PRPs, platelet-rich plasmas; GFs, growth factors; EGF, epidermal growth factor; TGF-alpha, transforming growth factor-alpha; IGF-1, insulin-like growth factor-1; Ang-2, angiopoietin-2; IL-1beta, interleukin-1 beta; HUVECs, human umbilical vein endothelial cells; hFOB 1.19, human fetal osteoblasts; and FBS, fetal bovine serum.

Various tools were designed to guide practitioners in the risk assessment of offenders, including the Level of Service and Case Management Inventory (LS/CMI). This instrument is based on risk assessment principles prioritizing the actuarial approach to clinical judgment. However, the tool’s architects allowed subjective judgment from the practitioners—referred to as clinical override—to modify an offender’s risk category under certain circumstances. Few studies, however, have examined these circumstances. Therefore, the current study used decision tree analyses among a quasi-population of Quebec offenders ( n = 15,744) to identify whether there are offenders more likely to be subjected to this discretion based on their characteristics. The results suggest that, although the override is rare, it occurred under few specific combinations of circumstances. More precisely, these findings propose that the utilization of the clinical override stems from a perceived discrepancy between risk prediction and management.

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Research summary In the past, the Canadian government followed in the footsteps of its American counterpart by enacting “sex offender laws.” Since the 1990s, however, the Canadian criminal justice system has taken a different approach to the issue of sex offender recidivism (SOR), focusing on treatment, rehabilitation, and community risk management. This evidence‐based approach has been criticized for not doing enough to prevent convicted offenders from sexually reoffending. This criticism has not been addressed empirically, leaving open the question of whether this Canadian policy shift is associated with changes in the rate of sexual recidivism. The present study uses a meta‐analytic framework to look at 185 Canadian‐based studies involving over 50,000 offenders, making it possible to combine 226 sexual recidivism rates. After controlling for factors such as follow‐up length and the independence of samples, weighted pooled recidivism rates have declined since the 1970s by more than 60%. This trend may have gone unnoticed because it is not related to the year of publication but to the period in which the data were collected. Policy implications The findings have significant implications for criminal justice practices including the importance of using risk assessment tools that are regularly calibrated to reflect the evolution of sexual recidivism rates over time. Although the current study cannot provide firm conclusions about the factors responsible for this gradual drop, several hypotheses are discussed. Knowledge‐based criminal justice practices, better training for professionals, and improvements in treatment programs may have had a subtle and cumulative impact on sexual recidivism rates. The importance of examining period effects on SOR using a comparative and international perspective is discussed.

Sex offender recidivism (SOR) has been the subject of research for over 70 years. Myths, misconceptions, and erroneous conclusions about SOR, however, remain widespread, impeding the development of evidence-based policies aimed at preventing sexual offenses. To address the rich but uneven literature, a comprehensive review was conducted making it possible to provide a contextualized overview of scientific knowledge against the backdrop of methodological issues, challenges, and shortcomings. Over the years, researchers have been asked to provide a simple answer to a seemingly simple question: what are the recidivism rates for sexual offending? In response, the field has produced a wide range of findings making it difficult to draw firm conclusions, leaving room for interpretation and personal biases. The variations in recidivism rates are attributable to offender and methodological characteristics, both of which are embedded in a particular sociolegal context. As a result, the base rate of SOR is more effectively considered in terms of a series of questions that should include the type of recidivism, with whom, over what period, and in what context. Issues and debates that have marked the field and fueled its growth are highlighted. Research innovations and important areas of research are also discussed.