Stated patient preferences for overnight at-home diagnostic assessment of sleep disorders.

PURPOSE: The diagnostic workup for assessment of sleep disorders commonly involves overnight testing to assess sleep patterns and pathological events. So far, little is known about preferences for provision of home sleep tests to patients with sleep disorders. This study aims to close this gap by eliciting preferences for home sleep testing using a discrete choice experiment (DCE). METHODS: A DCE with seven attributes of at-home sleep testing and three levels per attribute was developed using a fractional factorial design. Patients with and without previous sleep testing experience were recruited from two large sleep centers in Germany. Coefficients for attribute levels were calculated using a conditional logit model to estimate their influence on choice decisions and calculate the relative importance of each attribute. RESULTS: 305 patients (54.5 ± 13,1 years, 65.3% male) were enrolled, and 288 surveys with complete data included for analysis. Attributes with greatest relevance were Waiting time to discuss sleep study results; Waiting time to conduct sleep study, and Sleep quality during measurement. Of lowest importance was Diagnostic accuracy of sleep study, followed by Effort to apply sleep study device. Significant heterogeneity in choice behavior was found, including differences by gender, willingness-to-pay for sleep studies, and previous experience with sleep studies. Preferred location for conducting sleep testing was at-home in 50.7% and in-lab in 46.9%. CONCLUSIONS: Preferences and relative importance of home sleep test attributes vary among different subgroups. Considering those preferences can be important for clinicians and policymakers when designing care pathways and planning of testing policies for sleep disorders.

Patient-reported outcomes with hypoglossal nerve stimulation for treatment of obstructive sleep apnea: a systematic review and meta-analysis.

INTRODUCTION: Hypoglossal nerve stimulation (HNS) has recently been introduced as an alternative treatment for patients with OSA. A large number of studies have demonstrated substantial changes in OSA with this therapy by reducing respiratory events and improving symptoms such as daytime sleepiness and quality of life. The objective of this review was to conduct a systematic review and meta-analysis to evaluate patient-reported outcomes and experience with HNS therapy. METHODS: A systematic literature search of MEDLINE, Cochrane, and Web of Science was performed to identify randomized controlled and observational studies reporting subjective outcomes with different HNS systems in patients with OSA. Abstracts of 406 articles were screened and a subset of 55 articles were reviewed for eligibility. Risk of bias was assessed using the ROBINS-I tool. Meta-analysis using RevMan was performed when > 2 studies were identified that reported data on a specific outcome. RESULTS: Thirty-four publications reporting data on 3785 patients with a mean follow-up of 11.8 ± 12.2 months were identified and included in the meta-analysis. The analysis revealed a pooled effect of 4.59 points improvement in daytime sleepiness as measured by the ESS questionnaire (Z = 42.82, p < .001), 2.84 points improvement in daytime functioning as measured by the FOSQ score (Z = 28.38, p < .001), and 1.77 points improvement in sleep quality as measured by the PSQI questionnaire (Z = 2.53, p = .010). Patient-reported experience was consistently positive and revealed additional relevant aspects from this perspective. CONCLUSION: HNS therapy significantly improves quality of life in patients with OSA and reliably produces clinically meaningful effects on daytime sleepiness, daytime functioning, and sleep quality. Treatment regularly meets or exceeds the minimum clinically important differences defined for the respective instruments. Additional research is needed to further investigate effects on quality of life beyond improvements in daytime sleepiness and daytime functioning.

Patient preferences in obstructive sleep apnea-a discrete choice experiment.

BACKGROUND: Obstructive sleep apnea (OSA) is one of the most common chronic sleep disorders, which can be treated by different interventions. It is known that acceptance and adherence to these therapies is influenced by a variety of factors. However, there is a limited understanding of patient preferences and decision-making in the context of OSA treatment. METHODS: A discrete choice experiment was conducted on patients with OSA recruited from a tertiary sleep center to evaluate preferences for different treatment attributes. Participants received four different choice tasks with three hypothetical treatments, each defined by seven attributes. A random-effects logit model was used to estimate the influence of the different attributes on the choice decisions. Multivariate logistic regression analysis was carried out to evaluate interactions with medical variables. RESULTS: In a cohort of 241 subjects with OSA, preferences for treatment attributes and utilities derived from them differed. Most relevant attributes were Reduction in risk of comorbidities, Improvements of daytime sleepiness, Requirement for surgery, and Occurrence of treatment-related side effects. Demographic or medical variables, such as age, gender, or apnea-hypopnea index, did not influence the choice decision. Multivariate logistic regression revealed significant differences in preferences depending on OSA disease history (p = .025) and presence of OSA symptoms (p = .033). CONCLUSIONS: The study identified preferences for attributes of OSA and their utilities from a patient perspective. Relevant differences of preferences in subgroups of patients with OSA were identified, which may be important to consider in selecting appropriate treatments that lead to high rates of acceptance and adherence.

[Experiences with digital care of patients with chronic and acute lung diseases during the SARS-CoV-2 pandemic]. / Erfahrungen mit der digitalen Versorgung von Patienten mit chronischen und akuten Lungenerkrankungen während der SARS-CoV-2-Pandemie.

BACKGROUND: Management of patients with respiratory disorders, such as asthma or chronic obstructive pulmonary disease (COPD), became challenging during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic due to infection prevention measures. To maintain care, a remote monitoring program was initiated, comprising a smartphone app and a Bluetooth spirometry device. OBJECTIVE: To assess patient- and physician-related experience with remote monitoring. MATERIAL AND METHODS: Structured questionnaires were developed to rate experiences from the patient or physician perspective on six-level Likert scales. Interactions between patients and physicians via the digital platform and overall utilization was analyzed. RESULTS: A total of 745 patients with asthma, COPD, post-coronavirus disease 2019 (COVID-19) and other respiratory diseases were enrolled from 31 centers in Germany. Mean follow-up was 49.4 ± 12.6 weeks. Each participant submitted on average 289 measurements. Patient-reported experience with the remote monitoring program was positive, with the highest satisfaction reported for "Experience with home measurement" (1.4 ± 0.5; 99% positive), followed by "Communication/interaction" (1.8 ± 0.9; 83% positive) and "Overall satisfaction with program" (1.8 ± 0.8; 87% positive). In all, 70% reported subjective quality of life improvements related to participation in the program. Physician satisfaction with the program was also high with a mean rating of 2.2 ± 1.2. DISCUSSION: App-based remote monitoring was successfully implemented in routine care during the SARS-CoV­2 pandemic and demonstrated potential for improvements in care. Patient-relevant experience was positive in all dimensions and remote monitoring was well accepted. Physicians who participated in the program also expressed positive experiences, as demonstrated by a high level of interaction with the platform and positive evaluations of effects from the program.

The complexity of scaling up an mHealth intervention: the case of SMS for Life in Tanzania from a health systems integration perspective.

BACKGROUND: SMS for Life was one of the earliest large-scale implementations of mHealth innovations worldwide. Its goal was to increase visibility to antimalarial stock-outs through the use of SMS technology. The objective of this case study was to show the multiple innovations that SMS for Life brought to the Tanzanian public health sector and to discuss the challenges of scaling up that led to its discontinuation from a health systems perspective. METHODS: A qualitative case-study approach was used. This included a literature review, a document review of 61 project documents, a timeline of key events and the collection and analysis of 28 interviews with key stakeholders involved in or affected by the SMS for Life programme. Data collection was informed by the health system building blocks. We then carried out a thematic analysis using the WHO mHealth Assessment and Planning for Scale (MAPS) Toolkit as a framework. This served to identify the key reasons for the discontinuation of the programme. RESULTS: SMS for Life was reliable at scale and raised awareness of stock-outs with real-time monitoring. However, it was discontinued in 2015 after 4 years of a national rollout. The main reasons identified for the discontinuation were the programme's failure to adapt to the continuous changes in Tanzania's health system, the focus on stock-outs rather than ensuring appropriate stock management, and that it was perceived as costly by policy-makers. Despite its discontinuation, SMS for Life, together with co-existing technologies, triggered the development of the capacity to accommodate and integrate future technologies in the health system. CONCLUSION: This study shows the importance of engaging appropriate stakeholders from the outset, understanding and designing system-responsive interventions appropriately when scaling up and ensuring value to a broad range of health system actors. These shortcomings are common among digital health solutions and need to be better addressed in future implementations.

VirtoScan - a mobile, low-cost photogrammetry setup for fast post-mortem 3D full-body documentations in x-ray computed tomography and autopsy suites.

Injuries such as bite marks or boot prints can leave distinct patterns on the body's surface and can be used for 3D reconstructions. Although various systems for 3D surface imaging have been introduced in the forensic field, most techniques are both cost-intensive and time-consuming. In this article, we present the VirtoScan, a mobile, multi-camera rig based on close-range photogrammetry. The system can be integrated into automated PMCT scanning procedures or used manually together with lifting carts, autopsy tables and examination couch. The VirtoScan is based on a moveable frame that carries 7 digital single-lens reflex cameras. A remote control is attached to each camera and allows the simultaneous triggering of the shutter release of all cameras. Data acquisition in combination with the PMCT scanning procedures took 3:34 min for the 3D surface documentation of one side of the body compared to 20:20 min of acquisition time when using our in-house standard. A surface model comparison between the high resolution output from our in-house standard and a high resolution model from the multi-camera rig showed a mean surface deviation of 0.36 mm for the whole body scan and 0.13 mm for a second comparison of a detailed section of the scan. The use of the multi-camera rig reduces the acquisition time for whole-body surface documentations in medico-legal examinations and provides a low-cost 3D surface scanning alternative for forensic investigations.

The forensic holodeck: an immersive display for forensic crime scene reconstructions.

PURPOSE: In forensic investigations, crime scene reconstructions are created based on a variety of three-dimensional image modalities. Although the data gathered are three-dimensional, their presentation on computer screens and paper is two-dimensional, which incurs a loss of information. By applying immersive virtual reality (VR) techniques, we propose a system that allows a crime scene to be viewed as if the investigator were present at the scene. METHODS: We used a low-cost VR headset originally developed for computer gaming in our system. The headset offers a large viewing volume and tracks the user's head orientation in real-time, and an optical tracker is used for positional information. In addition, we created a crime scene reconstruction to demonstrate the system. DISCUSSION: In this article, we present a low-cost system that allows immersive, three-dimensional and interactive visualization of forensic incident scene reconstructions.

Treatment preferences and willingness to pay in patients with obstructive sleep apnea: relevance of treatment experience.

Background: Patients with obstructive sleep apnea (OSA) most commonly receive positive airway pressure therapy (PAP) as primary treatment, which is highly effective when used consistently. Little is known about the preferences for and relevance of attributes of OSA treatments, especially of non-PAP alternatives. The aim of this study was to evaluate treatment preferences and willingness to pay (WTP) among patients with and without previous experience of OSA therapies. Methods: A discrete choice experiment and a structured survey were applied to patients presenting for overnight polysomnography at a tertiary sleep center. Medical variables were obtained from hospital case records. Results: Over a period of 4 months, 241 subjects were enrolled and answered the questionnaire (61.8% with an existing diagnosis, 38.2% with a new diagnosis). The most preferred treatment among all patients was PAP therapy (51.1%), followed by mandibular advancement devices (18.1%), hypoglossal nerve stimulation (17.2%), and medication (13.7%). Approval for the different treatments varied by gender as well as by OSA therapy experience. The importance of attributes of OSA treatment varied too, with low rates of treatment-related side effects being equally important, independent of the preferred therapy. The most often stated monthly WTP for optimal sleep was €â€¯50, with increasing age leading to lower WTP values. Conclusion: Preferences for OSA therapies vary among patients and patient subgroups. PAP therapy is the most preferred treatment, though non-PAP interventions receive high approval ratings too, particularly in treatment-naïve patients. The importance of treatment attributes varies as well, depending on the choice of preferred treatment.

Quantification of phospholipids in infant formula and growing up milk by high-performance liquid chromatography with evaporative light scattering detector.

Phospholipids (PLs) are well known for their excellent emulsifier properties and more recently for their biological functions, such as cell signing, brain development, immune function, heart health, and cancer prevention, besides their physiological role in membrane composition. In dairy products, PLs represent 0.2-1% of milk fat. The milk PLs comprise phosphatidylcholine (PC), phosphatidylethanolamine (PE), and sphingomyelin (SPH) as the major compounds; phosphatidylinositol and phosphatidylserine are minor PLs. A new generation of dairy products claiming PL family content, such as SPH, is being produced; therefore, a validated method for quantifying PL families in dairy products is needed. In this study, an HPLC-evaporative light scattering detector method to quantify the most abundant milk PL families, i.e., PC, PE, and SPH, in infant formula and growing up milk was developed and validated.

Simulation of mirror surfaces for virtual estimation of visibility lines for 3D motor vehicle collision reconstruction.

3D reconstructions of motor vehicle collisions are used to identify the causes of these events and to identify potential violations of traffic regulations. Thus far, the reconstruction of mirrors has been a problem since they are often based on approximations or inaccurate data. Our aim with this paper was to confirm that structured light scans of a mirror improve the accuracy of simulating the field of view of mirrors. We analyzed the performances of virtual mirror surfaces based on structured light scans using real mirror surfaces and their reflections as references. We used an ATOS GOM III scanner to scan the mirrors and processed the 3D data using Geomagic Wrap. For scene reconstruction and to generate virtual images, we used 3ds Max. We compared the simulated virtual images and photographs of real scenes using Adobe Photoshop. Our results showed that we achieved clear and even mirror results and that the mirrors behaved as expected. The greatest measured deviation between an original photo and the corresponding virtual image was 20 pixels in the transverse direction for an image width of 4256 pixels. We discussed the influences of data processing and alignment of the 3D models on the results. The study was limited to a distance of 1.6m, and the method was not able to simulate an interior mirror. In conclusion, structured light scans of mirror surfaces can be used to simulate virtual mirror surfaces with regard to 3D motor vehicle collision reconstruction.

Multi-camera system for 3D forensic documentation.

Three-dimensional (3D) surface documentation is well established in forensic documentation. The most common systems include laser scanners and surface scanners with optical 3D cameras. An additional documentation tool is photogrammetry. This article introduces the botscan© (botspot GmbH, Berlin, Germany) multi-camera system for the forensic markerless photogrammetric whole body 3D surface documentation of living persons in standing posture. We used the botscan© multi-camera system to document a person in 360°. The system has a modular design and works with 64 digital single-lens reflex (DSLR) cameras. The cameras were evenly distributed in a circular chamber. We generated 3D models from the photographs using the PhotoScan© (Agisoft LLC, St. Petersburg, Russia) software. Our results revealed that the botscan© and PhotoScan© produced 360° 3D models with detailed textures. The 3D models had very accurate geometries and could be scaled to full size with the help of scale bars. In conclusion, this multi-camera system provided a rapid and simple method for documenting the whole body of a person to generate 3D data with Photoscan©.

VIRTOPSY--scientific documentation, reconstruction and animation in forensic: individual and real 3D data based geo-metric approach including optical body/object surface and radiological CT/MRI scanning.

Until today, most of the documentation of forensic relevant medical findings is limited to traditional 2D photography, 2D conventional radiographs, sketches and verbal description. There are still some limitations of the classic documentation in forensic science especially if a 3D documentation is necessary. The goal of this paper is to demonstrate new 3D real data based geo-metric technology approaches. This paper present approaches to a 3D geo-metric documentation of injuries on the body surface and internal injuries in the living and deceased cases. Using modern imaging methods such as photogrammetry, optical surface and radiological CT/MRI scanning in combination it could be demonstrated that a real, full 3D data based individual documentation of the body surface and internal structures is possible in a non-invasive and non-destructive manner. Using the data merging/fusing and animation possibilities, it is possible to answer reconstructive questions of the dynamic development of patterned injuries (morphologic imprints) and to evaluate the possibility, that they are matchable or linkable to suspected injury-causing instruments. For the first time, to our knowledge, the method of optical and radiological 3D scanning was used to document the forensic relevant injuries of human body in combination with vehicle damages. By this complementary documentation approach, individual forensic real data based analysis and animation were possible linking body injuries to vehicle deformations or damages. These data allow conclusions to be drawn for automobile accident research, optimization of vehicle safety (pedestrian and passenger) and for further development of crash dummies. Real 3D data based documentation opens a new horizon for scientific reconstruction and animation by bringing added value and a real quality improvement in forensic science.

Optical 3D surface digitizing in forensic medicine: 3D documentation of skin and bone injuries.

Photography process reduces a three-dimensional (3D) wound to a two-dimensional level. If there is a need for a high-resolution 3D dataset of an object, it needs to be three-dimensionally scanned. No-contact optical 3D digitizing surface scanners can be used as a powerful tool for wound and injury-causing instrument analysis in trauma cases. The 3D skin wound and a bone injury documentation using the optical scanner Advanced TOpometric Sensor (ATOS II, GOM International, Switzerland) will be demonstrated using two illustrative cases. Using this 3D optical digitizing method the wounds (the virtual 3D computer model of the skin and the bone injuries) and the virtual 3D model of the injury-causing tool are graphically documented in 3D in real-life size and shape and can be rotated in the CAD program on the computer screen. In addition, the virtual 3D models of the bone injuries and tool can now be compared in a 3D CAD program against one another in virtual space, to see if there are matching areas. Further steps in forensic medicine will be a full 3D surface documentation of the human body and all the forensic relevant injuries using optical 3D scanners.

'Morphological imprint': determination of the injury-causing weapon from the wound morphology using forensic 3D/CAD-supported photogrammetry.

Forensic three-dimensional/computer aided design (CAD)-supported photogrammetry (FPHG) plays an important role in the field of the documentation of forensic relevant injuries; particularly so when a detailed, 3D reconstruction is necessary. This is demonstrated in the case of a patterned blunt injury to the face of a victim, which injury was subsequently proven by FPHG to have been caused by a blow from the muzzle of a soft air gun. The objects to be evaluated had to be series photographed in order to be evaluated virtually on the computer. These photo series were then analyzed with the RolleiMetric system. This system measures and calculates the spatial location of distinctive points on the objects' surfaces, and creates 3D data models of the objects. In a 3D/CAD program, the "virtual 3D model of the injury" is then compared against the "virtual 3D model of the possible injury-causing instrument". The validation of FPHG, as shown by the 3D match between certain characteristics of the muzzle form and the facial injury, demonstrates how this 3D method can be used for patterned wound documentation and analysis.

3D surface and body documentation in forensic medicine: 3-D/CAD Photogrammetry merged with 3D radiological scanning.

A main goal of forensic medicine is to document and to translate medical findings to a language and/or visualization that is readable and understandable for judicial persons and for medical laymen. Therefore, in addition to classical methods, scientific cutting-edge technologies can and should be used. Through the use of the Forensic, 3-D/CAD-supported Photogrammetric method the documentation of so-called "morphologic fingerprints" has been realized. Forensic, 3-D/CAD-supported Photogrammetry creates morphologic data models of the injury and of the suspected injury-causing instrument allowing the evaluation of a match between the injury and the instrument. In addition to the photogrammetric body surface registration, the radiological documentation provided by a volume scan (i.e., spiral, multi-detector CT, or MRI) registers the sub-surface injury, which is not visible to Photogrammetry. The new, combined method of merging Photogrammetry and Radiology data sets creates the potential to perform many kinds of reconstructions and postprocessing of (patterned) injuries in the realm of forensic medical case work. Using this merging method of colored photogrammetric surface and gray-scale radiological internal documentation, a great step towards a new kind of reality-based, high-tech wound documentation and visualization in forensic medicine is made. The combination of the methods of 3D/CAD Photogrammetry and Radiology has the advantage of being observer-independent, non-subjective, non-invasive, digitally storable over years or decades and even transferable over the web for second opinion.

Forensic microradiology: micro-computed tomography (Micro-CT) and analysis of patterned injuries inside of bone.

When a knife is stabbed in bone, it leaves an impression in the bone. The characteristics (shape, size, etc.) may indicate the type of tool used to produce the patterned injury in bone. Until now it has been impossible in forensic sciences to document such damage precisely and non-destructively. Micro-computed tomography (Micro-CT) offers an opportunity to analyze patterned injuries of tool marks made in bone. Using high-resolution Micro-CT and computer software, detailed analysis of three-dimensional (3D) architecture has recently become feasible and allows microstructural 3D bone information to be collected. With adequate viewing software, data from 2D slice of an arbitrary plane can be extracted from 3D datasets. Using such software as a "digital virtual knife," the examiner can interactively section and analyze the 3D sample. Analysis of the bone injury revealed that Micro-CT provides an opportunity to correlate a bone injury to an injury-causing instrument. Even broken knife tips can be graphically and non-destructively assigned to a suspect weapon.

Quantification of phospholipids classes in human milk.

Phospholipids are integral constituents of the milk fat globule membranes and they play a central role in infants' immune and inflammatory responses. A methodology employing liquid chromatography coupled with evaporative light scattering detector has been optimized and validated to quantify the major phospholipids classes in human milk. Phospholipids were extracted using chloroform and methanol and separated on C18 column. Repeatability, intermediate reproducibility, and recovery values were calculated and a large sample set of human milk analyzed. In human milk, phospholipid classes were quantified at concentrations of 0.6 mg/100 g for phosphatidylinositol; 4.2 mg/100 g for phosphatidylethanolamine, 0.4 mg/100 g for phosphatidylserine, 2.8 mg/100 g for phosphatidylcholine, and 4.6 mg/100 g for sphingomyelin. Their relative standard deviation of repeatability and intermediate reproducibility values ranging between 0.8 and 13.4 % and between 2.4 and 25.7 %, respectively. The recovery values ranged between 67 and 112 %. Finally, the validated method was used to quantify phospholipid classes in human milk collected from 50 volunteers 4 weeks postpartum providing absolute content of these lipids in a relatively large cohort. The average content of total phospholipids was 23.8 mg/100 g that corresponds to an estimated mean intake of 140 mg phospholipids/day in a 4-week old infant when exclusively breast-fed.

Haptics in forensics: the possibilities and advantages in using the haptic device for reconstruction approaches in forensic science.

Non-invasive documentation methods such as surface scanning and radiological imaging are gaining in importance in the forensic field. These three-dimensional technologies provide digital 3D data, which are processed and handled in the computer. However, the sense of touch gets lost using the virtual approach. The haptic device enables the use of the sense of touch to handle and feel digital 3D data. The multifunctional application of a haptic device for forensic approaches is evaluated and illustrated in three different cases: the representation of bone fractures of the lower extremities, by traffic accidents, in a non-invasive manner; the comparison of bone injuries with the presumed injury-inflicting instrument; and in a gunshot case, the identification of the gun by the muzzle imprint, and the reconstruction of the holding position of the gun. The 3D models of the bones are generated from the Computed Tomography (CT) images. The 3D models of the exterior injuries, the injury-inflicting tools and the bone injuries, where a higher resolution is necessary, are created by the optical surface scan. The haptic device is used in combination with the software FreeForm Modelling Plus for touching the surface of the 3D models to feel the minute injuries and the surface of tools, to reposition displaced bone parts and to compare an injury-causing instrument with an injury. The repositioning of 3D models in a reconstruction is easier, faster and more precisely executed by means of using the sense of touch and with the user-friendly movement in the 3D space. For representation purposes, the fracture lines of bones are coloured. This work demonstrates that the haptic device is a suitable and efficient application in forensic science. The haptic device offers a new way in the handling of digital data in the virtual 3D space.

Post-mortem radiological CT identification based on classical ante-mortem X-ray examinations.

Radiological identification is important in forensic medicine. Identification using comparison of individualising structures with ante- and post-mortem conventional radiographs has been known for a long time. New radiological procedures such as computed tomography (CT) and magnetic resonance imaging (MRI) are being increasingly used for identification. In this paper, a new comparative approach using various radiological methods is described and its application demonstrated. This new approach is the comparison of ante-mortem conventional radiographs with projected images calculated from post-mortem CT data. The identification procedure will be illustrated with reference to the frontal sinus and the pelvis.

Application of 3D documentation and geometric reconstruction methods in traffic accident analysis: with high resolution surface scanning, radiological MSCT/MRI scanning and real data based animation.

The examination of traffic accidents is daily routine in forensic medicine. An important question in the analysis of the victims of traffic accidents, for example in collisions between motor vehicles and pedestrians or cyclists, is the situation of the impact. Apart from forensic medical examinations (external examination and autopsy), three-dimensional technologies and methods are gaining importance in forensic investigations. Besides the post-mortem multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) for the documentation and analysis of internal findings, highly precise 3D surface scanning is employed for the documentation of the external body findings and of injury-inflicting instruments. The correlation of injuries of the body to the injury-inflicting object and the accident mechanism are of great importance. The applied methods include documentation of the external and internal body and the involved vehicles and inflicting tools as well as the analysis of the acquired data. The body surface and the accident vehicles with their damages were digitized by 3D surface scanning. For the internal findings of the body, post-mortem MSCT and MRI were used. The analysis included the processing of the obtained data to 3D models, determination of the driving direction of the vehicle, correlation of injuries to the vehicle damages, geometric determination of the impact situation and evaluation of further findings of the accident. In the following article, the benefits of the 3D documentation and computer-assisted, drawn-to-scale 3D comparisons of the relevant injuries with the damages to the vehicle in the analysis of the course of accidents, especially with regard to the impact situation, are shown on two examined cases.