Decision support for epidural hematoma

(this is a guest post from DigitalNeurosurgeon.com, slightly modified for Surgical Neurology International)

The Brain Trauma Foundation has created and published guidelines on the treatment of brain trauma a few years ago. The Guidelines for the Surgical Management of Traumatic Brain Injury are available as PDF and in a searchable online format. What lacks, is the availability on a mobile platform, preferably as an interactive decision support system (like their Head Injury Prognosis calculator). Seems an excellent topic for NeuroMind 2 (appears in Q1-2012).

Approach

The guidelines are text-based, no flowcharts have been provided. This makes direct implementation of the guidelines in an app difficult, as I think I need to make clear what algorithm is used in the app. In the end, if you intend to use it to make decisions, you need to be able to check the algorithm in case you want to. So here is the 1-2-3 of converting a text-based guideline into an application:

  1. Read the text of the guidelines (or in this case: the Recommendations)
  2. Create a flowchart from the text
  3. Build the app based on the flowchart

I will explain more about the symbols that are used in the flowchart in a separate topic. Until then, this Open Course Ware tutorial gives you a nice introduction.

Epidural hematoma

Now here is the flowchart I created:

And here is a screenshot of the app:

For some more details and screenshots, click here.

Pieter Kubben
Information Technology editor
Surgical Neurology International

2 Comments

  1. Garni Barkhoudarian says:

    Hi Peter,

    This looks really good. My only concern is in the setting of posterior fossa epidural hematomas. I don’t think this algorithm could be applied safely for these epidurals given the smaller volume of the posterior fossa and the high risk of severe neurological deficits if it expands.

  2. Thanks for the comment! You are right in this, I will check the original guidelines whether they state explicitly that this only concerns supratentorial hematomas.

    Pieter

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