Retrospective CT examinations of clavicular ossification - development of a clinical decision support system based on classical scale-based assessments and modern machine learning methodology to improve the validity and reliability of forensic age assessm

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Cross-border migration movements of people with undocumented dates of birth have led to a need for forensic age assessments when the age of these people is of legal significance. In Germany and numerous other countries the age limit of 18 has the greatest practical relevance. Only the assessment of the ossification of the medial clavicular epiphysis currently allows proof beyond reasonable doubt of the completion of the 18th year of life. Thin-slice CT is currently considered the method of choice for imaging the medial clavicular epiphysis. The main objective of the project is to considerably improve the validity and reliability of age assessments based on a CT scan of the clavicles. This includes as a basis the establishment of a first reference population optimised in terms of sample size and age distribution, and free of individuals with pathologies or medications that may affect bone maturation. Three independent experts will determine stages of clavicular ossification years according to established scales to maximize validity. The use of machine learning techniques will objectify the assessment of the ossification status of the medial clavicular epiphysis; it will also allow the search for new features applicable at older ages, not readily available for the human eye. Ratings based on machine learning methodology (both using established scales and new predictors) will be transformed into an open demonstrator for a clinical decision support system which might later on help medicolegal specialists outside of the few existing expert centers worldwide to perform legal age assessment with an objectively derivable diagnostic accuracy.