Detection of Inflicted Bruises by Alternate Light: Results of a Randomized Controlled Trial

Bruises are often difficult to detect on victims of violence, potentially impacting investigation and prosecution. The purpose of our randomized controlled trial was to measure the effectiveness of an alternate light source (ALS) within visible and long ultraviolet spectrums at improving bruise dete...

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Bibliographic Details
Published in:Journal of forensic sciences 2020-07, Vol.65 (4), p.1191-1198
Main Authors: Scafide, Katherine N., Sheridan, Daniel J., Downing, Nancy R., Hayat, Matthew J.
Format: Article
Language:English
Subjects:
Adult
alternate light
bruises
Bruising
Clinical trials
Color
Contusions
Contusions - pathology
Cross-Over Studies
Crossovers
detection
Female
forensic examination
Forensic medicine
Forensic Pathology - methods
General
Pathology/Biology
Humans
injury
Light
Light sources
Male
Multivariable control
Randomization
Sex Factors
Skin Pigmentation
Skinfold Thickness
ultraviolet
violence
Weight
White light
Young Adult
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Summary:Bruises are often difficult to detect on victims of violence, potentially impacting investigation and prosecution. The purpose of our randomized controlled trial was to measure the effectiveness of an alternate light source (ALS) within visible and long ultraviolet spectrums at improving bruise detection compared to white light over time. We also examined the effects of skin color, age, gender, localized fat, and injury mechanism on bruise detection. Participants included 157 healthy adults with balanced sampling across six skin color categories. Bruises were created under the controlled application of a paintball pellet and dropped weight to one upper and lower arm, respectively. Using a crossover design, both bruises were examined 21 times over 4 weeks. Ten different wavelength (350–535 nm) and filter (yellow, orange, red) combinations were used. Multilevel models were used to analyze 2903 examinations on both upper and lower arms. Results in multivariable models showed after controlling for other covariates 415 and 450 nm using a yellow filter had greater odds of detecting evidence of bruising than white light (Upper Arm: 415 nm: OR = 5.34, 95% CI: 4.35–6.56; 450 nm: OR = 4.08, 95% CI: 3.36–4.96). Under either light source, being female and having more localized fat had increased odds of detecting bruises created by the dropped weight (female: OR = 2.96, 95% CI: 2.37–3.70; fat: OR = 1.21, 95% CI: 1.09–1.34). Our results support ALS as an appropriate tool to enhance concurrent physical assessment of bruises in the presence of known history of injury. Future development and evaluation of clinical practice guidelines for ALS application are needed.
ISSN:0022-1198
1556-4029
DOI:10.1111/1556-4029.14294