Friday, March 3, 2023

Our OMI Toolbox Application is out now !

We are happy to announce that our "OMI Toolbox" application has just released and ready for your use. 

As myocardial infarction (MI) and many other diagnoses (for example left ventricular hypertrophy, prior MI etc.) can cause ST-segment elevation (STE) on electrocardiogram (ECG), the distinction between them may be hard and complicated. Furthermore, some ECGs may not meet the STEMI criteria but may still be diagnostic for acute coronary occlusion (ACO). For this purpose, only one set of diagnostic or differentiating criteria (STEMI criteria) is not enough, therefore a bunch of different tools are needed to make a distinction between two particular diagnoses (for example, STEMI vs. benign early depolarization) and diagnose subtle occlusion MI (OMI). Many researchers, including the editors of this blog, tried to develop such tools in the recent past and we have recommended their use in certain clinical scenarios in many posts on this blog. 

Recently, we published a structured approach to ECG diagnosis of OMI in the Archives of Turkish Society of Cardiology. It consisted of ten steps and several tools were used in each step to make a correct diagnosis of OMI. 

Here is the original paper (open access) and below the ten step algorithm:

As you will notice, there is a tool icon in many of the steps, some of which needs complicated mathematical calculations. Of course, this is a problem for the busy clinician. Therefore, we thought that a smartphone application for this issue might be a good idea. And here it is:

OMI Toolbox

In this toolbox you will find the complete ten-step algorithm and all ECG tools for differential diagnosis. You will find a fully zoomable example ECG for each step, an explanatory text and clickable direct links to some calculators to be used as ECG tools for OMI diagnosis. The majority of the ECGs are from Stephen W. Smith and Emre Aslanger, but we also thank external researchers for their demonstrative ECGs (thanks to Philip L. Mar for atrial activity ECG).

At each step, you will also find active links to the original publications.

Additionally, the App also includes a chest pain section, namely EDACS risk score, which is already a well known and validated tool for the approach to acute chest pain (many thanks for its developers and their courtesy for letting us to use it in our App, Martin Than, MD; John Pickering, BSc, PhD, BA and Dylan Flaws, MSc, PhD). Another handy section is for troponin levels and their delta cut-offs, which can be modified according to the kit used in your hospital.   

We would like to thank Muzaffer Değertekin, MD, PhD, Prof. (President Elect) and Bülent Mutlu, MD, Prof. (Associate General Secretary) of Turkish Society of Cardiology, for their support. Although the opinions expressed in the App are not necessarily those of Turkish Society of Cardiology, we cordially believe that the development of an OMI App under the auspices of a leading cardiology society is a really important act. 

We also indebted to Özlem Yıldırımtürk, MD, Prof.; Dursun Akaslan, MD; and Alain Vadeboncoeur, MD, Prof. for their support in the development process. Many thanks to Redwan Seid Busery, MD, Eren Uysaler, MD for Android version and Ümit Öztürk, MD, Selim Yazıcı, MD for iOS version for their endeavors in quality controlWe also thank Wael Almutairi, BSc and Basel Alenazy, MD for Arabic translation (which is, unfortunately, currently unavailable); Elmir Jafarov, MD for Azerbaijani ; Tsao Jian-Hsiung, MD, for Chinese; Alain Vadeboncoeur, MD, Prof., Nicolas Peschanski, MD, PhD, Assoc. Prof., Damien Gaumont, MScEMS and Aurelio Bandiera for French; Jürgen Heuser, MD, Michael Holly, André Stahlhofen and Christiane Feldmann for German; Khaitov Sukhrob Sharipbayevich, MD, Abdikarimov Sultanbek, MD, İlkhomzhon Kalandarov, MD and Tansu Çelik, MD for Russian; and David Brun, MD for Spanish translation. As many of these contributors are followers of our blog, this App should be regarded as an achievement of drsmithsecgblog community and a nice example of how a dedicated community with shared interest can collaborate and give rise to useful products, despite the limitations of distance, language and geography.  

The App can be download from Apple App Store and Google Play Store in English, Turkish, French, German, Spanish, Chinese, Russian, Azerbaijani (according to your phone's language). We developed an Arabic version, but experienced some problems relating to Arabic alphabet, so it is unfortunately not included in the App for now.

For any comments, suggestions or errors please write as at 

For download: 

Enjoy !

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