Decision support: Spinal instability neoplastic score

“The Spine Instability Neoplastic Score is a comprehensive classification system with content validity that can guide clinicians in identifying when patients with neoplastic disease of the spine may benefit from surgical consultation. It can also aid surgeons in assessing the key components of spinal instability due to neoplasia and may become a prognostic tool for surgical decision-making when put in context with other key elements such as neurologic symptoms, extent of disease, prognosis, patient health factors, oncologic subtype, and radiosensitivity of the tumor.” (Fisher et al, Spine 2010).

Looks like an excellent opportunity for decision support, as this 6-tier score is a little too complex to remember by heart, in my opinion. Nevertheless, it is very useful, so it should have a place in clinical practice for neurosurgeons and orthopedic surgeons.

Here is how it looks in NeuroMind 2 on iPhone:

The 6 predictors from the SINS

All values are multiple choice items, so on iPhone they are selected using a co-called “picker” interface item (which is the official term for that rolling thing…):

Selecting a predictor value

As you can see, the text in the picker is a little too long for the small iPhone screen. In that case, the full text is displayed below the picker to facilitate reading. On the larger iPad screen, it will be completely visible within the picker itself.

Based on the user input, an advise for the individual patient is returned:

SINS score and treatment suggestion

Later I will also implement the SINS score in the classical Score menu (which is not visible in the development interface shown above). So you can choose whether to use the new decision support features of NeuroMind 2, or just browse the score and perform the calculations yourself (as you are doing with NeuroMind 1.x at the moment).

More images from the SINS decision support module are available in the gallery below…