Apps for improving knowledge of clinical trials and point-of-care learning

Robert Hasty, DO, FACOI, Campbell University School of Osteopathic Medicine & Southeastern Health Administration, 300 West 27th Street, Lumberton, NC 28358.

E-mail address: rhasty@me.com.

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‌Journal club for iPhone and android

Journal clubs are a proven and important component of medical education programs.1 When physicians graduate from residency programs and enter practices without time dedicated to scholarly activity, it is a challenge to stay current on literature. Another challenge is the tremendous growth in the major landmark, acronym-named trials (possibly contributed to the finding that acronym-named trials are more likely to be published).2

One app that helps clinicians review and stay current on landmark trials in the literature is the Journal Club for iPhone and Android (currently $2.99 in the iTunes App Store as well as Google Play for Android users). The app covers major pivotal trials, including trials back in the 1990s, such as MADIT-II, JUPITER, ACCORD, ALLHAT,

and RALES. The app gives the bottom line, major points, related guidelines, study design, population, outcomes, and criticisms of each trial. The choice of the articles for the reviews seems to be careful and is focused on the trials that have affected guidelines or best medical practices in our modern era of evidence-based medicine. The reviews of each article are concise, academic, and unbiased. The work of dissecting the article has already been done. The trials can be categorized by specialty, disease, trial acronym, or recently added. The app might also be able to augment a journal club for a residency program or a medical school. It is also a quick and efficient way for a family physician to review and update their knowledge of these pivotal trials in any convenient setting.

Dragon medical search by Nuance communications

Computerized clinical decision support systems are quickly becoming an indispensable part of modern medical practice and have been proven to improve clinical decision making.3 The idea is that a healthcare provider uses technology to access evidence and knowledge in real time to improve patient care. Many electronic health records are now integrating clinical support tools into the systems to make accessing the support tools convenient.4 Some of the limitations with these systems is that they are tied to single sources of information or do not have the ability to easily search multiple databases.

One app that has made clinical decision support convenient is Dragon Medical Search by Nuance Commu- nication (currently available for free in the iTunes App Store).

‌It is made by the same company commonly used for dictation. When the app launches, it prompts the user to tap a button and speak. The app recognizes speech and instantly performs a multi-engine search, with Google search, Med- scape, Medline, IMO (ICD-9 results), and a drug database search. The results are delivered in a carrousel menu, where the user simply rotates through the various search engines to see the corresponding results. The speech recognition seems to be excellent and the results are delivered quickly (usually less than 1 second). The Medscape news results give relevant and recent results on the topic in question. The ICD-9 database results come from IMO, and the results were accurate on the conditions that are chosen. The compelling feature of this app is how quick and convenient it is to research multiple databases on medical conditions from any location.‌‌‌‌

Both of these applications offer unique and novel approaches for the family physician to improve or enhance their medical knowledge.

References

1. Neurology. 2007;68(15):E19–E20.

2. Acronym-named randomized trials in medicine — the ART in medicine study. N Engl J Med. 2006;355:101–102

3. Garg Amit X, Adhikari Neill KJ, McDonald Heather, et al: Effects of computerized clinical decision support systems on practitioner perform- ance and patient outcomes. J Am Med Assoc. 2005;293(10):1223– 1238. http://dx.doi.org/10.1001/jama.293.10.1223

4. O'Connor Patrick J, Sperl-Hillen JoAnn M, Rush William A, et al: Impact of electronic health record clinical decision support on diabetes care: a randomized trial. Ann Fam Med. 2011;9:12–21. http://dx.doi.org/ 10.1370/afm.1196