Forensic pathologists' decisions are critical in police investigations and court proceedings as they determine whether an unnatural death of a young child was an accident or homicide. Does cognitive bias affect forensic pathologists' decision-making? To address this question, we examined all death certificates issued during a 10-year period in the State of Nevada in the United States for children under the age of six. We also conducted an experiment with 133 forensic pathologists in which we tested whether knowledge of irrelevant non-medical information that should have no bearing on forensic pathologists' decisions influenced their manner of death determinations. The dataset of death certificates indicated that forensic pathologists were more likely to rule "homicide" rather than "accident" for deaths of Black children relative to White children. This may arise because the base-rate expectation creates an a priori cognitive bias to rule that Black children died as a result of homicide, which then perpetuates itself. Corroborating this explanation, the experimental data with the 133 forensic pathologists exhibited biased decisions when given identical medical information but different irrelevant non-medical information about the race of the child and who was the caregiver who brought them to the hospital. These findings together demonstrate how extraneous information can result in cognitive bias in forensic pathology decision-making.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/1556-4029.14697

Cognitive bias in forensic pathology decisions.

/pdf/cognitive-bias-in-forensic-pathology-decisions-3hpbvbaouo.pdf

Cognitive bias in forensic pathology decisions

Linear Sequential Unmasking-Expanded (LSU-E): A general approach for improving decision making as well as minimizing noise and bias.

As robotic surgery has increased in popularity, the lack of haptic feedback has become a growing issue due to the application of excessive forces that may lead to clinical problems such as intraoperative and postoperative suture breakage. Previous suture breakage warning systems have largely depended on visual and/or auditory feedback modalities, which have been shown to increase cognitive load and reduce operator performance. This work catalogues a new sensing technology and haptic feedback system (HFS) that can reduce instances of suture failure without negatively impacting performance outcomes including knot quality. Suture breakage is common in knot-tying as the pulling motion introduces prominent shear forces. A shear sensor mountable on the da Vinci robotic surgical system's Cadiere grasper detects forces that correlate to the suture's internal tension. HFS then provides vibration feedback to the operator as forces near a particular material's failure load. To validate the system, subjects tightened a total of four knots, two with the Haptic Feedback System (HFS) and two without feedback. The number of suture breakages were recorded and knot fidelity was evaluated by measuring knot slippage. Results showed that instances of suture failure were significantly reduced when HFS was enabled ( p = 0.0078). Notably, knots tied with HFS also showed improved quality compared to those tied without feedback ( p = 0.010). The results highlight the value of HFS in improving robotic procedure outcomes by reducing instances of suture failures, producing better knots, and reducing the need for corrective measures.

Suture Breakage Warning System for Robotic Surgery

Forensic scientists have long held that objectivity is a core tenet of our analyses and the expert-witness statements that can result. Certainly, the rhetoric of objectivity holds an undeniable allure given the fact that we, unlike many other scientists, may testify to our results in a court of law. However, our faith in objectivity is complicated by the facts that: 1.) pure scientific objectivity does not exist; and 2.) espousing the myth of objectivity is neither neutral nor benign. We will consider both points herein, before concluding with recommendations for a strong, realistic, and ethical practice of forensic science that does not require faith in a dangerous myth.

Objectivity is a myth that harms the practice and diversity of forensic science.

The tensile strength of a surgical suture is essential in maintaining the integrity of vascular anastomoses. While faulty operative technique and the loading strength of individual sutures have been implicated in spontaneous suture line disruptions, there has, to date, never been a published postmortem analysis of a suture that has known to have failed. We present the case of suture line disruption leading to fatal exsanguination in a 77-year-old man following carotid endarterectomy with a facial vein patch. Using both dissecting and scanning electron microscopy, we determined that surgical technique (an untied knot) was the cause of the suture line disruption. The removal of a broken or untied suture at surgery or at autopsy should not preclude proper analysis of the failed suture, because the results can have both medico-legal and public health implications.

Judy Melinek

Papers

Cognitive bias in forensic pathology decisions.

Cognitive bias in forensic pathology decisions

Postmortem analysis of anastomotic suture line disruption following carotid endarterectomy.

Authors' Response to Peterson et al Commentary on.

Authors’ Response to Tse et al Commentary on