Kremer Célia, Racette Stéphanie, Marton Dominique, Sauvageau Anny
Laboratoire de sciences judiciaires et de médecine légale, Edifice Wilfrid-Derome, Montreal (Quebec), Canada.
Am J Forensic Med Pathol. 2008 Dec;29(4):295-6. doi: 10.1097/PAF.0b013e3181847db0.
In child deaths investigation, radiologic examination is particularly important in the diagnosis of child abuse. In the province of Quebec, Canada, all autopsies for suspicious deaths are performed at a centralized forensic laboratory where, because of budget restrictions, forensic pathologists rely on their own knowledge for radiographs interpretations. To assess the validity of this radiologic examination by nonradiologist forensic specialist, we reviewed all cases of child death on a 1-year period. A total of 20 cases were reviewed by an experienced pediatric radiologist, and this interpretation was compared with pathologist's conclusions. Forensic pathologists missed an important finding in 3 positive cases. Yet, none of those missed findings would have significantly changed the cases outcome, because other autopsy findings had already oriented the final diagnosis. Nevertheless, this result is alarming. In a general context of financing problems, it can be appealing to management team to restrict access to external consultants. This study is important in reminding that such money savings do not come without a decrease in quality.
在儿童死亡调查中，放射学检查在虐待儿童的诊断中尤为重要。在加拿大魁北克省，所有可疑死亡案例的尸检都在一个集中的法医实验室进行，由于预算限制，法医病理学家依靠自己的知识解读X光片。为了评估非放射科法医专家进行的这种放射学检查的有效性，我们回顾了一年内所有儿童死亡案例。一位经验丰富的儿科放射科医生对总共20个案例进行了审查，并将此解读与病理学家的结论进行了比较。法医病理学家在3个阳性案例中遗漏了一项重要发现。然而，这些遗漏的发现都不会显著改变案件结果，因为其他尸检结果已经确定了最终诊断。尽管如此，这一结果令人担忧。在普遍存在资金问题的情况下，管理团队可能会倾向于限制外部顾问的参与。这项研究很重要，它提醒人们，这种节省资金的做法并非没有质量下降的代价。
