Smartphone applications in burns
Introduction
Since the introduction of smartphones by the “Stockholm Smartphone Team” [1] in 1997, the term smartphone has become common in our daily lives. Nowadays, a smartphone is synonymous with a device, which associates the properties of a mobile phone with the possibilities of a personal computer. Another historic milestone of the smartphone was the introduction of the first touch screen [1] on mobile devices in 2000. Heather Leonhard of the “Business Insider” expects that there will be 1.4 billion smartphone users worldwide at the end of 2014, indicating that nearly every fifth human being on the planet will possibly own one [2]. Most smartphones run on Google's operating system Android (60%) followed by Apple's iOS (40%) [2]. In 2008, both Apple and Google introduced their application (app) stores, which have made it easy for users to individualize their mobile devices. From 2008 until July 2011, 15 billion apps were downloaded from the Apple's App Store [3]. Google Play Store, formerly Android Market from Google, hosts more than one million apps to date [4]. About half of these apps have become available in Apple's App Store [3]. The widespread penetration of smartphones in the population has, of course, had an effect on the way in which we interact in our professional and private daily lives: smartphones are supposed to be used more often than personal computers, laptops, or even pen and paper.
Even in daily clinical practice, electronic devices form an integral part of modern medicine. These devices may help guide patient care in hospitals, they may help find the right diagnosis, and they are sometimes helpful in therapeutic decision making. All these properties can be provided by different devices or they can be included in one system. Nowadays, custom-made apps for smartphones and their users are able to assume a majority, if not all, of these tasks. Therefore, modern app stores have special categories for medical/health-care apps. In the medical literature, a growing number of authors described the continuous rise in the popularity of smartphone apps [5], [6], [7], [8]. Mosa et al. [5] described that most apps in medicine are used for disease diagnosis, medical calculations, or drug references. To enable special apps for every field of medicine, numerous different apps for almost every medical specialty have been made available. Most are free for download and some are to be purchased.
In the treatment of burns, many different apps have been on offer ranging from first-aid leaflets, literature and papers, or games to calculation apps.
The aim of this study was to review the offered apps applicable in the treatment of burns on Google's Android and Apple's iOS smartphones and to focus on the following parameters: costs (free/paid), developers, content, target groups (medical professionals/laypersons), and available interfaces (e.g., hospital information system/HIS). Furthermore, we compared all available calculation apps in a study based on a standardized patient model.
Section snippets
Ethics
A formal ethical review board approval was not required, because we did not use any personal or patient data.
Design
A systematic review of the two provided app stores was performed from 25 February until 1 March 2014. The terms for research were defined: “burn,” “burns,” “thermal,” and the German word “Verbrennung.” At first, the terms were searched in Google Play Store (formerly Android Market) by using the following link: https://play.google.com/store/apps. As a second step, Apple's App Store was
Results
Detailed results of the available apps are described in Table 1 (for Google's Android) and Table 2 (for Apple's iOS). The research process is illustrated in two flowcharts (Fig. 1, Fig. 2). In every store, we could identify four types of apps: calculators, information, books/journals, and games. Thirty-two calculator apps (13 for Android, 21 for iOS, and two of the same name in both stores) usually provide functionality both for estimating the TBSA and for calculating the TFR, whereas some apps
Discussion
We have supplied within this review an overview of apps for burns. The daily rising demand of medical apps for smartphones has a strong impact on finding the “right” app for orderly medical decisions. Van Velsen et al. [9] mentioned an app overload in the context of health care. In addition, we compared all free available calculation apps with a patient model. This comparison showed that 19 apps provide comparable and reliable results by the TFR calculation (Table 3, Table 4). Furthermore, our
Conclusion
Overall, there are some helpful apps available for burns in both app stores, although there is still a lack of data security especially for calculation apps. Many of them may provide support in daily medical decisions and, of course, allow a continuous collection of data. Our study of free calculation apps showed that most of the calculated TFRs correlate. The benefit of an accurate and objective estimation of the burned TBSA and, furthermore, an optimized fluid resuscitation is
Conflict of interest statement
N/A.
Funding
We want to thank the Austrian Burn Treatment, Research and Prevention Study Group (ABUSG) for the funding of the paid calculation apps www.abusg.com.
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Cited by (44)
The burn injury transfer feedback form: A 16 year Australian statewide review of burn inter-hospital transfer
2023, BurnsCitation Excerpt :To our knowledge, this is the first clinical study to document improvements in TBSA estimation in association with a smartphone-based application. Whilst a number of apps for burn size calculation are available for download [30], to date, no study has evaluated an app’s effectiveness with respect to traditional methods of burn size assessment in a real world clinical setting [31–33]. The findings of the interrupted time series analysis, which was conducted to analyse the trends in clinical concerns over time, detected a significant ‘breakpoint’ in the period of 2014 and 2015, coinciding with roll-out of the NSW Trauma App.
The effect of a known object in a static image of a burn to improve the burn size estimation
2021, BurnsCitation Excerpt :For this pilot study, we used 2D images as at present many centres use these to assess burns from referring hospitals. Although we know the literature now suggests 3D methods improve burn size estimation, our aim was to determine if 2D images which are currently a more commonly used method, could be improved [12–14]. When we consider the experience of an assessor this did not improve estimation with the average percentage error of consultants being 146%, registrars 94% and burns nurses 102%.
Smart Trauma: Improving the Delivery of Evidence-Based Trauma Care
2019, Journal of Surgical ResearchCitation Excerpt :The field of trauma lends itself well to mobile application use due to the protocolized nature of management and the fast pace at which trauma-related injuries need to be treated. Many existing trauma apps are in the form of calculators such as those for burn resuscitation, but other apps that have been created include tools for massive transfusion, triage, wound assessment, and injury prevention.6-12 In our study, we explored the use of a trauma-focused smartphone application created with free online software to deliver evidence-based trauma care at our institution.
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These authors contributed equally to this work.