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I added a reminder for the SLIC tool about subaxial cervical spine injury. I have trouble in remembering the SLIC Scale, even though it’s not that complicated. I guess if you use it regularly it will be easy to remember, but what if you did not have to use it for some time?

The tool I have been blogging about will support decision making, but it also needs to original scale. On purpose, I kept it very simple:

I load the scale in a UITextView, which is automatically displayed if you turn the iPhone. In the first version, I used a UIWebView: this offers more layout features, but I find the text too small to read – and zoom/scroll is not really helpful for a quick lookup. Although this can be moderated, the new approach is very simple and powerful. And fast!

After the discussion in this blog post I decided to follow your advise and keep the summary-section in the old format. For a technical reason I used the other approach in the Background information part: there is an issue with the width of the screen, I am not able to use it completely. In the current approach it is not too disturbing. For me, it’s fine for now.

The main change is that the Background part does not contain HTML anymore (I used to display it in a UIWebView) but it is just a table with plain text now. The reason is only related to speed of data entry: this is much faster! I expected some advantage of the UIWebView approach when I chose it, but it made things rather complicated. Not anymore! ;-)

Click for large version

As you can see in the image, I added a category checklists, on which I will come back later. I think it might be the most important category in the app. There’s even a chance that it might be the only category in the final app (with the rest as some form of subcategory).

As I re-entered clinical practice now, I am discovering some issues in which I want to have help. If I can build it into the iPhone, I will do it if it improves the quality of my patient care. So stay tuned, I expect more to follow during the next 1-2 months on this.

In my previous post on the SLIC scale for subaxial cervical spine injury I posted some screenshots within my iNeuroMind iPhone project. However, this scale is that important that I think it deserves a special app – and orthopedic surgeons might be interested as well.

I needed to find out how to work with the iPhone’s plist format in setting up some kind of decision tree mechanism that I earlier used on other mobile devices. Done! Adding some nice visual effects, and all possibilities from the iPhone, and you get a result like this (click for large version):

SLIC decision supporting system

There we go! The autorotation component is supported as well, and will remind you of the original SLIC scale in case you cannot remember it by heart (like me). I still need to implement the actual decision trees, but at least the technology behind it is working now as it should.

Cervical spine injury is a topic that remains difficult in my opinion. When can I consider the spine to be “stable” (no abnormal motion) and when is external stabilization indicated. Prescribing a Halo-vest for 12 weeks is not really a nice thing to do if unnecessary. On the other hand, not prescribing it when it is necessary, is even worse. Fortunately, help is on its way!

Vaccaro et al published two very helpful articles on this topic. The first article describes the subaxial cervical spine injury classification system (SLIC). The second article describes an evidence-based algorithm that will assist surgeons in answering the 2 most common questions they face when managing subaxial cervical spine trauma: “Should I operate?” and “Which surgical approach should I select?”

I already implemented the first article in the iPhone app before I found the second, that one will come later. Here is a screenshot, with two different kinds of layout (click on the image for a large version).

SLIC on iPhone

The second layout (on the right) came across this morning… accidentally. I changed some settings, and I found this result. Which I like better!! There is more space for text, and less “unused space”. In the meantime, I do not have the impression that it gets too crowded. And yes, I know that I need to increase the height of the lower cell a little in the new version. That’s easily done!

What layout do you think is best: the left (old) or the right (new) one? Let me know!