A comparison of two smartphone applications and the validation of smartphone applications as tools for fluid calculation for burns resuscitation

We conducted a randomised, blinded study to compare the accuracy and perceived usability of two smartphone apps (uBurn© and MerseyBurns©) and a general purpose electronic calculator for calculating fluid requirements using the Parkland formula. Bespoke software randomly generated simulated clinical data; randomly allocated the sequence of calculation methods; recorded participants’ responses and response times; and calculated error magnitude. Participants calculated fluid requirements for nine scenarios (three for each: calculator, uBurn©, MerseyBurns©); then rated ease of use (VAS) and preference (ranking), and made written comments. Data were analysed using ANOVA and qualitative methods. The sample population consisted of 34 volunteers who performed a total of 306 calculations. The three methods showed no significant difference in incidence or magnitude of errors. Mean (SD) response time in seconds for the calculator was 86.7 (50.7), compared to 71.7 (42.9) for uBurn© and 69.0 (35.6) for MerseyBurns©. Both apps were significantly faster than the calculator (p = 0.013 and p = 0.017 respectively, ANOVA: Tukey's HSD test). All methods showed a learning effect (p < 0.001). The participants rated ease of use on a VAS scale with a higher score indicating greater ease of use. The calculator was easiest to use with a mean score (SD) of 12.3 (2.1), followed by MerseyBurns© with 11.8 (2.7) and then uBurn© with 11.3 (2.7). The differences were not found to be significant at the p = 0.05 level after using paired samples t-test and a multiple correction was applied manually. Preference ranking followed a similar trend with mean rankings (SD) of 1.85 (0.17), 1.94 (0.74) and 2.18 (0.90) for the calculator, MerseyBurns© and uBurn© respectively. Again, none of these differences were significant at the p = 0.05 level.