in cases of interpersonal violence, especially in individuals with darkly pigmented skin, so we applaud your research on this issue.Practitioners need to be as accurate as possible in their evaluation.The use of tools to assist in the identification of injuries can be very helpful. We also recognize that forensic sciences and the associated analysis or evaluation must remain accurate and valid and not utilize "presumptive tests without confirmation" or tests lacking "reliability, reproducibility, repeatability, and replicability" [2,3].When reading this article, we were struck by the remarkable similarity in methods with previous publications by these authors on this topic [4,5]. All three studies have the same number of 157 participants. This study and the study published in 2020 describe the

show abstract

Predicting alternate light absorption in areas of trauma based on degree of skin pigmentation: Not all wavelengths are equal

Cited by 3 publications

References 30 publications

Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial

Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial

Examining the use of alternative light sources in medico-legal assessments of blunt-force trauma: a systematic review

Commentary on: Downing NR, Scafide KN, Ali Z, Hayat MJ. Visibility of inflicted bruises by alternate light: Results of a randomized controlled trial. J Forensic Sci. 2024;69(3):880–7. https://doi.org/10.1111/1556‐4029.15481

Contact Info

Product

Resources

About