Reasons for Lack of Consensus in Forensic Pathologist Interpretation of Photographs of Patterns of Injury of the Skin

Abstract

In a previous study, a survey-based analysis of pathologist diagnoses of patterned injury in which participants were asked makes diagnoses from photographs in the absence of history or context. The level of consensus was low. A follow-up survey was created to ask those who responded to the first survey why they answered as they did or why they were unsure of their answers. The most common reason for lack of consensus was that the lesion was nonspecific. Responses invoking ambiguity were more common than those that indicated a confident difference in diagnosis. There were differences between demographic groups, with age and experience being most prominent. These findings suggest that differences in image interpretation do not generally reflect firm differences in diagnosis as much as differing ways of dealing with ambiguity in the absence of history and context. A third survey will study the effect of the addition of contextual information.

Keywords: consensus; forensic pathology; forensic science; image analysis; inference; patterned injury; photograph.