Obtaining appropriate interval estimates for age when multiple indicators are used: evaluation of an ad-hoc procedure.

When an estimate of age is needed, typically multiple indicators are present as found in skeletal or dental information. There exists a vast literature on approaches to estimate age from such multivariate data. Application of Bayes' rule has been proposed to overcome drawbacks of classical regression models but becomes less trivial as soon as the number of indicators increases. Each of the age indicators can lead to a different point estimate ("the most plausible value for age") and a prediction interval ("the range of possible values"). The major challenge in the combination of multiple indicators is not the calculation of a combined point estimate for age but the construction of an appropriate prediction interval. Ignoring the correlation between the age indicators results in intervals being too small. Boldsen et al. (2002) presented an ad-hoc procedure to construct an approximate confidence interval without the need to model the multivariate correlation structure between the indicators. The aim of the present paper is to bring under attention this pragmatic approach and to evaluate its performance in a practical setting. This is all the more needed since recent publications ignore the need for interval estimation. To illustrate and evaluate the method, Köhler et al. (1995) third molar scores are used to estimate the age in a dataset of 3200 male subjects in the juvenile age range.

Age estimation in the living: Transition analysis on developing third molars.

A radiographic assessment of third molar development is essential for differentiating between juveniles and adolescents in forensic age estimations. As the developmental stages of third molars are highly correlated, age estimates based on a combination of a full set of third molar scores are statistically complicated. Transition analysis (TA) is a statistical method developed for estimating age at death in skeletons, which combines several correlated developmental traits into one age estimate including a 95% prediction interval. The aim of this study was to evaluate the performance of TA in the living on a full set of third molar scores. A cross sectional sample of 854 panoramic radiographs, homogenously distributed by sex and age (15.0-24.0 years), were randomly split in two; a reference sample for obtaining age estimates including a 95% prediction interval according to TA; and a validation sample to test the age estimates against actual age. The mean inaccuracy of the age estimates was 1.82 years (±1.35) in males and 1.81 years (±1.44) in females. The mean bias was 0.55 years (±2.20) in males and 0.31 years (±2.30) in females. Of the actual ages, 93.7% of the males and 95.9% of the females (validation sample) fell within the 95% prediction interval. Moreover, at a sensitivity and specificity of 0.824 and 0.937 in males and 0.814 and 0.827 in females, TA performs well in differentiating between being a minor as opposed to an adult. Although accuracy does not outperform other methods, TA provides unbiased age estimates which minimize the risk of wrongly estimating minors as adults. Furthermore, when corrected ad hoc, TA produces appropriate prediction intervals. As TA allows expansion with additional traits, i.e. stages of development of the left hand-wrist and the clavicle, it has a great potential for future more accurate and reproducible age estimates, including an estimated probability of having attained the legal age limit of 18 years.

Forensic age estimation from the clavicle using 1.0T MRI--preliminary results.

OBJECTIVES: As forensic age estimations in the living are performed without medical indication, there is a need for the development of non-ionizing methods. This study investigates the use of 1.0T MRI to visualize the ossification status of the medial end of the clavicle. MATERIAL AND METHODS: T2 weighted 3D images were collected from a 1.0T MR system. We prospectively scanned 102 subjects, 47 autopsy cases and 55 living volunteers (12-33 years). Images were scored in blind trials by three observers using a 4-stage system. Observers differed by level of training and radiological expertise. RESULTS: Motion artefacts reduced image resolution in living subjects. However, mean age at stage 4 was significantly different from mean age at stage 2 and 3. The minimum age at stage 4 was 19.8 years. Inter-observer agreement was moderate for autopsy cases and slight for living subjects. By contrasting subjects of "incomplete fusion" (≤ stage 3 on both sides) against "fused" (at least one stage 4), agreement rate rose to moderate (K=0.414) for living subjects. Despite the low agreement rate, no subject younger than 18 years was assessed as having "fused" clavicles. CONCLUSION: At lower image resolution, a 2-stage system increases agreements rates among observers. To further increase accuracy, clavicle staging needs to be performed by trained observers. If available, a 1.0T MR system may be used for age estimation in the living. However, further studies are needed to ensure that the ability to discriminate adults from minors, i.e. 18 years, is maintained.