Sensitivity of the Colposcopy Exam After Sexual Assault

性侵犯后阴道镜检查的敏感性

• 批准号: 6709387
• 负责人: Marilyn S Sommers
• 金额: $ 26.01万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-05-01 至 2006-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6709387
• 关键词: African American; adult human (21+); bioimaging /biomedical imaging; caucasian American; clinical research; endoscopy; female; forensic medicine; human subject; longitudinal human study; photography; racial /ethnic difference; rape; rectum /anus; sex behavior; vagina; women' s health

The National Violence Against Women survey reported that 1 of 6 US women have experienced an attempted or completed rape. Each year almost three million women are injured during rape and sexual assault. Because of the success in identifying microscopic genital injury in sexual assaulted children, more practitioners are using a colposcope during the exam of adult females. Colposcopic photos are then used in court testimony to document non-consensual vs. consensual sex. The specific aim of this study is to determine whether experts can accurately predict consensual vs. non-consensual sex from colposcopic photographs. Research questions include: 1) Can experts differentiate between colposcopic photos of women groups of women: those who have experienced consensual vs. non-consensual sex? 2) When viewed as colposcopic photons, what is the difference in number, type and location of injury to the female genitalia and/or anus after consensual versus non-consensual sex? 3) What are the differences in the sensitivity and specificity of colposcopic photos in detecting injury to the female genitalia and/or anus in African-American and White women? The study will involve prospective enrollment of control subjects who will undergo a colposcopic exam following consensual sex. The photographs derived from the exam will be compared to a retrospective review of photographs from unidentified sexual assault survivors. 100 control subjects who are examined after consensual sexual intercourse will be enrolled over the three years of the study. Chart records and colposcopic photos of sexual assault survivors will be reviewed retrospectively and matched to control subjects by ethnicity, age, and time from assault to exam. A panel of five gynecologic and forensic experts will attempt to differentiate between the photographs of women with consensual (n=100) and non-consensual (n=100) attempt to differentiate between the photographs of women with consensual (n=100) and non-consensual (n=100) sex. They will also determine the frequency, type and location of injury to the female genitalia and/or anus after consensual versus non- consensual sex. Sensitivity, specificity, and other statistics describing the raters' ability to differentiate between the two sets of photographs will be calculated. Findings will also support or refute statements by experts that they can differentiate consensual versus non-consensual sex from colposcopy photos. Ultimately the study has the potential to improve evidence-based practice and enhance conviction rates for rape.

全国暴力侵害妇女调查报告称，每6名美国妇女中就有1人经历过强奸未遂或强奸未遂。每年有近300万妇女在强奸和性侵犯中受伤。由于在鉴别性侵犯儿童的显微生殖器损伤方面取得了成功，越来越多的医生在对成年女性进行检查时使用阴道镜。阴道镜下的照片随后被用于法庭证词，以记录非自愿性行为和自愿性行为。这项研究的具体目的是确定专家是否能准确地从阴道镜照片中预测双方自愿的性行为与非双方自愿的性行为。研究问题包括：1)专家能否区分女性的阴道镜照片：经历过自愿性行为和非自愿性行为的女性群体？2)当被视为阴道镜光子时，经双方同意的性行为与非双方同意的性行为后，女性生殖器和/或肛门损伤的数量、类型和位置有什么不同？3)在非裔美国人和白人女性中，阴道镜照片检测女性生殖器和/或肛门损伤的敏感性和特异性有何差异？该研究将包括前瞻性登记的对照受试者，他们将在双方同意的性行为后接受阴道镜检查。来自考试的照片将与来自身份不明的性侵犯幸存者的照片进行回顾性审查。在为期三年的研究中，100名对照受试者将在双方同意的性交后接受检查。将对性侵幸存者的病历记录和阴道镜照片进行回顾性审查，并根据种族、年龄和从性侵到检查的时间与对照受试者进行匹配。一个由五位妇科和法医专家组成的小组将试图区分经双方同意（n=100）和非双方同意（n=100）的妇女照片，试图区分经双方同意（n=100）和非双方同意（n=100）的妇女照片。他们还将确定女性生殖器和/或肛门在双方同意与非双方同意的性行为后损伤的频率、类型和位置。灵敏度、特异性和其他描述评分者区分两组照片的能力的统计数据将被计算出来。研究结果也将支持或反驳专家的说法，即他们可以从阴道镜照片中区分双方自愿的性行为和非双方自愿的性行为。最终，这项研究有可能改善基于证据的实践，提高强奸的定罪率。