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iMedicalApps: Best of 2018 … So Far

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iMedicalApps: Best of 2018 … So Far

Eight winners, eight months in

MedpageToday

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There are still a few months left in 2018, but since January, medical app developers for both iOS and Android have been busily releasing new medical apps. Many of the most popular ones are consumer-facing, patient-based apps. Are there any worthy medical apps for doctors, nurses, and other providers? Yes!

We took a look at our review archives and found the best medical apps of 2018… so far. We’re sure many more will be released before January, but we wanted to share those medical apps from 2018 that we think you’ll find useful and ensure that you’re practicing evidence-based medicine at the point of care.

Here they are, in no particular order:

The Best Medical Apps of 2018 (so far)

TreatHF

You probably already know that heart failure is one of the top causes of morbidity and mortality – it accounts for 1 in 9 deaths. Recently, the American College of Cardiology (ACC) guideline revised the terminology from the old systolic and diastolic heart failure to heart failure with preserved (HfPEF) or reduced ejection fraction (HFrEF). Etiology and treatment for both can be confusing for providers and patients.

Luckily, the ACC released the TreatHF app that combines their 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment and the 2017 ACC/AHA/HFSA Focused Update of their 2013 HF guideline into a convenient point-of-care app for patients with stage C HFrEF. Providers input data on patient’s current use of standard medications and enter potential indications/contraindications to other medications or treatments. The app provides tailored advice for titrating current medications as well as additional drugs and/or other specific evidence-based treatments for the patient. Providers can email themselves a summary and reference more detailed information on all available treatments in the therapy reference section of the app.

Preconception Care

There are many resources available for preconception care, but most have not been available in app form. There is a fabulous National Curriculum on Preconception Care available for free as part of the national Preconception Health and Health Care Initiative (PCHHC). Until now, this resource was only available online. Thanks to Dr. Joshua Steinberg, we now have a Preconception Care Quick Ref derived from the PCHHC toolkit. The PCHHC is coordinated by the Center for Maternal and Infant Health, the UNC, Chapel Hill Medical School. It is comprised of over 70 different organizations with the vision “that all women and men of reproductive age will achieve optimal health and wellness…”

ACP CPG App

The American College of Physicians (ACP) represents one of the largest specialties in the country – general internal medicine. The ACP has also been producing high-quality clinical practice guidelines for decades which are published in the Annals of Internal Medicine. Their strict adherence to the evidence has caused some controversy. For example, their recommendations on the lack of evidence for pelvic exams in asymptomatic women were not well-received by ACOG (even though the ACP got it right). They published similarly correct yet controversial takes on the evidence regarding the length of osteoporosis treatment, when to repeat DEXA scans, and treatments for low back pain. The only guideline that perhaps seems not entirely in line with current evidence is their guideline on the treatment of hypertension in patients over 60 years old. Surprisingly, the evidence review did not fully embrace the recent SPRINT trial leaving the guideline with a 150 mm Hg cut-off for treatment for most patients despite some compelling evidence to the contrary from SPRINT (and the recent AHA/ACC guideline).

Now all of the ACP’s current and past guidelines can be reviewed easily in a straightforward app called ACP Clinical Guidelines. The app includes all current and past guidelines in alphabetical order with brief summaries of the guidelines, key recommendations, talking points for patients, and links to the full guideline PDF and the web version on the Annals website.

EBM Stats Calc

One of my passions is practicing and teaching evidence-based medicine (EBM). But where should providers go for EBM stats? For busy primary care providers and any medical student, resident or even many residency faculty members, applying EBM stats at the point of care is just too complicated. You can’t do the math in your head and the calculations going from pre- to post-test probability are mind-boggling. Many of the top medical references such as UpToDate, DynamedPlus, Essential Evidence, and Medscape contain great EBM information and some include useful stats such as the Number Needed to Treat (NNT) and Number Needed to Harm (NNH). However, these can be time-consuming to find and depending on your subscription/resource may require an internet/cellular connection. Current medical calculators such as MdCalc, QxCalculate, MediMath, and MedCalc (now MedCalx) include some of these basic EBM stats. So far the most complete EBM calc app is MedCalc 3000 EBM Stats, but it costs $9.99.

Now there’s the EBM Stats Calc. The app does the brain-melting calculations for NNT/NNH/NNS, post-test probability from sensitivity/specificity, and post-test probability from likelihood ratios. Each calculator includes a detailed discussion with practical examples. It’s well referenced and effortless to use.

QuitMedKit

Tobacco use remains the number-one preventable cause of morbidity and mortality in the United States and worldwide. So it’s important for providers to get involved. That’s where the QuitMedKit can help. The app was developed by Alexander V. Prokhorov, MD, PhD, and Mario Luca, MS, at MD Anderson. It’s intended to assist healthcare providers in counseling and treatment of tobacco dependence. The app includes the evidence-based 5A’s approach, information on medications for cessation, tips on motivational interviewing, graphics to assist in cessation, and links to online resources.

CDC Anticoagulation Manager

With so many potential patient care scenarios that require anticoagulation and now many more choices for treatment, where can a provider turn for an excellent point-of-care resource? One option for non-valvular atrial fibrillation is the outstanding American College of Cardiology’s Anticoag Evaluator or the MAQI2 Anticoagulation Toolkit from the University of Michigan. Both are good options. But for the best medical apps of 2018, we chose CDC Anticoagulation Manager that covers an even wider gamut of medical conditions requiring anticoagulation including VTE, fetal loss, HIT, and arterial thrombosis in addition to atrial fibrillation. It might just become your go-to source.

The Sublux App

What apps are available that teach the basics of plain radiography for more than just chest X-rays and ortho trauma? Are there any that include management of the pathology as well? Yes! It’s the Sublux app by Core Medical Apps. Sublux includes a primer on the basics of X-ray interpretation, a body/system approach to plain radiography, and over 200 different pathologies with evidence-based treatments. Best known for their app called Core Clerkships, the authors are a group of medical students/residents who met at Tufts. Sublux is their latest app.

CDC PTT Advisor

One of the more common tests ordered, particularly on inpatients, are necessary coagulation studies such as the PT, INR, and PTT. These tests are frequently monitored in patients on anticoagulation medications and are part of the standard evaluation of patients with anemia, bleeding issues, and liver abnormalities. Although many apps already exist to assist providers in selecting and monitoring anticoagulation such as the excellent American College of Cardiology’s Anticoag Evaluator, few assist providers with abnormal coags.

Using several diagnostic algorithms for both children and adults, the app walks providers through the workup of an abnormal PTT. The app was developed by a group of pathologists from Vanderbilt, University of Alabama, and Cedars-Sinai Hospital. Interestingly, a separate group of physicians attempted to test the accuracy of the app in aiding physician decision making. Most apps have no such evidence, but the CDC PTT Advisor now does. The study was just published online ahead of print in the Journal of the American Medical Informatics Association. The authors created eight clinical vignettes with normal and abnormal PTT’s and tested 46 internal medicine physicians at seven different clinical sites. The authors analyzed data from 368 vignettes comparing physician performance using the app to standard clinical decision support. In the vignettes where the CDC PTT Advisor app was used, physicians significantly outperformed standard clinical decision support with correct test ordering and diagnostic decision making (83% versus 70% correct), physician confidence in their decisions (7.5 versus. 6.3 on a 10 point scale), and time to vignette completion (3:02 versus 3:53 minutes).

This post originally appeared on iMedicalApps.com.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. government.

2018-09-14T17:30:00-0400
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At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.

Medpage Today

iMedicalApps: Best of 2018 ... So Far

Eight winners, eight months in

MedpageToday

  • by

There are still a few months left in 2018, but since January, medical app developers for both iOS and Android have been busily releasing new medical apps. Many of the most popular ones are consumer-facing, patient-based apps. Are there any worthy medical apps for doctors, nurses, and other providers? Yes!

We took a look at our review archives and found the best medical apps of 2018... so far. We're sure many more will be released before January, but we wanted to share those medical apps from 2018 that we think you'll find useful and ensure that you're practicing evidence-based medicine at the point of care.

Here they are, in no particular order:

The Best Medical Apps of 2018 (so far)

TreatHF

You probably already know that heart failure is one of the top causes of morbidity and mortality – it accounts for 1 in 9 deaths. Recently, the American College of Cardiology (ACC) guideline revised the terminology from the old systolic and diastolic heart failure to heart failure with preserved (HfPEF) or reduced ejection fraction (HFrEF). Etiology and treatment for both can be confusing for providers and patients.

Luckily, the ACC released the TreatHF app that combines their 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment and the 2017 ACC/AHA/HFSA Focused Update of their 2013 HF guideline into a convenient point-of-care app for patients with stage C HFrEF. Providers input data on patient's current use of standard medications and enter potential indications/contraindications to other medications or treatments. The app provides tailored advice for titrating current medications as well as additional drugs and/or other specific evidence-based treatments for the patient. Providers can email themselves a summary and reference more detailed information on all available treatments in the therapy reference section of the app.

Preconception Care

There are many resources available for preconception care, but most have not been available in app form. There is a fabulous National Curriculum on Preconception Care available for free as part of the national Preconception Health and Health Care Initiative (PCHHC). Until now, this resource was only available online. Thanks to Dr. Joshua Steinberg, we now have a Preconception Care Quick Ref derived from the PCHHC toolkit. The PCHHC is coordinated by the Center for Maternal and Infant Health, the UNC, Chapel Hill Medical School. It is comprised of over 70 different organizations with the vision "that all women and men of reproductive age will achieve optimal health and wellness..."

ACP CPG App

The American College of Physicians (ACP) represents one of the largest specialties in the country – general internal medicine. The ACP has also been producing high-quality clinical practice guidelines for decades which are published in the Annals of Internal Medicine. Their strict adherence to the evidence has caused some controversy. For example, their recommendations on the lack of evidence for pelvic exams in asymptomatic women were not well-received by ACOG (even though the ACP got it right). They published similarly correct yet controversial takes on the evidence regarding the length of osteoporosis treatment, when to repeat DEXA scans, and treatments for low back pain. The only guideline that perhaps seems not entirely in line with current evidence is their guideline on the treatment of hypertension in patients over 60 years old. Surprisingly, the evidence review did not fully embrace the recent SPRINT trial leaving the guideline with a 150 mm Hg cut-off for treatment for most patients despite some compelling evidence to the contrary from SPRINT (and the recent AHA/ACC guideline).

Now all of the ACP's current and past guidelines can be reviewed easily in a straightforward app called ACP Clinical Guidelines. The app includes all current and past guidelines in alphabetical order with brief summaries of the guidelines, key recommendations, talking points for patients, and links to the full guideline PDF and the web version on the Annals website.

EBM Stats Calc

One of my passions is practicing and teaching evidence-based medicine (EBM). But where should providers go for EBM stats? For busy primary care providers and any medical student, resident or even many residency faculty members, applying EBM stats at the point of care is just too complicated. You can't do the math in your head and the calculations going from pre- to post-test probability are mind-boggling. Many of the top medical references such as UpToDate, DynamedPlus, Essential Evidence, and Medscape contain great EBM information and some include useful stats such as the Number Needed to Treat (NNT) and Number Needed to Harm (NNH). However, these can be time-consuming to find and depending on your subscription/resource may require an internet/cellular connection. Current medical calculators such as MdCalc, QxCalculate, MediMath, and MedCalc (now MedCalx) include some of these basic EBM stats. So far the most complete EBM calc app is MedCalc 3000 EBM Stats, but it costs $9.99.

Now there's the EBM Stats Calc. The app does the brain-melting calculations for NNT/NNH/NNS, post-test probability from sensitivity/specificity, and post-test probability from likelihood ratios. Each calculator includes a detailed discussion with practical examples. It's well referenced and effortless to use.

QuitMedKit

Tobacco use remains the number-one preventable cause of morbidity and mortality in the United States and worldwide. So it's important for providers to get involved. That's where the QuitMedKit can help. The app was developed by Alexander V. Prokhorov, MD, PhD, and Mario Luca, MS, at MD Anderson. It's intended to assist healthcare providers in counseling and treatment of tobacco dependence. The app includes the evidence-based 5A's approach, information on medications for cessation, tips on motivational interviewing, graphics to assist in cessation, and links to online resources.

CDC Anticoagulation Manager

With so many potential patient care scenarios that require anticoagulation and now many more choices for treatment, where can a provider turn for an excellent point-of-care resource? One option for non-valvular atrial fibrillation is the outstanding American College of Cardiology's Anticoag Evaluator or the MAQI2 Anticoagulation Toolkit from the University of Michigan. Both are good options. But for the best medical apps of 2018, we chose CDC Anticoagulation Manager that covers an even wider gamut of medical conditions requiring anticoagulation including VTE, fetal loss, HIT, and arterial thrombosis in addition to atrial fibrillation. It might just become your go-to source.

The Sublux App

What apps are available that teach the basics of plain radiography for more than just chest X-rays and ortho trauma? Are there any that include management of the pathology as well? Yes! It's the Sublux app by Core Medical Apps. Sublux includes a primer on the basics of X-ray interpretation, a body/system approach to plain radiography, and over 200 different pathologies with evidence-based treatments. Best known for their app called Core Clerkships, the authors are a group of medical students/residents who met at Tufts. Sublux is their latest app.

CDC PTT Advisor

One of the more common tests ordered, particularly on inpatients, are necessary coagulation studies such as the PT, INR, and PTT. These tests are frequently monitored in patients on anticoagulation medications and are part of the standard evaluation of patients with anemia, bleeding issues, and liver abnormalities. Although many apps already exist to assist providers in selecting and monitoring anticoagulation such as the excellent American College of Cardiology's Anticoag Evaluator, few assist providers with abnormal coags.

Using several diagnostic algorithms for both children and adults, the app walks providers through the workup of an abnormal PTT. The app was developed by a group of pathologists from Vanderbilt, University of Alabama, and Cedars-Sinai Hospital. Interestingly, a separate group of physicians attempted to test the accuracy of the app in aiding physician decision making. Most apps have no such evidence, but the CDC PTT Advisor now does. The study was just published online ahead of print in the Journal of the American Medical Informatics Association. The authors created eight clinical vignettes with normal and abnormal PTT's and tested 46 internal medicine physicians at seven different clinical sites. The authors analyzed data from 368 vignettes comparing physician performance using the app to standard clinical decision support. In the vignettes where the CDC PTT Advisor app was used, physicians significantly outperformed standard clinical decision support with correct test ordering and diagnostic decision making (83% versus 70% correct), physician confidence in their decisions (7.5 versus. 6.3 on a 10 point scale), and time to vignette completion (3:02 versus 3:53 minutes).

This post originally appeared on iMedicalApps.com.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. government.

2018-09-14T17:30:00-0400
Comments

Accessibility Statement

At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.



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Dr Irfanullah Khan Born: 15th July,1994 in Khagram,Dir Upper KPK Pakistan. Others names:Doctor Irfo,Peshoo Education:Pharm-D Scholar Graduated from Abasyn University Peshawar. Occupation:Clinical Pharmacist,Doctor,Entrepreneur. Home Town:Dir Upper Height: 6 feet. Website:Iukmedonline.com

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