MedRules Clinical Prediction Rules for Palm OS® Handhelds DESCRIPTION MedRules is an award-winning application featuring useful clinical prediction rules taken from the medical literature. A few of the available rules may be seen in the animated screenshots shown to the right. Additional rules will be added over time. Complete references for each rule may be found by clicking the question mark icon in the upper-right corner of the screen. This application is for educational use only. It should not be used to make decisions affecting patient care. WHAT'S INCLUDED? Acute Sinusitis Alcoholic Liver Disease APACHE II Score Appendicitis Score Bishop Score Bleeding Risk Prediction Breast Cancer Risk (Gail) Cardiac Arrest Outcome Cervical Radiography Child's Classification Community-acquired Pneumonia Coronary Disease Probability Coronary Disease Risk Croup Score CT in Minor Head Injury DVT Probability Ectopic Pregnancy Family Practice Incidence Rates GI Bleed Mortality In-Hospital Cardiac Arrest Mangled Extremity Score MI Criteria in Chest Pain w/LBBB Ottawa Ankle Rules Ottawa Foot Rules Ottawa Knee Rules Pediatric Trauma Score Pharyngitis Evaluation Predicting Pulmonary Embolism Pre-Op Cardiac Risk (Detsky) Pre-Op Cardiac Risk (Goldman) Pre-Op Cardiac Risk (Lee) Ranson's Criteria Renal Artery Stenosis Revised Trauma Score Romhilt-Estes Criteria for LVH Strep Pharyngitis Probability Stroke Risk in A-Fib Successful VBAC Trauma Score UTI Diagnosis REQUIREMENTS Requires Palm OS® 3.1 or higher. MedRules and its libraries currently require approximately 348KB of memory. DOWNLOADING & INSTALLATION Download the .zip archive for MedRules version 3.3 here. Unzip 'MedRules.prc', 'NSBRuntime.prc', and 'MathLib.prc' and perform a HotSync® function to transfer them to your Palm OS® device. All three files are required in order for MedRules to function. If you're upgrading from a previous version of MedRules, it's a good idea to delete the old version from your Palm OS® handheld before installing the new one. Depending on the applications you're using on your Palm OS® device, you may already have a version of 'NSBRuntime.prc' or 'MathLib.prc' installed. 'NSBRuntime.prc' is the NS BASIC runtime module, and is required for any program written using NS BASIC. IMPORTANT: Please install the 'NSBRuntime.prc' file included in the MedRules archive in order to ensure that you're using the correct version (MedRules was compiled under NS BASIC version 3.0.3, and is only warranted to work with NSBRuntime version 3.0.3; if you have other NS BASIC programs installed that require a different version of NSBRuntime, MedRules may crash or behave unpredictably.) 'MathLib.prc' is a free shared library that can be used by any Palm OS® 2.0+ program that needs IEEE-754 double-precision math functions. It's distributed under the terms of the GNU Library General Public License, and is freely available with full source code and documentation from the MathLib information page. A copy is included in the MedRules archive for your convenience. SO HOW MUCH DOES THIS THING COST? MedRules is freeware for personal use. It is not public domain software and may not be sold or used for commercial purposes without the express written permission of the author. BACKGROUND MedRules was written using NS BASIC. Users will likely notice that MedRules executes somewhat slower than Palm OS® programs written using C/C++ development tools such as CodeWarrior. This is because NS BASIC programs are compiled into p-code, not native assembly language, and are executed using a runtime engine (the 'NSBRuntime.prc' file). The slowdown results from this process, not the source code itself. For that reason, speeding it up is out of my hands. The learning curve for a non-programmer such as myself is a significant stumbling block to developing in C/C++. At this point, I'm willing to put up with NS BASIC's sluggishness in exchange for the ability to develop the application at all. Hopefully, others will feel similarly. NS BASIC is in its early stages of development, and it's quite possible that future versions will execute faster. If you have any suggestions regarding ways to improve this application, or know of a specific clinical prediction rule that you would like to have included, please send me a description and the relevant citation from the literature, and I'll see what I can do. VERSION HISTORY 7/1/00 Ver. 0.1 - INITIAL ALPHA RELEASE of PalmCPR 7/3/00 Ver. 0.2 - Added dynamic updating of PE score, preserved checkbox values when changing screens. 7/4/00 Ver. 0.3 - Menu structure implemented, added Ranson's Criteria. 7/4/00 Ver. 0.4 - Added Goldman Criteria and bleeding risk prediction score. 7/5/00 Ver. 0.5 - Added Fine's rule for community-acquired pneumonia. 7/6/00 Ver. 0.6 - Changed name of application from PalmCPR (too confusing) to MedRules (less confusing...?) 7/9/00 Ver. 0.7 - Added five new rules! 7/9/00 Ver. 0.8 - Added trauma score. 7/12/00 Ver. 0.9 - Added APACHE II score. 7/14/00 Ver. 1.0 - Added FP incidence rates and MI criteria in LBBB. Fixed some minor display glitches. 7/15/00 Ver. 1.01 - Added Pediatric Trauma Score, Revised Trauma Score, and mortality criteria for alcoholic liver disease. 7/18/00 Ver. 1.02 - Added rules for UTI, acute sinusitis, DVT, and in-hospital cardiac arrest. Modified PE rule to include incidence data. 7/20/00 Ver. 1.03 - Added coronary heart disease risk (Framingham data) and Romhilt-Estes criteria for LVH. 7/23/00 Ver. 1.04 - Added Bishop score. Enabled hardware button scrolling in main menu. 7/25/00 Ver. 1.05 - Added renal artery stenosis prediction rule. MathLib is now required. 9/6/00 Ver. 1.1 - Added Detsky criteria for preoperative cardiac risk, Child's classification of liver disease severity, and a second pharyngitis evaluation rule. 9/25/00 Ver. 1.2 - Added Gail Model for estimating 5-year risk of invasive breast cancer. 9/26/00 - Ver. 1.2 - Fixed a bug in Gail Model which caused some results to become additive 11/13/00 - Ver. 1.3 - Recompiled under NS BASIC ver. 1.07. Slight performance (speed) improvement. No new features added. 11/27/00 - Ver. 1.4 - Fixed a bug in Bishop Score which gave inconsistent results for a score of 9. Thanks to Mike Potts for pointing this out. 11/28/00 - Ver. 1.5 - Gail Model removed due to conflicting results as compared to other available models. 11/30/00 - Ver. 1.6 - User Agreement screen added. 12/1/00 - Ver. 1.7 - Fixed a bug in the Revised Trauma Score. Thanks to Dave Jarvis for finding it. 12/3/00 - Ver. 1.71 - Added six new rules: Ottawa Ankle Rules, Ottawa Foot Rules, Ottawa Knee Rules, CT in Minor Head Injury, Mangled Extremity Score, and Pre-Op Cardiac Risk (Lee Criteria). 12/3/00 - Ver. 1.8 - Rules may now be sorted by category, and the last category viewed is saved between executions. Slightly faster launch time. 12/10/00 - Ver. 1.9 - The Gail Model is back, along with five new rules: Successful VBAC, Ectopic Pregnancy, Stroke Risk in A-Fib, GI Bleed Mortality, and Cervical Radiography. 1/31/01 - Ver. 2.0 - Recompiled under NS BASIC ver. 1.08. No new features added. 4/23/01 - Ver. 2.1 - Recompiled under NS BASIC ver. 1.10. Now supports text scrolling using up/down buttons. 8/1/01 - Ver. 2.2 - Expiration date advanced. No new features. 8/29/01 - Ver. 2.3 - Fixed bug in Pulmonary Embolism module. Thanks to Dr. Lorenzo Di Francesco for catching it. 10/17/01 - Ver. 2.4 - Recompiled under NS BASIC ver. 2.0.3. No new features added. 3/31/02 - Ver. 2.5 - Recompiled under NS BASIC ver. 2.0.5. Added an option to disable the user agreement dialog via the "About MedRules" screen. 11/28/02 - Ver. 3.0 - Recompiled under NS BASIC ver. 3.0.1. Added a color icon and Palm OS 5 compatibility. 12/19/02 - Ver. 3.1 - Corrections to labels on Community-Acquired Pneumonia rule. 6/5/03 - Ver. 3.3 - Expiration date removed. LICENSE & DISCLAIMER MedRules is Copyright ©2003 by Kent E. Willyard, M.D. Permission to use, copy, and distribute this software and its documentation for any non-commercial purpose, without fee, and without a written agreement is hereby granted, provided that the above copyright notice, this paragraph and the following three paragraphs appear in all copies. For commercial usage, please contact the author. The author has made every effort to ensure that the information provided by this software is accurate and within generally accepted medical standards at the time of publication. However, as medical science is constantly changing and human error is always possible, the author and any other party involved with the publication of this software do not warrant that it is accurate or complete, nor are they responsible for omissions or errors or for any outcomes resulting from the use of this software. This application is for educational use only. It should not be used to make decisions affecting patient care. IN NO EVENT SHALL THE AUTHOR BE LIABLE TO ANY PARTY FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES, INCLUDING LOST PROFITS, ARISING OUT OF THE USE OF THIS SOFTWARE AND ITS DOCUMENTATION, EVEN IF THE AUTHOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGE. THE AUTHOR SPECIFICALLY DISCLAIMS ANY WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. THE SOFTWARE PROVIDED HEREUNDER IS ON AN "AS IS" BASIS, AND THE AUTHOR HAS NO OBLIGATIONS TO PROVIDE MAINTENANCE, SUPPORT, UPDATES, ENHANCEMENTS, OR MODIFICATIONS.