Original ArticlesEstablishing Standards for Side-by-Side Radiographic ComparisonsRoss, Ann H. PhD, D-ABFA, C-FASE; Lanfear, Alicja K. PhD; Maxwell, Ashley B. MAAuthor Information From the *Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC; †Department of Biology, Middle Tennessee State University, Murfreesboro, TN; and ‡Department of Anthropology, University of South Florida, Tampa, FL. Manuscript received October 21, 2015; accepted December 21, 2015. Supported by grant 2010-DN-BX-K214 from the National Institutes of Justice. The authors report no conflict of interest. Reprints: Ann H. Ross, PhD, D-ABFA, C-FASE, Department of Sociology and Anthropology, North Carolina State University, Campus Box 8107, Raleigh, NC 27695-8107. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: June 2016 - Volume 37 - Issue 2 - p 86-94 doi: 10.1097/PAF.0000000000000223 Buy Metrics Abstract The objectives of this research were to evaluate the use of various anatomical features that are visible in standard radiographs and to develop a standard system of assessing concordant features for making positive identifications through radiographic comparison. The radiographs used in the study include craniofacial (n = 41), chest (n = 100), and proximal femur (n = 49), which were made available by the North Carolina Office of the Chief Medical Examiner. Radiographs were scored for number of concordant features and were analyzed using classification decision trees. The accuracy of the classification tree models was evaluated using a receiver operating characteristic. Two or more points of concordance are required in lateral cranial radiographs for a 97% probability of a positive identification. If more than 1 concordant feature exists on the cervical vertebrae, there is a 99% probability of correct identification. For thoracic and lumbar vertebrae, 4 or more concordant features are required for a 98% probability of correct identification. If there are 1 or more femoral head and neck concordant features, the probability of a correct identification is 94% and 97%, respectively. This study established the minimum number of concordant areas needed to confirm positive identifications in 3 standard radiographic views. © 2016 by Lippincott Williams & Wilkins.