For the busy primary care provider, deciding whether or not to order an imaging test for various medical conditions can be challenging. The American Academy of Family Physicians and the American College of Radiology (ACR) provide different Choosing Wisely recommendations for various conditions. The ACR publishes their Appropriateness Criteria online, but only basic search functions are allowed for non-members and there is no mobile version available.
For certain musculoskeletal conditions such as neck, ankle and knee pain, the Ottawa Rules have been proposed to aid providers in their medical decision making concerning imaging. The rules were derived and validated over many years of research by Dr Ian Stiell at The Ottawa Hospital. These rules are available in various medical calculator apps such as QxCalculate, MediMath, MedCalc, and our new favorite, MDCalc.
Now Dr Stiell and his research team in Ottawa have released a dedicated app for the Ottawa Rules — called The Ottawa Rules. The Ottawa Rules medical app is designed to educate providers about the validated rules, and aims to decrease unnecessary radiographic imaging. Additionally, the medical app is part of a study at Ottawa Hospital, but you can download and use the Ottawa Rules app without being part of the research study.
Evidence based medicine
The Ottawa Rules app contains some of the most famous Ottawa Rules with links to all of the original validation studies for each. Additionally, the medical app contains high quality videos showing the author applying each rule at the bedside on simulated patients. Surprisingly the Ottawa Rules app doesn’t contain information on the sensitivity/specificity/likelihood ratios for each rule unless you pull up the linked articles. Apps such as MDCalc contain much of the same information as well as hundreds of additional calculators.
Who would benefit from this App?
Students, nurses, residents, mid-levels, emergency medicine, primary care and orthopedics providers who treat patients with the included musculoskeletal injuries.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Simple to use interface with quality illustrations and algorithms to apply rules at the point of care.
- High quality videos showing the author applying the rules at the bedside on simulated patients.
- Links to all of the original validation studies for the rules.
- Available for Android.
- Medical App lacks some specifics on evidence based medicine unless you view all of the videos or read the linked articles.
- Does not contain all of the Ottawa Rules at this time (lacks concussion rule for example).
- Focused only on the Ottawa Rules.
The Ottawa Rules medical app should help decrease the overuse of imaging for musculoskeletal injuries by making these validated rules approachable to every provider. The medical app has a multimedia approach to explain how to use the rules which is a nice touch. However, we prefer the simplicity of MDCalc for giving nearly the same information (frankly even more specifics on sensitivity/specificity, etc.) in a written format.
- Overall Score
- User Interface
Excellent interface design with quality illustrations and quality videos of how to apply the rules.
- Multimedia Usage
App has links to the author’s website, links to all of the supporting validation articles, videos of how to use the rules at the point of care, etc.
App is free.
- Real World Applicability
The Ottawa Rules is a beautiful app that presents these famous prediction rules in all their glory. The medical app also is part of a study and according to the authors will be expanded to include other Ottawa Rules soon. The only reservation is that many other calculator apps already contain versions of these rules and MDCalc contains more information about them than the Ottawa Rules app actually does. Therefore, you may not want/need a dedicated Ottawa Rules app.
- Device Used For Review
iPhone 6S running iOS 9.3.1
- Available for DownloadAndroidiPhoneiPad