By: Yvette Ho, MD Orthopaedic Surgery Resident, Maimonides Medical Center, Brooklyn NY
Being an orthopaedic surgery resident with a particular interest in orthopaedic oncology, I was excited to try out the Tumorpedia family of apps.
I am always interested in expanding my sources of mobile references, and mobile study aids for orthopaedic in-training exams are sparse.
The Tumorpedia family of apps (Lite, Bone, Soft Tissue, Foot and Ankle, and Spanish) for iPhone/iPad claims to be “the most comprehensive source of musculoskeletal tumor information available for mobile devices.”
Developed by Digital Image Flow, with content from Dr. Dr. Henry DeGroot III, M.D., F.A.A.O.S. – the creator of the bonetumor.org website. With this app is claiming to be “the most comprehensive source for musculoskeletal tumor information available for mobile devices,”, it seemed right up my alley!
The family of apps includes:
- Lite (free version)
- Soft Tissue
- Foot and Ankle
The Tumorpedia family appears to be designed in basically the same mold, with each app pulling a different subset of diagnoses from a database. This particular review addresses the Lite, Bone, Soft Tissue and Foot/Ankle applications.
When first opening each app, a dialog box opens up asking if you would like to ‘update the app database.’ It seems that it would be a nice feature to constantly update the information in the app without requiring an entire update installation each time.
The greatest strength of this grouping of apps is their ease of use. The UI is basic, but immediately recognizable and intuitive for all iPhone/iPad users. The initial screen lists all available diagnoses, in a format similar to the iOS address book.
Clicking on a diagnosis opens to a page on which various subsections of information are accessible through tabs on top including General Information, PIC, xrays, MRI, CT, pathology, differential diagnosis, and treatment. For some topics, the PIC section has a clinical photo while others have incidence and demographics.
Each page also has a ‘Share’ button that does not appear to be functional at this time.
In sections with multiple images, the user can scroll through the series of images with the familiar horizontal finger swipe. Zooming into images is not an option, though the images are generally sized appropriately so the user can appreciate the salient details. I did initially miss the fact that there were sometimes multiple images, though, because it is hard to see the white indicator dots on the pale blue background. Eventually, though, I figured it out.
Now, while the UI is simple to use, the apps fall short on content, particularly with scope of diagnoses. Of all four apps, the Bone app definitely has the most robust list of diagnoses. While not comprehensive, it does include a reasonable smattering of bone tumors and tumor-like conditions, as well as a few syndromes associated with bony lesions such as McCune-Albright, Ollier’s and Mafucci’s syndromes.
What could be confusing is that multiple non-tumor diagnoses are listed (e.g., ‘avulsive cortical irregularity,’ ‘bone island,’ ‘osteomyelitis’ and ‘chronic multifocal osteomyelitis,’ to name a few). There is also a separate entry entitled ‘Tumor Mimics,’ which includes only gout, stress fractures, and PVNS together as “non-neoplastic lesions that may look and act like bone tumors.” However, about a full third of the diagnoses in this app, not listed as Tumor Mimics, are non-neoplastic lesions.
The ‘Soft Tissue’ and ‘Foot and Ankle’ apps have a very small pool of diagnoses. The Soft Tissue app, at the time of this review, has 14 entities listed; they are not all tumors (e.g. ‘runners bump,’ and ‘calcific periarthritis’). They don’t yet include the most common soft tissue sarcomas like MFH (which is listed in the bone section) or rhabdomyosarcoma.
The ‘Foot and Ankle’ app has 23 diagnoses, though synovial chondromatosis is not only listed twice -once in English and once in Spanish – but is also not specifically concerning the foot and ankle.
This type of error is prevalent throughout all the apps in the family. In fact, the editing overall is quite inconsistent throughout all the applications. The various entries appear to have been written by different people, as their level of depth varies widely. While the content for the most part appears correct, there are no references listed for any of them. The entry for ‘synovial chondromatosis’ appears to have been copied from a review paper, complete with reference numbers but no references.
One additional note is that you need to have a connection (network or wifi) in order to view images as they are not stored locally – so much for studying on the subway!
All in all, these apps are simple to use but currently are not comprehensive enough to be either a fully functional reference or study guide. If they are updated, however, they may become more useful in the future.
- Lite: free
- Bone, Soft Tissue, Foot and Ankle: $2.99 apiece
- Intuitive UI
- A possibility of being useful in the future, if the database is updated with better editing and more diagnoses
- Far from comprehensive
- No references
- Poorly edited
- Good idea, and may be useful in the future
- Not comprehensive enough to be useful as either a reference or study aid