Evaluation of image quality of digital photo documentation of female genital injuries following sexual assault

Abstract

With the patient's consent, physical injuries sustained in a sexual assault are evaluated and treated by the sexual assault nurse examiner (SANE) and documented on preprinted traumagrams and with photographs. Digital imaging is now available to the SANE for documentation of sexual assault injuries, but studies of the image quality of forensic digital imaging of female genital injuries after sexual assault were not found in the literature. The Photo Documentation Image Quality Scoring System (PDIQSS) was developed to rate the image quality of digital photo documentation of female genital injuries after sexual assault. Three expert observers performed evaluations on 30 separate images at two points in time. An image quality score, the sum of eight integral technical and anatomical attributes on the PDIQSS, was obtained for each image. Individual image quality ratings, defined by rating image quality for each of the data, were also determined. The results demonstrated a high level of image quality and agreement when measured in all dimensions. For the SANE in clinical practice, the results of this study indicate that a high degree of agreement exists between expert observers when using the PDIQSS to rate image quality of individual digital photographs of female genital injuries after sexual assault.

Injuries from intimate partner and sexual violence: Significance and classification systems

“…3 _ENREF_33 In contrast, a recent study of image quality illustrates the profound difficulty of maintaining standardization of forensic photo-documentation and interpretation. 48 Digital images of female genital injuries were collected as part of a research protocol and rated for “quality.” The study, however, was confounded by multiple methodological errors including lack of data on the validity of the raters’ expertise, lack of control over image delivery systems (computer monitors and software, room lighting), and a lack of relevance of the outcome measures (Naturalness and Usefulness). The quality of digital images is a fertile area for exploration as photo-documentation becomes routine, 10 but interpretation needs to be empirically tested with a rigorous methodological approach.…”