DigitalNeurosurgeon.com

Update after two months presence in the App Store: > 15.000 downloads for my iPhone apps! Thanks to all people who downloaded and are using the software. I hope you like it.

I already wrote a post that some of my iPhone apps have been mentioned on other weblogs. Now there is a new blog to add to that list. It’s called Medicalchemy and it’s the blog from Nurse Practitioner Degree. They wrote a post titled “33 iPhone Apps Every Healthcare Professional Needs” and I am happy to see that NeuroMind made it into that list.

What’s going on at the moment? I have applied for a university grant on m-learning, and proudly mentioned all these blogs that highlighted my iPhone apps (with particular attention to the interview on iMedicalApps.com). Further I was pleasantly surprised to see that Safe OR from QxMD is for free now. They make interesting apps, but the former price of €7,99 was too much for that app. Safe Surgery is for free, and got a nice reference in one of the Safe OR reviews (click for original size):

Dutch comment on Safe OR, referring to Safe Surgery

Regarding iPhone development, I have paused that now. Temporarily, I guess. Just waiting for iPhone OS 4 to arrive, before continuing.

For now, I am making progress with my efforts in open web standards. As there is some NDA involved in my current project, I cannot do into details on the content now. But I’ve improved my knowledge of CSS and JavaScript / Jquery already, and expect to learn more in the future. I am especially grateful for the nice examples by Soh Tanaka and the Nifty Corners article.

Planning to update NeuroMind’s content soon, and continuing development in these open standard on a new app.

And that’s two! Last week SLIC has been accepted for the App Store, and today NeuroMind has been added as well! I like this screenshot, and although in Dutch, you’ll get the point! ;-)

Both apps together (click for full size)

I intend to publish an article in a peer-reviewed scientific journal about both. Currenly I am preparing the first manuscript on SLIC. Tomorrow, the new version of the Maastricht University magazine will appear that contains an interview with me on the apps (in Dutch).

The SLIC application on subaxial cervical spine injury has an updated interface now. Here is a screenshot (click for full size version):

User testing revelead a minor issue that caused some confusion. The abbreviation “DSS”, used for Decision Supporting System, also stands for Dutch Spine Society. And it made me realize that “DSS” is not really self-explanatory… so the buttons at the bottom of the screen have been updated.

Another request was to make the description of the decision tree (which displays it full title under the selection component) clickable. This also has been changed (from UITextView to UIButton with customized skin): now the user can go into Questions-mode immediately by clicking the text.

As Steve Krug writes in his book, the issue of usability comes down to that one point: “Don’t make me think!“

The New Year’s break has been quite productive for me. After the progress with the NeuroMind application, I could make serious progress on the SLIC application as well.

As a reminder, SLIC is a subaxial cervical spine injury classification system, described by Vaccaro et al (Spine, 2007). Based on this classification, some evidence-based algorithms on the surgical approach to subaxial cervical spine injury have been described by Dvorak et al (Spine, 2007). I liked both articles, and have developed an iPhone application that facilitates application of the system.

In my opinion, the application can be considered as finished now. Waiting for some last beta testing results, I do not expect to make serious modifications anymore. After some struggle with the code, the application now displays the decision chart automatically full screen if it is selected. Using multitouch gestures on the iPhone (“pinching”) it can be zoomed in for better reading. It works great on XCode’s iPhone simulator, although there seems to be a small delay in loading the chart on my device.

Further progress includes an improved version of the SLIC classification system, which is shown by rotating the device to landscape mode (“horizontal”). It also includes references to the articles mentioned above. The last addition which I think I need to provide, is a disclaimer.

Here is an updated screenshot compilation of the app (click for large version):

SLIC version 0.9

I hope to see you soon…. in the App Store!

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!

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!