# Sex Estimation from Computed Tomography of Os
## 4 Discussion
\begin{table}
\begin{tabular}{l c c c} \hline  & **Male** & **Female** & **Total** \\ \hline Sex estimation & 57.50\% (23/40) & 85\% (34/40) & 71.25\% (57/80) \\ Accuracy rate & 55\% (22/40) & 85\% (34/40) & 70\% (56/80) \\ Accuracy & 95.65\% (22/23) & 100\% (34/34) & 98.24\% (56/57) \\ \hline \end{tabular} Sex estimation—frequency of specimens in which sex was estimated; accuracy rate—frequency of samples in which sex estimation was correct in relation to the total performed; accuracy—frequency of sample in which sex estimation was performed correctly from the total possible to be estimated [23].  
\end{table} 
Table 4: Sex estimation and accuracy using DSP software. of [PERSON] et al. [23], whose indeterminate percentage ranged between 4.7% and 58%, depending on the number of variables available, our analysis revealed that 28.75% of the cases (42.5% of the men and 15% of the women) were not classified. Several factors could contribute to specimens being classified as undetermined. Some specimens may exhibit features not indicative of either male or female sex characteristics. Female pelvises appear easier to classify in the current study, as there was only one sex classification error. For females, the sex estimation rate was 85%, with an accuracy rate of 85% (the gross accuracy was 100%, meaning that all females from the entire sample that could be estimated were correctly classified). Therefore, the software may have difficulty classifying specimens that deviate from the norm or fall within a gray area between male and female characteristics. Although undetermined specimens were present, only one error in sex classification occurred: misclassifying a male specimen as female. This indicates that, despite encountering challenges in specific cases, the software consistently demonstrates high accuracy in sex estimation. In sex estimation, it is essential to balance sensitivity (correctly identifying true positives) and specificity (correctly identifying true negatives). In summary, the cautious and responsible approach of counting undetermined cases as correct, even if it artificially inflates accuracy, helps maintain specificity by avoiding false positives (misclassifications). The DSP software's reliability in sex estimation for complete and fragmented os coxae achieved misclassification values below 2%. The success of the software in achieving such high accuracy is attributed to the use of a classification probability criterion of 0.95. While this criterion may result in a decreased number of individuals correctly classified, it significantly reduces the risk of misclassification. The selected cut-off level of 95% utilized in the DSP method eliminates the issue of misclassification, which is one of its strengths [16; 35]. The software's approach of classifying individuals with a probability lower than 0.95 as undetermined and prioritizing reliability over attempting to estimate sexes in all individuals is a practical and effective strategy. The high overall accuracy rate of 98.24% highlights the effectiveness of DSP software in sex estimation and emphasizes the crucial importance of accuracy in sex estimation. Notably, all female specimens that could be estimated were correctly classified, achieving a perfect accuracy rate of 100%. Likewise, males exhibited a commendably high accuracy rate of 95.65%. When applying a threshold of 0.95, some samples are not categorized as male or female; however, reducing misclassifications is more advantageous for forensic practice. Our findings are consistent with research that indicates a higher proportion of indeterminate sex among men [16; 35], in contrast with the findings of [PERSON] et al. [20], who had 9.43% of pelvic bones misclassified as males and 14% as females. The importance of undetermined cases lies in their potential impact on the accuracy of sex classification.