{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:14:12Z","timestamp":1784740452801,"version":"3.55.0"},"reference-count":37,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hum Exp Toxicol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Accurate determinations of the cause of death are crucial for public health, crime investigations, and social justice. In the Netherlands, cause-of-death determinations rely heavily on external examinations, which can miss substance-related deaths. This study investigates the added value of toxicological blood testing in the determination of the cause and manner of death by forensic physicians in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Collected blood samples of 642 decedents that were examined by a forensic physician in Amsterdam and surrounding regions underwent toxicological testing. Findings and concluding remarks from the external examination and toxicological testing were compared using descriptive statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Blood samples of 69% of cases tested positive for one or more pharmaceuticals, and 36% tested positive for illicit drugs and\/or alcohol. In 55% of cases, toxicological testing revealed substances that were not indicated by the external examination. Its findings also prompted a revision of the initial cause and manner of death in 18 cases (3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Key limitations in this study include that not all detected substances were quantified and a verification bias of the included cases, which may have led to an underrepresentation of unsuspected detections. Nonetheless, despite the constraints of (routine) screening capabilities and the effects of post-mortem degradation and redistribution, this study presented the importance of toxicological blood testing within a multifaceted approach that combines toxicological findings with scene evidence, medical history and the external examination, which is essential for improving the accuracy of cause-of-death determinations by the forensic physician.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09603271251387259","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:54:21Z","timestamp":1761130461000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Added value of post-mortem toxicological blood testing in medicolegal death investigations in Amsterdam and surrounding regions, 2017-2018"],"prefix":"10.1177","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7259-1538","authenticated-orcid":false,"given":"Nina C.","family":"Eckhardt","sequence":"first","affiliation":[{"name":"Public Health Service Amsterdam"},{"name":"Location University of Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Kadhim","sequence":"additional","affiliation":[{"name":"OLVG Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Ceelen","sequence":"additional","affiliation":[{"name":"Public Health Service Amsterdam"},{"name":"Location University of Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6983-4535","authenticated-orcid":false,"given":"Vina N.","family":"Slev","sequence":"additional","affiliation":[{"name":"Public Health Service Amsterdam"},{"name":"Location University of Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo J. 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