{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:14:31Z","timestamp":1788329671565,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Forensic Sciences"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Determining the cause of death using postmortem fentanyl concentrations in femoral blood remains a major challenge in forensic toxicology. This is due to substantial concentration overlap between overdose deaths and incidental non\u2010drug\u2010related deaths. Existing literature largely reports descriptive statistics such as ranges and medians. These statistics do not provide an objective framework for evaluating the evidentiary value of a specific fentanyl concentration. Using distribution analysis, nonparametric tests, and likelihood ratios, we developed a four\u2010zone statistical model to quantify overdose probability based on fentanyl concentrations in femoral blood. We also determined how polysubstance use alters these probabilities, leading to adjustments in the interpretive windows. Logistic regression modeling showed that age and sex contribute minimally to overdose probability and identified which drug classes best predict overdose classification. Together, these results provide a rigorous and objective method to determine postmortem overdose certainty in fentanyl\u2010only and multi\u2010drug intoxication cases.<\/jats:p>","DOI":"10.1111\/1556-4029.70401","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T10:49:14Z","timestamp":1782816554000},"page":"2293-2304","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A 4\u2010zone model to determine fentanyl overdose probability"],"prefix":"10.1111","volume":"71","author":[{"given":"Manolo U.","family":"Rios","sequence":"first","affiliation":[{"name":"Department of Pathology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica B.","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Dallas County Southwestern Institute of Forensic Sciences  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3570-6604","authenticated-orcid":false,"given":"Sara K.","family":"Dempsey","sequence":"additional","affiliation":[{"name":"Dallas County Southwestern Institute of Forensic Sciences  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1556\u20104029.15155"},{"issue":"3","key":"e_1_2_9_3_1","first-page":"1","article-title":"Drug overdose deaths involving fentanyl, 2011\u20132016","volume":"68","author":"Spencer MRT","year":"2019","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000712"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bkae061"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/30.8.603"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/20961790.2018.1460063"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bks005"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2010.525514"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2025.112551"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP4X5VHFSOERFT"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1556\u20104029.12381"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/32.8.639"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13181\u2010012\u20100253\u2010z"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxac.2022.06.048"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16318"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109740"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2023.110993"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2020.110352"}],"container-title":["Journal of Forensic Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1556-4029.70401","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1556-4029.70401","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1556-4029.70401","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:39:01Z","timestamp":1788327541000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1556-4029.70401"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/1556-4029.70401"],"URL":"https:\/\/doi.org\/10.1111\/1556-4029.70401","archive":["Portico"],"relation":{},"ISSN":["0022-1198","1556-4029"],"issn-type":[{"value":"0022-1198","type":"print"},{"value":"1556-4029","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"2026-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}