Age Estimation of Adolescents for Legal Purposes (AGE-ADO)
Age Estimation of Adolescents for Legal Purposes: Determining the Medical Response
Economic globalisation has been associated with a rise of cross-border migration in Europe. In France, courts commonly demand appropriate medical tests aimed at age estimations of supposed minors without documentation. Determining the age of foreign adolescents may be important in order to define the rights and protection afforded them by law depending on this status, and the conditions in which they may be detained or held in police custody if they are under suspicion. Age estimation is considered to be ideally based on the combination of clinical, skeletal, and dental examinations. A number of forensic physicians do not integrate published recommendations or the results of published studies into their daily practice. Previous studies have shown that medical practice is heterogeneous in this area. Factors determining this heterogeneity are unknown.
We hypothesize that the personal and professional development of the physician, as well as the characteristics and the circumstances of medical examination can affect medical response on age determination, beyond clinical and radiological data. The purpose of this study is to identify factors determining medical response to courts.
研究概览
地位
详细说明
Economic globalisation has been associated with a rise of cross-border migration in Europe. Courts commonly demand appropriate medical tests aimed at age estimations of supposed minors without documentation. Determining the age of foreign adolescents may be important in order to define the rights and protection afforded them by law depending on this status, and the conditions in which they may be detained or held in police custody if they are under suspicion.
Guidelines for age estimation in living individuals have been proposed and are based on the combination of general clinical, skeletal, and dental examinations. However, guidelines for paediatricians in the UK and a national consensus conference in France on doctors' attendance on detainees in police custody have stated that the currently available methods generally do not enable a doctor to state with confidence if a detainee is a minor or not. The validity of currently used methods has also been questioned by the French National Consultative Ethics Committee on Health and Life Sciences.
As any middle school teacher can testify, anthropometric measures such as height and weight, and visible signs of sexual maturity vary widely from one adolescent to another, so that general clinical examination has limited value for age estimation. The skeletal examination is considered more reliable. In the reference radiological method, X-ray examination of the left hand and wrist is compared with standard images from an atlas published by Greulich and Pyle, who collected standards obtained in the 1930's and 1940's from an American white middle-class population. The main criteria applied for dental age determination are the eruption and development of the third molars, based on external and X-ray examination.
Age estimation is considered to be ideally based on the combination of clinical, skeletal, and dental examinations. However, it is not easy to determine from available published series if the estimated age of a given individual is a precise age or a spectrum of possible ages, and in this case how broad is the proposed spectrum. Indeed, the information in the radiological atlas by Greulich and Pyle is statistical, not individual. The use of such data for forensic purposes has never been intended by the authors, nor validated. Moreover, the ethnic and socioeconomic characteristics of the adolescents examined today in Western Europe may differ largely from those presented in the atlas, as previously suggested. The role of ethnic factors in skeletal maturation has been repeatedly studied and gave conflicting results. In most series evaluating skeletal age in different populations, hand and wrist X-rays were obtained from healthy subjects or patients received for evaluation of trauma. The conclusions of these studies may not be validated, or at least should be considered cautiously, when extrapolating results to adolescents without documents involved in judicial procedures, who have heterogeneous and largely unevaluated psychological and socioeconomic characteristics. A number of forensic physicians do not integrate published recommendations or the results of published studies into their daily practice. Previous studies have shown that medical practice is heterogeneous in this area. Factors determining this heterogeneity are unknown.
We hypothesize that the personal and professional development of the physician, as well as the characteristics and the circumstances of medical examination can affect medical response on age determination, beyond clinical and radiological data. The main objective of this study is to identify factors determining medical response to courts. A secondary objective is to evaluate how evidence-based data obtained from medical journals are taken into account in medical decision making by forensic physicians.
The main evaluated criterium is the medical response transmitted to courts regarding age determination.
Methods Prospective observational study of 500 age determinations requested by courts in migrant adolescents without documentation, in 18 departments of forensic medicine in France. Non-inclusion criterium is the refusal of the adolescent to undergo a medical examination.
研究类型
注册 (实际的)
联系人和位置
学习地点
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Bondy、法国、93140
- : Jean Verdier hospital, Department of forensic medicine
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Adolescent or young adult referred by judicial authorities for age determination
Exclusion Criteria:
- Refusal to undergo a medical examination
学习计划
研究是如何设计的?
设计细节
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
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Medical response transmitted to courts regarding age determination, at the end of medical examination
大体时间:One hour
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One hour
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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Age evaluation based on published evidence on age determination, as evaluated by independent experts at 12 months
大体时间:12 months
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In each case, compatibility of (1) age (or age interval) transmitted to courts and (2) age evaluation based on published evidence on age determination, as evaluated by independent experts.
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12 months
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合作者和调查者
调查人员
- 首席研究员:PATRICK CHARIOT, MD、AP-HP Hospital Jean Verdier
出版物和有用的链接
一般刊物
- Pruvost MO, Boraud C, Chariot P. Skeletal age determination in adolescents involved in judicial procedures: from evidence-based principles to medical practice. J Med Ethics. 2010 Feb;36(2):71-4. doi: 10.1136/jme.2009.031948.
- Buken B, Safak AA, Yazici B, Buken E, Mayda AS. Is the assessment of bone age by the Greulich-Pyle method reliable at forensic age estimation for Turkish children? Forensic Sci Int. 2007 Dec 20;173(2-3):146-53. doi: 10.1016/j.forsciint.2007.02.023. Epub 2007 Mar 27.
- Schmeling A, Olze A, Reisinger W, Geserick G. Age estimation of living people undergoing criminal proceedings. Lancet. 2001 Jul 14;358(9276):89-90. doi: 10.1016/S0140-6736(01)05379-X. No abstract available.
- Garamendi PM, Landa MI, Ballesteros J, Solano MA. Reliability of the methods applied to assess age minority in living subjects around 18 years old. A survey on a Moroccan origin population. Forensic Sci Int. 2005 Nov 10;154(1):3-12. doi: 10.1016/j.forsciint.2004.08.018. Epub 2004 Nov 10.
- Hassanali J. The third permanent molar eruption in Kenyan Africans and Asians. Ann Hum Biol. 1985 Nov-Dec;12(6):517-23. doi: 10.1080/03014468500008091.
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- AOR 11118
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