Difference between revisions of "Journal:Introductory evidence on data management and practice systems of forensic autopsies in sudden and unnatural deaths: A scoping review"
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==Background== | ==Background== | ||
The global burden of trauma, particularly in low- and middle-income countries places a large strain on resources, and therefore, the diagnostic value of autopsies must be reiterated | The global burden of trauma, particularly in low- and middle-income countries (LMICs) places a large strain on resources, and therefore, the diagnostic value of autopsies must be reiterated. [Salona Prahladh 2018] The use of autopsies remains the gold standard in assessing standards of medical care. There is a concerning decline in autopsies even though their value to the medical fraternity is acknowledged. [Aase 2013; Bagher et al. 2015] [[Forensic science|Forensic medicine]] and [[Pathology#Forensic pathology|forensic pathology]] apply scientific and medical knowledge to inquests, and the autopsy is frequently regarded as the focus of the death investigation. The investigation into sudden unexpected and unnatural deaths supports criminal justice, aids in litigation, and provides important information for [[public health]], including surveillance, [[epidemiology]], and prevention programs. [Bagher et al. 2015; Tseng et al. 2018; Barbería et al. 2018; Pan et al. 2019; Soto Martinez et al. 2019] The evidence serves to inform policy not only for injury prevention and control, but also to prevent suicide, violence, or substance abuse. [Barbería et al. 2018; Pan et al. 2019; Rao et al. 2005; Grills et al. 2011; Prinsloo 2019; Willcox et al. 2020] | ||
Globally, death investigations are conducted according to prevailing legislation, which differs from country to country. Historically, the coroner system was formalized into law by England’s King Richard I in 1194, with the first coroners being knights. [Koehler 2016] The coroner system from England was introduced in the 1600s by American colonists, becoming an important part of the death investigation system in what would become the United States of America. However, the role of the office was later reduced to the medicolegal examination of a body and the determination of the cause and manner of death. [Koehler 2016] Throughout the Middle Ages, the functions of the coroner included conducting inquests, attending to and inspecting the dead, and investigating suspicious deaths. | |||
In the US, coroners are generally public officials with minimal to no medical training. Some coroners only serve part-time capacities, and they also often have other full-time employment. The medical examiner system was introduced due to public dissatisfaction with the coroner system, accusations of corruption, and an increased need to have highly trained personnel in the death investigation. [Koehler 2016] This led to the emergence of a separate discipline of forensic medicine, which began in the seventeenth century. [Choo and Choi 2012] The first medical examiner system was introduced in Massachusetts in 1877. | |||
In 1959, the medical subspecialty of forensic pathology was formally certified, and medical examiners were trained in pathology. Forensic pathology is viewed as a subspecialty of [[anatomical pathology]] in countries such as Canada and the United Kingdom. In countries such as South Africa and Australia, one may train solely in forensic pathology for a minimum of a year (usually more), with additional training in anatomical pathology. In South Africa, the medicolegal death investigation is conducted primarily in terms of the Inquests Act (Act 58 of 1959). The medicolegal autopsies are performed by medical practitioners, but due to the large annual number of unnatural deaths and the small number of qualified forensic pathologists in South Africa, a large number of these autopsies are performed by colleagues with limited formal training in performing autopsies. [du Toit-Prinsloo and Saayman 2012] | |||
The fundamental essence of forensic pathologists’ work is to investigate and report the cause of death. The importance of reporting the cause of death is reiterated and forms the basis of The Global Burden of Disease study. [Roth et al. 2018] This comprehensive worldwide observational epidemiological study describes mortality and morbidity from major diseases, injuries, and risk factors to health at global, national, and regional levels. Mortality reporting systems can help to prioritize health system investments, track progress towards global development goals, and guide scientific research. [Roth et al. 2018] The Global Burden of Disease study acknowledges the need for wider adoption and improvement of these systems because continuous reporting of cause-specific mortality in many countries represents a success for global health. | |||
[[Information]] derived from autopsies has historically been paper-documented, filed, and archived. With the current age of technology, this information can be stored and managed electronically to better ensure reporting that is current, relevant, and contributory to training and service delivery, policy implementation, and social interventions. The current [[Coronavirus disease 2019|COVID-19]] [[pandemic]] has accentuated the importance of wireless technology and the use of the internet to transcend normal communications. Due to safety reasons, much work has to be conducted remotely in many business sectors, including the medical sector. General practitioners conducted consultations virtually to adhere to social distancing and safety measures, and telephonic communication and [[telemedicine]] became a necessity due to the pandemic. At this current point in time, we are forced to be open-minded to integrate technology into our daily work lives. | |||
This scoping review was conducted to map the evidence on [[Information management|data management]] and practice systems, their use, benefits, and challenges in forensic medicine. The information gained on the use and availability of digital technologies and their strengths and limitations to collect autopsy data can inform models to suit similar purposes in forensic medicine in LMICs. | |||
==Methods== | |||
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==Notes== | ==Notes== | ||
This presentation is faithful to the original, with only a few minor changes to presentation, grammar, and punctuation. In some cases important information was missing from the references, and that information was added. | This presentation is faithful to the original, with only a few minor changes to presentation, grammar, and punctuation. In some cases important information was missing from the references, and that information was added. The original article lists references in alphabetical order; this version lists them in order of appearance, by design. | ||
<!--Place all category tags here--> | <!--Place all category tags here--> | ||
Revision as of 22:38, 22 February 2023
| Full article title | Introductory evidence on data management and practice systems of forensic autopsies in sudden and unnatural deaths: A scoping review |
|---|---|
| Journal | Egyptian Journal of Forensic Sciences |
| Author(s) | Prahladh, Salona; van Wyk, Jacqueline |
| Author affiliation(s) | Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal |
| Primary contact | Email: prahladhs at ukzn dot ac dot za |
| Year published | 2022 |
| Volume and issue | 12 |
| Article # | 38 |
| DOI | 10.1186/s41935-022-00293-3 |
| ISSN | 2090-5939 |
| Distribution license | Creative Commons Attribution 4.0 International |
| Website | https://ejfs.springeropen.com/articles/10.1186/s41935-022-00293-3 |
| Download | https://ejfs.springeropen.com/counter/pdf/10.1186/s41935-022-00293-3.pdf (PDF) |
 |
This article should be considered a work in progress and incomplete. Consider this article incomplete until this notice is removed. |
Abstract
Background: The investigation into sudden unexpected and unnatural deaths supports criminal justice, aids in litigation, and provides important information for public health, including surveillance, epidemiology, and prevention programs. The use of mortality data to convey trends can inform policy development and resource allocations. Hence, data practices and data management systems in forensic medicine are critical. This study scoped literature and described the body of knowledge on data management and practice systems in forensic medicine.
Methods: Five steps of the methodological framework of Arksey and O’Malley guided this scoping review. A combination of keywords, Boolean terms, and medical subject headings was used to search PubMed, EBSCOhost (CINAHL with full text and Health Sources), Cochrane Library, Scopus, Web of Science, Science Direct, WorldCat, and Google Scholar from June 18–24 of 2020, and again in November 2021, for peer review papers. This study included articles involving unnatural deaths, focused on data practice or data management systems, relating to forensic medicine, all study designs, and published in English. Screening, selection, and data extraction were conducted by two reviews. Thematic analysis was conducted, and the results were reported using both quantitative and qualitative methods.
Results: Of the examined 23,059 articles, 16 met this study’s inclusion criteria. The included articles were published between 2008 and 2019. Eight of the 16 articles were published between 2017 and 2019. Most of the included studies were conducted in the United States (5) and Australia/New Zealand (4). Only two publications were from lower- and middle-income countries (LMICs; Nigeria and Mexico), and the remaining 14 were from high-income countries (Italy, Denmark, US, Australia, New Zealand, Japan, Switzerland, and Canada). The data management systems found in this study were as follows: Virtopsy, Canadian Coroner and Medical Examiner Database, Infant Injury Database, Ibadan pilot fatal injury surveillance system, Medical Examiners and Coroners Alert System, National Violent Deaths Reporting System, AM/PM Database, Tokyo CDISC/ODM, and National Coronial Information System.
Conclusions: This study’s results revealed limited articles relating to data management and practice systems in forensic medicine—particularly in LMICs—indicating there is a prevalence of unnatural deaths in LMICs. This study, therefore, recommends research on data management and practice systems relating to forensic medicine in LMICs to inform policy decisions.
Keywords: unnatural death, data practice, data management systems, autopsy, post-mortem examination, forensic medicine, pathology
Background
The global burden of trauma, particularly in low- and middle-income countries (LMICs) places a large strain on resources, and therefore, the diagnostic value of autopsies must be reiterated. [Salona Prahladh 2018] The use of autopsies remains the gold standard in assessing standards of medical care. There is a concerning decline in autopsies even though their value to the medical fraternity is acknowledged. [Aase 2013; Bagher et al. 2015] Forensic medicine and forensic pathology apply scientific and medical knowledge to inquests, and the autopsy is frequently regarded as the focus of the death investigation. The investigation into sudden unexpected and unnatural deaths supports criminal justice, aids in litigation, and provides important information for public health, including surveillance, epidemiology, and prevention programs. [Bagher et al. 2015; Tseng et al. 2018; Barbería et al. 2018; Pan et al. 2019; Soto Martinez et al. 2019] The evidence serves to inform policy not only for injury prevention and control, but also to prevent suicide, violence, or substance abuse. [Barbería et al. 2018; Pan et al. 2019; Rao et al. 2005; Grills et al. 2011; Prinsloo 2019; Willcox et al. 2020]
Globally, death investigations are conducted according to prevailing legislation, which differs from country to country. Historically, the coroner system was formalized into law by England’s King Richard I in 1194, with the first coroners being knights. [Koehler 2016] The coroner system from England was introduced in the 1600s by American colonists, becoming an important part of the death investigation system in what would become the United States of America. However, the role of the office was later reduced to the medicolegal examination of a body and the determination of the cause and manner of death. [Koehler 2016] Throughout the Middle Ages, the functions of the coroner included conducting inquests, attending to and inspecting the dead, and investigating suspicious deaths.
In the US, coroners are generally public officials with minimal to no medical training. Some coroners only serve part-time capacities, and they also often have other full-time employment. The medical examiner system was introduced due to public dissatisfaction with the coroner system, accusations of corruption, and an increased need to have highly trained personnel in the death investigation. [Koehler 2016] This led to the emergence of a separate discipline of forensic medicine, which began in the seventeenth century. [Choo and Choi 2012] The first medical examiner system was introduced in Massachusetts in 1877.
In 1959, the medical subspecialty of forensic pathology was formally certified, and medical examiners were trained in pathology. Forensic pathology is viewed as a subspecialty of anatomical pathology in countries such as Canada and the United Kingdom. In countries such as South Africa and Australia, one may train solely in forensic pathology for a minimum of a year (usually more), with additional training in anatomical pathology. In South Africa, the medicolegal death investigation is conducted primarily in terms of the Inquests Act (Act 58 of 1959). The medicolegal autopsies are performed by medical practitioners, but due to the large annual number of unnatural deaths and the small number of qualified forensic pathologists in South Africa, a large number of these autopsies are performed by colleagues with limited formal training in performing autopsies. [du Toit-Prinsloo and Saayman 2012]
The fundamental essence of forensic pathologists’ work is to investigate and report the cause of death. The importance of reporting the cause of death is reiterated and forms the basis of The Global Burden of Disease study. [Roth et al. 2018] This comprehensive worldwide observational epidemiological study describes mortality and morbidity from major diseases, injuries, and risk factors to health at global, national, and regional levels. Mortality reporting systems can help to prioritize health system investments, track progress towards global development goals, and guide scientific research. [Roth et al. 2018] The Global Burden of Disease study acknowledges the need for wider adoption and improvement of these systems because continuous reporting of cause-specific mortality in many countries represents a success for global health.
Information derived from autopsies has historically been paper-documented, filed, and archived. With the current age of technology, this information can be stored and managed electronically to better ensure reporting that is current, relevant, and contributory to training and service delivery, policy implementation, and social interventions. The current COVID-19 pandemic has accentuated the importance of wireless technology and the use of the internet to transcend normal communications. Due to safety reasons, much work has to be conducted remotely in many business sectors, including the medical sector. General practitioners conducted consultations virtually to adhere to social distancing and safety measures, and telephonic communication and telemedicine became a necessity due to the pandemic. At this current point in time, we are forced to be open-minded to integrate technology into our daily work lives.
This scoping review was conducted to map the evidence on data management and practice systems, their use, benefits, and challenges in forensic medicine. The information gained on the use and availability of digital technologies and their strengths and limitations to collect autopsy data can inform models to suit similar purposes in forensic medicine in LMICs.
Methods
References
Notes
This presentation is faithful to the original, with only a few minor changes to presentation, grammar, and punctuation. In some cases important information was missing from the references, and that information was added. The original article lists references in alphabetical order; this version lists them in order of appearance, by design.
