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Model-Independent Approaches for Pharmacokinetic Data: Noncompartmental Analysis00:59

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Noncompartmental analyses offer an alternative method for describing drug pharmacokinetics without relying on a specific compartmental model. In this approach, the drug's pharmacokinetics are assumed to be linear, with the terminal phase log-linear. This assumption allows for simplified analysis and interpretation of the drug's behavior in the body.
One important characteristic of noncompartmental analyses is that drug exposure increases proportionally with increasing doses. This...
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Data-Based Method to Reduce Unnecessary Autopsies in Suspected Overdose Deaths.

Nicole D'Anna1, Megan Brown1, Alex K Williamson1,2

  • 1Office of Chief Medical Examiner.

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|November 6, 2025
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Summary
This summary is machine-generated.

The New York City Office of Chief Medical Examiner (OCME) can reduce autopsies for suspected opioid overdose deaths by 32.8% using a toxicology-focused approach (View-Tox). This method accurately certifies most cases without full autopsy, easing the burden on forensic pathologists.

Keywords:
autopsycause of deathforensic pathologysuspected overdosetoxicology

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Area of Science:

  • Forensic Pathology
  • Toxicology
  • Public Health

Background:

  • The opioid overdose crisis significantly impacts medical examiner offices, leading to an overwhelming number of cases.
  • A national shortage of forensic pathologists makes it challenging to perform autopsies on all suspected overdose deaths as recommended.
  • The New York City Office of Chief Medical Examiner (OCME) faces severe strain due to over 3000 overdose deaths in 2022.

Purpose of the Study:

  • To assess the feasibility of certifying suspected overdose deaths using a limited approach (View-Tox) instead of full autopsies.
  • To determine the accuracy of certifying deaths based on history, external examination, and toxicology testing.
  • To evaluate the potential reduction in autopsy workload for the OCME.

Main Methods:

  • Utilized the Suspected Deaths (SPOT) database from the OCME Drug Intelligence and Intervention Group (DIIG).
  • Applied six exclusionary criteria to identify cases eligible for the View-Tox approach.
  • Cases were evaluated based on known history, circumstances, external examination, and toxicology results.

Main Results:

  • The View-Tox eligibility criteria successfully excluded homicides, suicides, non-overdose accidents, and most undetermined manner deaths.
  • Among eligible cases, 99.2% were accurately certified using toxicology results and pre-autopsy information alone.
  • Implementing this approach could have reduced autopsies for suspected overdose deaths at OCME by 32.8% in 2022.

Conclusions:

  • A View-Tox approach, focusing on toxicology and available information, is highly accurate for certifying many suspected overdose deaths.
  • This strategy can significantly decrease the autopsy burden on medical examiner offices during public health crises.
  • The findings support a more efficient case management system for overdose deaths, preserving resources and addressing pathologist shortages.