As any suffering research assistant knows, collecting and recording outcome and functional scores is one of the most important pieces of any clinical research project yet one that can become unpleasantly challenging. Using a valid test to report patients’ outcome is a minimum requirement for acceptance of a research paper into a reputable journal.
In every specialty, many validated or at least standardized scoring systems exist. In orthopedics, this is further multiplied by the many different anatomic locations (knee, shoulder, hip, etc). Remembering the nuances of each scoring system is nearly impossible for mere mortals. Yet, using paper forms to collect this data during a hurried patient visit adds even more work since these forms need to be transcribed and entered into a research spreadsheet or database.
Therefore, it could indeed be quite useful for orthopedic researchers to have an iPhone app like Ortho Scores (iTunes) that has internally encoded all the major scoring systems. The app allows for quick data entry using a series of well designed screens and the iPad version is even faster since the larger screen space allows for more questions to be viewed at a time.
What is even more enticing would be to allow patients to enter their own self-reported outcome scores (e.g. the well accepted SF-12 and SF-36 questionnaires) using an iPad provided in the waiting room. This would speed patient flow in a busy clinic, while the iPad touch interface should be easily intuitive for most any patient.
In order for this to become a reality, however, the app should allow the doctor or research assistant to hide other patients’ information before handing over the iPad. I did not see that the Ortho Scores has such a “lock-down” feature, although it might be something the developers are considering.
The main faults with this application are predictable. At this time, the app does not appear to interface with any electronic health records (EHR) so patients’ identifying information has to be entered manually. Data export is limited to email,and it does not appear to have options for export to spreadsheet or database file formats (e.g., .XLS .CSV or .FP7). Also, there does not appear to be a web-based or other method to enter or view data except for the app.
If more more self-reportied patient information were available, it could only encourage physicians to focus more on patients’ perception of their own outcomes rather than on what doctors think is important. Even with the above drawbacks, the application appears to be promising and we hope to see it used in more surgeons’ practices to find out how our patients are actually doing.
