Increasing confidence in paleopathological diagnosis - Application of the Istanbul terminological framework

摘要

Paleopathological reporting is hampered by a lack of precision in the confidence levels of diagnosis. In this article, we recommend the application of a slightly modified system of nomenclature ratified by the UN and widely used in forensic medicine for the identification of torture. The application of this terminological framework within paleopathology would encourage consistency between practitioners and enhance the reliability of comparisons between cases. The importance of terminological precision has exercised the attention of many human and animal paleopathologists. Particular emphasis has been placed on the language used to describe the appearance, anatomical position, and extent of macroscopic lesions (e.g., Buikstra and Ubelaker, 1994; Kniisel and Ogden, 2007, 1797; Lovell, 2000; Ortner, 1991,2003; Roberts and Connell, 2004; Vann and Thomas, 2006). This emphasis stems from a consensual view that detailed description precedes and underpins differential diagnosis. Such an approach also enables lesion diagnoses to be confirmed or challenged at a later date, even in the absence of the original specimen. The latter is especially prescient given the increasingly legislated or required practice of re-burying human remains following analysis (e.g., due to NAGPRA legislation in the United States) and the worrying, but less well documented trend, of disposing of animal bones due to storage pressures.