A probability model for estimating age in young individuals relative to key legal thresholds: 15, 18 or 21-year

• Published in: International journal of legal medicine 2024-09, p.1
• Main Authors: Heldring, Nina, Rezaie, Ali-Reza, Larsson, André, Gahn, Rebecca, Zilg, Brita, Camilleri, Simon, Saade, Antoine, Wesp, Philipp, Palm, Elias, Kvist, Ola
• Format: Article
• Language: English
• Subjects: Medicin och hälsovetenskap
• ISSN: 0937-9827; 1437-1596; 1437-1596
• DOI: 10.1007/s00414-024-03324-x

Age estimations are relevant for pre-trial detention, sentencing in criminal cases and as part of the evaluation in asylum processes to protect the rights and privileges of minors. No current method can determine an exact chronological age due to individual variations in biological development. This study seeks to develop a validated statistical model for estimating an age relative to key legal thresholds (15, 18, and 21 years) based on a skeletal (CT-clavicle, radiography-hand/wrist or MR-knee) and tooth (radiography-third molar) developmental stages. The whole model is based on 34 scientific studies, divided into examinations of the hand/wrist (15 studies), clavicle (5 studies), distal femur (4 studies), and third molars (10 studies). In total, data from approximately 27,000 individuals have been incorporated and the model has subsequently been validated with data from 5,000 individuals. The core framework of the model is built upon transition analysis and is further developed by a combination of a type of parametric bootstrapping and Bayesian theory. Validation of the model includes testing the models on independent datasets of individuals with known ages and shows a high precision with separate populations aligning closely with the model's predictions. The practical use of the complex statistical model requires a user-friendly tool to provide probabilities together with the margin of error. The assessment based on the model forms the medical component for the overall evaluation of an individual's age.