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Top 15 Internal Medicine apps for iPhone and Android 2015

Discussion in 'Medical Students Cafe' started by Egyptian Doctor, May 25, 2015.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Best Medical Calculator: QxMD Calculate

    Having a solid medical calculator on your smartphone is essential and few have the breadth and depth of QxMD’s Calculate. Whether you’re calculating a Wells Score for a patient with pleuritic chest pain or a PORT score for suspected bacterial pneumonia,Calculate has you covered. The range of calculators is impressive, organized by subject area or alphabetically (though most users will probably use the search function). Most calculators include a brief explanation and the associated reference. Many references open directly in QxMD Read, another iMedicalApps favorite. For users that have institutional credentials, the full text is automatically downloaded as well. Overall, QxMD Calculate is a must have for internists and primary care physicians.

    QxMD Calculate


    Best Medical Literature Apps: QxMD Read and Journal Club
    Keeping up with medical literature is essential for clinicians in any specialty but can be particularly challenging for internal medicine clinicians given the breadth of knowledge required in day to day practice. Here we include two apps that provide very different but complementary functionality.

    QxMD Read

    QxMD’s Read is our favorite app for curating and keeping up with your favorite journals. Read gives you a centralized place to review each issue of JAMA, NEJM, AAFP, and any other journal you find useful. All users can get abstracts and Pubmed links to articles; users with institutional credentials can also pull full text PDFs within the app. There are other solid apps out there that offer simple functions. iMedicalApps Associate Editor Megan Von Isenburg, MSLS recently compared the leading choices out there for keeping up with the medical literature. Thanks to its speed, institutional integration, annotating functionality, and local storage options, Read came out on top with Docphin coming in a close second.

    Journal Club

    Journal Club is another outstanding and essential app that offers something different: the ability to critically review landmark studies that have impacted clinical practice. Rather than just the abstract or the manuscript, Journal Club gives everything from the context that led to the trial, the key facts about methodology like inclusion/exclusion criteria, the results, and a discussion with critical appraisal of the study. Perhaps you want to review the use of novel oral anticoagulants in patients with deep venous thrombosis. Just tap over to the Diseases section and select DVT – you can review AMPlFY (apixiban), CLOT (LMWH), MAGELLAN (rivaroxaban), and RECOVER (dabigatran).

    QxMD Read

    Journal Club

    Image Challenges: JAMA Network Challenge and NEJM Image Challenge
    NEJM Image Challenge

    Image challenges are a fun and quick way to learn about diseases, both the common ones and the zebras. The NEJM Image Challenge is usually the first one that comes to mind, with an outstanding app available for several years now. The app opens to a set of thumbnailed images – tapping on whichever one peaks your interest gets you to the vignette, answer choices, and short descriptions of the pathology that were submitted by clinicians and reviewed by NEJM editors. A big limitation here is that the app is only available for iPhone.

    JAMA Network Challenge

    More recently, JAMA has jumped into the action with the JAMA Network (JN) Challenge app for iOS (iPhone and iPad) and Android. This app requires a free JN account and offers timed image challenges sequentially (rather than a menu of choices) with high quality explanations of the associated pathology that are more in depth than those in the NEJM Image Challenge. The app’s design is arguably cleaner and more user-friendly than the NEJM app. On the other hand, it’s more rigid in structure than theNEJM Image Challenge in that each image challenge is timed, randomly selected, and presented in a fixed order, five at a time. The JN Challenge is an outstanding free choice and a serious contender for the best in this class.

    Honorable mention: Figure 1

    Another app worth mentioning, often described as a doctor’s Instagram, which offers a large library of user-submitted images and vignettes. Users can post answers and comments to each image, creating some pretty interesting discussion threads around both diagnosis and subsequent management. The limitation here is that answers, entered into the comment thread by whoever submitted the image, tend to be a lot more variable in terms of quality and depth of information. For clinicians interested in more discussion and engagement with other clinicians.

    NEJM Image Challenge

    • iMedicalApps full review here
    • Price: $2.99
    • Find the app on iTunes
    JAMA Network Challenge
    The Cardiology Pack: ACC Anticoag Evaluator & ASCVD Risk Estimator
    For internal medicine and primary care clinicians, a lot of visits focus on cardiac problems. So having a strong set of tools to turn to in those visits is crucial. The two we recommend are from the American College of Cardiology and American Heart Association.

    Anticoag Evaluator

    Atrial fibrillation is one common problem that is frequently managed by internists and for that we recommend the ACC’s free Anticoag Evaluator. This app offers a quick and easy way to calculate the CHADS2-VASC score and HAS-BLED score. Its real strength though is that it then gives not only the risk of stroke without therapy, but also gives the risk reduction and bleeding risk percentages with warfarin, aspirin, and all approved novel oral anticoagulants except edoxoban (which was very recently approved) as well as dosing information. It’s an outstanding tool for discussions about initiating anticoagulation in patients with a new diagnosis of atrial fibrillation. Unfortunately it does not yet include recommendations on transitioning between different types of therapy; nonetheless, it’s a great free tool for the occasional visits for palpitations.

    ASCVD Risk Estimator

    The second app in our cardiology pack is the free ASCVD Risk Calculator. The 2013 ACC/AHA guidelines introduced an entirely new approach to primary prevention of heart disease, for many patients based on the new pooled cohort equations that replaced the Framingham risk estimates. This app is the quickest way to calculate a 10-year ASCVD risk estimate and find the associated guideline recommendation. In addition, the app includes background information directed at both clinicians and patients, the latter of which can be a useful guide to clinicians on how to explain this whole approach. There’s also information on the associated lifestyle modification guidelines. While many calculator apps include the risk estimate equations, this app gives internists a quick and easy way to review the entire set of associated guidelines as well.

    ACC Anticoag Evaluator
    ASCVD Risk Estimator
    Medical News: MedPage Today
    MedPage Today

    Now more than ever, staying up to date means more than just reading the latest issues of NEJM and JAMA. Controversies around the 2013 lipid management guidelines, the evolution of health insurance exchanges, and changes and challenges to physician re-certification are just a few of the headlines over the past year that impact most clinicians. To keep up with that range of healthcare news, MedPage Today has long been an iMedicalApps favorite. The app has a clean, simple design with articles written by an experienced team of medical reporters and reviewed by clinicians. The app also includes opportunities to earn CME, offered in collaboration with the University of Pennsylvania School of Medicine.

    Honorable mention: Medscape’s MedPulse

    A more recent addition to this space is Medscape’s MedPulse app. The app includes medical news on a broad range of specialties and topics pulled from both Medscape and other sources. Generally, the clinician review in particular makes MedPage Today my first go-to for news about clinical trials, new guidelines, and similar news. Where the app really excels is in its beautiful design and unique areas like a cleverly designed section that provides curated news pulled from Twitter. The expert columns are also great, like those from Stanford Medicine chief Bob Harrington, Johns Hopkins infectious disease expert Paul Auwaerter, and more. Its definitely an app worth checking out.

    MedPage Today
    MedPulse
    • iMedicalApps full review here
    • Price: Free
    • Find the app on iTunes
    General Medical Reference: UpToDate, Dynamed, and Medscape
    UpToDate

    For many of us, especially my residents and fellows, UpToDate is the medical application of choice for answering clinical questions. This app is ideal at the point of care in clinic, on the ward, in the ICU, during rounds, morning report, and anywhere really. It is the most comprehensive app available for internal medicine and is available as a mobile app for individual and institutional subscribers to UpToDate.

    Dynamed

    That said, UpToDate isn’t the only choice out there for quick medical reference tools. We recently wrote about 3 alternatives to UpToDate, looking at reference apps that hold their own against UpToDate. In particular, we were fans of Dynamed. Although not as comprehensive as UpToDate, Dynamed is one of the most evidence-based apps available. Previously hampered by a poor user interface, Dynamed recently released a new mobile app that is much improved compared to the old version. We recently reviewed the new version of Dynamed and found it the closest competitor to UpToDate yet.

    Medscape

    Finally, don’t count out the free Medscape app. Medscape is an interesting mix of an app! Part clinical reference, part drug guide, part news aggregator, part CME app, the Medscape app is a true jack of all trades. Remember that many apps, including Medscape, share user information with the pharmaceutical industry. The entire app can be used offline. Unfortunately, its medical disease and condition reference contains only 4,400 conditions compared to UpToDate’s nearly 10,000!

    Again, see our recent review of alternatives to UpToDate where we look at Dynamed and Medscape along with a few other apps that are worth considering.

    UpToDate

    Dynamed

    Medscape

    Drug References: Epocrates, Lexi-Comp, Micromedex
    Epocrates

    Epocrates has been my go-to drug guide since medical school. It has changed a lot since then, but remains the friendliest, fastest drug guide available. If you purchase the premium version, Epocrates Essentials, you receive additional apps including a medical calculator, point of care tables, alternative medicines, infectious disease guide, and a disease content section developed in conjunction with the British Medical Journal. Further, while Epocrates might have a free version, they do have a close relationship with pharma, as we have highlighted prior in an article: “Why free medical apps aren’t really free“.

    Lexi-Comp
    For the most detailed and complete drug information available you can’t go wrong withLexi-Comp. This app really shines when I am on the wards and need more detail about a particular medication. Lexi-Comp doesn’t come cheap, but many institutions provide free access to Lexi-Comp for their providers so make sure to check with your medical librarian or hospital pharmacy. The complete version of Lexi-Comp includes multiple embedded apps including guides for toxicology, infectious disease, natural products, 5-minute clinical consult, and many others.

    Micromedex
    An outstanding and significantly cheaper alternative to Epocrates Essentials or Lexi-Comp is Micromedex. This app may be available to readers via institutional subscription, but can be obtained on its own for a small annual fee. Micromedex provides a similar level of detail as Lexi-Comp on issues such as pharmacokinetics that are missing from Epocrates. However, I find the user interface and graphics to be a step below the alternatives.

    Epocrates
    • Price: Free for Epocrates Rx, $159.99/year for Epocrates Essentials
    • Find the app on iTunes and Google Play
    Lexi-Comp
    • Price: $175/year Lexi-Comp Clinical Suite to $595/year Lexi-Comp Complete + Online
    • Find the app on iTunes and Google Play
    Micromedex
    Infectious Disease Reference: Johns Hopkins ABX Guide

    The Johns Hopkins ABX guide is my go-to “bug” guide. Although it utilizes the same Infectious Disease Society of America (IDSA) treatment recommendations as theSanford Guide, I find its user interface more elegant and efficient. By the time the Sanford Guide “loads”, I can already be reading antibiotic recommendations in the Hopkins app. Furthermore, Hopkins gives more detailed information about the disease itself, from signs and symptoms to lab information. The app also provides detailed information on antibiotics, antivirals, etc. that are typically only found in pharmacy textbooks. This information is very useful and frequently eliminates the need for me to look up more about a particular condition or treatment in UpToDate, Dynamed or Lexi-Comp.

    Johns Hopkins ABX Guide
    Geriatrics Reference: Geriatrics at Your Fingertips

    The American Geriatric Society (AGS) has released a number of very useful geriatrics apps over the years, but Geriatrics at Your Fingertips remains the most comprehensive. It has been a standard “read” for all of my residents on their geriatrics rotation. A popular pocket guide since 1998, the mobile version has seen several different versions and publishers, most currently Atmosphere Apps. This latest version is the most aesthetically pleasing and easy to use of any of its mobile predecessors. The app is essentially a miniature geriatrics textbook with chapters on geriatric assessment, appropriate prescribing, dementia and delirium, falls, etc. The appendices contain many handy assessment instruments from the Mini-Cog and Geriatric Depression Scale to an Opioid Risk Tool. Unfortunately, most of these tools are really just page translations and not as useful as some dedicated calculators available. The app is updated annually, but some of the recommendations are not “up to date” with current medical literature or are clearly expert opinion based. Some may also find the AGS’s iGeriatrics app useful for accessing many of their position statements, such as the Beers Criteria, and a bargain at $2.99.

    Geriatrics at your fingertips
    Dermatology Reference: VisualDx

    Although many of us are comfortable with common skin conditions, rashes that defy easy pattern recognition do pop up and can be important clues to systemic disease. Here, VisualDx has replaced my need to reach for a dermatology text. The app allows you to search by topic and see pictures, diagnostic signs/symptoms, differential diagnosis, and treatment options. What really stands out is its ability to help build a differential diagnosis. You plug in what you are seeing using common dermatology terms, other physical exam findings, vitals, and history and it generates a handy differential diagnosis. This is very handy, especially when your dermatology consultant is not readily available. I really haven’t found an alternative dermatology app that I prefer, but some reasonable alternatives include DoctorDerm and The Color Atlas of Family Medicine.

    VisualDx
    • iMedicalApps full review here
    • Price: $199.99 Essentials; $299.99 Complete
    • Find the app on iTunes and Google Play

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    Egyptian Doctor, May 25, 2015
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