# Sex Estimation from Computed Tomography of Os
## 4 Discussion  
See estimation from bones has an important role in determining biological profile and subsequently in the identification process. Our primary aim in this study was to assess the utility of the Diagnose Sexuelle Probabiliste (DSP) method within a contemporary population sample from Romania. By doing so, we sought to evaluate the effectiveness of this software in the current practice of forensic anthropology within the country. Many studies validate the DSP method as a valuable tool in the sex estimation of the pelvic bone [17, 18, 21, 36]. [PERSON] et al. [21] and [PERSON] et al. [18] tested the reliability of the DSP method using CT scan images from a sample of the modern French population, respectively, from the contemporary Danish population. The study by [PERSON] et al. [37] aimed to determine whether the established standards for sex estimation are maintained in the 3D reconstruction of the image. His research focuses on the metric analysis of the pelvic bone through the DSP tool, one of the most distinctive anatomical skeletal structures between men and women. The findings indicated a close to 62% accuracy in estimating sex. However, there is still room for improvement because, in 37% of cases, sex cannot be identified. One of the challenges observed in this study is the lack of precision in placing landmarks in the 3D reconstruction of the pelvic images [37]. In contrast to [PERSON] et al. 's [20] findings, which did not identify statistically significant differences between the sexes for PUM, the comparative analysis of the four pelvic variables between males and females revealed a significant difference between males and females for PUM and ISMM. In line with the results of earlier studies, the measurements for ISM were greater in men (\(p\) = 0.021), whereas the values for PUM were statistically higher in women (\(p\) = 0.032) [18, 21]. In contrast to [PERSON]'s [21] findings, which found that the measures of SCOX and VEAC were significantly higher for men, in our study, the VEAC and SCOX measures did not show a statistically significant difference between the sexes (\(p\) = 0.707; \(p\) = 0.803, respectively). When using this combination of four measurements (PUM, SCOX, ISMM, VEAC), we were able to estimate the sex in 71.25% of cases, with an accuracy rate of 70%. This is slightly less than what other studies have revealed. Using CT scans of the hip bones from 52 men and 54 women in a modern French population, [PERSON] et al. [21] evaluated the DSP tool's accuracy and found that it was 97.2% accurate for women and 92.3% accurate for men, with an indetermination level ranging from 2.8 to 73.1%, whereas 88.34% accuracy was obtained in a validation study conducted on a mixed Brazilian population [20]. While other studies' values were higher in men than women, our results were greater in women [18]. Females had a high sex estimation rate (85%, with an accuracy rate of 85%), whereas males had a lower rate (57.50%). Acknowledging methodological limitations: The DSP method, for instance, is potentially limited by its reliance on ten variables for accurate sex estimation. The method's accuracy significantly decreases if any of these variables are missing or incomplete. A disadvantage of the DSP tool is that it cannot always identify sex, and the accuracy rate for sex estimation is lower when not all ten variables are available [18, 21]. According to the findings of a recent study on dry bones from a contemporary French population [18], the degree of indeterminacy in fewer measurements affects sex estimation and accuracy. In forensic contexts, it is often preferred to classify individuals as 'undetermined' rather than misclassified. The term \"undetermined\" refers to cases where the sex of the specimens could not be accurately classified using the DSP software. In line with the findings