Evidence of point-of-care diagnostics in forensic death investigations: A scoping review

Point-of-care (POC) diagnostics represent promising health-technology tools capable of providing rapid, on-site analytical support for forensic investigations. This scoping review aimed to systematically map the available evidence on applying POC diagnostics in forensic investigations. The focus is on their potential ability to act as rapid screening and triage tools to assist in determining the cause of death and exploring the challenges and opportunities associated with their implementation on a global scale.

A comprehensive literature search was conducted across multiple databases, including PubMed, ProQuest Central, Academic Search Complete, Africa Wide, CINAHL, MEDLINE, and Web of Science. Out of the 7603 records screened, four studies met the eligibility criteria and were included in the review. Reporting adhered to the PRISMA-ScR guidelines.

These studies demonstrated the expanding role of POC devices in various aspects of forensic investigations, including rapid triage in overdose cases, malaria diagnosis in travel-related deaths, SARS-CoV-2 screening, and hemoglobin testing in child deaths. These studies also highlighted the limitations of POC devices in the postmortem context, emphasizing the need for careful calibration, confirmation, and interpretation of the results. This review identified POC diagnostics as a potential bridge between forensic investigations and public health surveillance, with findings indicating both cause-of-death determination and broader public health strategies. Operational, ethical, and policy considerations for using POC devices in forensic investigations were also discussed.

This review revealed challenges in ensuring the standardization, accuracy, and integration of POC diagnostics into established forensic practices. Further research is required to evaluate the diagnostic accuracy, cost-effectiveness, and performance of POC tools in forensic settings. Comprehensive guidelines and standardized operating procedures should be developed to ensure the successful implementation of POC diagnostics in forensic investigations. Given the limited and heterogeneous evidence, POC devices in forensic death investigations should be seen as preliminary aids rather than diagnostic instruments.