OrthoGuidelines app is a great resource for managing musculoskeletal injuries

Guidelines are increasingly being looked at as tools to promote evidence based, cost effective care. Orthopedics is no exception. We previously reviewed a web-based application for Appropriate Use Criteria provided by at the American Academy of Orthopaedic Surgeons (AAOS).

The AAOS has recently created a new, more comprehensive, mobile application called OrthoGuidelines. This app was developed under the leadership of project director Kevin Bozic, M.D. The OrthoGuidelines app is an independent native mobile app that combines Clinical Practice Guidelines and Appropriate Use Criteria.

Appropriate Use Criteria (AUC), in general, specify when it is appropriate to use a particular procedure or test. AUCs facilitate surgical decisions by combining the best available scientific evidence with the collective judgment of physicians in order to determine the appropriateness of performing a procedure. AUC topics come from AAOS Clinical Practice Guidelines that establish the effectiveness of various procedures for a given disease, disorder, or condition.

The OrthoGuidelines app is free to download and anyone can use the app. The app opens to a row layout homepage. There is no login or need to register to use the app. From the available rows, the user can either view “All Guidelines” or sort by various options including “Strength” of the recommendations, “Stage of Care” in treatment, and by AUCs only. A search feature is also available, however, it is relatively easy to scroll through and find the topic of interest.

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All of the available AAOS guidelines are available in the app.

Selecting a topic brings up a quick screen that briefly describes the position statements. At the top of the screen is an option to download the full document as a PDF. The number of stars associated with each aspect of the CPG is especially useful in interpreting the recommendations quickly.

Selecting one of the recommendations provides a rationale and associated references to support the findings of that guideline.

It is an improvement over the previous web-design app that this native app includes the CPGs and AUCs in one location. The app also allows for navigating the AUCs separately from the CPGs.

This app is a great service provided by at the AAOS. Countless hours have been devoted to the studies that comprise the guidelines. Similarly, numerous individuals have dedicated a significant amount of time and work to reviewing the available literature and synthesizing the information for these CPGs and AUCs. This app is the product of a great deal of work and does a wonderful job of presenting the information. Finally, the AAOS has designed the app with features to allow users to obtain Continuing Medical Education credit by using the app. This is a very unique and helpful feature.
I know some practicing orthopaedic surgeons are frustrated by the number of “inconclusive” and “limited evidence” statements in the guidelines. However, this is not a reflection of the app or of the guidelines. The guidelines are supposed to follow strict rules to allow the highest quality evidence. The inconclusive statements should be a motivation to practicing surgeons to design new and better studies to answer these deficits in our understanding. This is a great app that can be easily updated as more information is discovered related to these topics.

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Video Review (by Dr. Saif Usman)