The Ottawa Rules, a set of rules that helps physicians determine when to order an X-ray or CT scan, is now available for download on iOS and Android operating systems.

The rules, developed by emergency department physicians at The Ottawa Hospital and the University of Ottawa, are applied to the ankle, knee or spine, and are evidence-based decision trees that help determine whether a scan is needed for injured bones.

Included in the app are the Ottawa Knee Rule, the Ottawa Ankle Rule, and the Canadian C-Spine Rule, which were previously only available as posters or online. They have been validated by more than 20 studies, translated into several languages, and are used by physicians worldwide, according to the announcement.
“Studies have repeatedly shown that the Ottawa Rules reduce unnecessary use of X-ray and CT scans, reduce wait times and save money for the health care system,” said Dr. Ian Stiell, an emergency physician and research chair at The Ottawa Hospital, distinguished professor at the University of Ottawa and creator of the Ottawa Rules, in a statement.

“Physicians can have an easy-access, interactive option to refresh their memory of The Ottawa Rules,” Laura Salter, a member of Dr. Stiell's research staff, told HCB News. “This app brings the rules to the quick-click access of the mobile world with an easy-to-follow and visually appealing layout.”

In the video below, Dr. Stiell explains how to use the Ottawa Knee Rule on patients.



The Ottawa Hospital mHealth Research team also created the app ImmunizeCA, which helps people living in Canada keep track of their immunization record and access expert-reviewed information about recommended and routine vaccinations.

The creators acknowledge that the rules are still not as widely used as possible, and that was one of the reasons to create the app. The team hopes that the information provided by the app, which can also be found online, will spread to emergency departments around the world.

The Ottawa Rules app is just the beginning, said Salter, and there have been other validated clinical decision rules such as the Canadian CT Head Rule, developed by physicians at The Ottawa Hospital Research Institute, that will be implemented into the app in the future.

In Tongji Hospital of Tongji University School of Medicine in Shanghai, China, researchers examined the Ottawa Ankle Rules’ (OAR) accuracy for diagnosing fractures in patients with acute ankle sprains, which was published in PLOS ONE. The patients were examined by orthopedic specialists using OAR and then underwent ankle radiography.

The OAR results were compared with the radiographs to determine the accuracy of OAR for ankle fractures, and the researchers found that OAR could decrease unnecessary radiographs by 31.1 percent.

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