This issue’s apps include a great statin management app from the American College of Cardiology, an STD treatment app from the Centers for Disease Control and Prevention, and an evidence-based cancer-screening app. In addition to helping physicians make the best treatment decisions for their patients, all three of these apps are free to download and use.
STD Treatment Tx Guide by the CDC
The CDC isn’t new to the App Store—their STD Tx Guide app has been in the store since 2013. Whereas previous iterations of STD Tx Guide were OK, their most recent version of the app is a must-have for physicians. This version, released in January 2016, contains the most recent updates to treatment algorithms for sexually transmitted diseases.
In addition, the app itself now has key functions that were not present prior. When you open the app, you can go through the conditions immediately. Not only are sexually transmitted diseases listed, but so are other conditions such as sexual assault.
My favorite feature of the updated app is that the information is now native to the app. Previously, all the information for treatments and conditions had to be accessed online through the app, but now, almost all the information is native. This means you can use the app even when you don’t have an internet connection, and it loads significantly faster than before.
Ways the app could improve. A more thorough “More Info” section for each of the conditions would improve this app. Currently this section has short paragraphs and great references, but more details about diagnosing, managing and caring for conditions would be welcome.
The “Sexual History” section could also be improved if it lost its PDF feel and were instead optimized for mobile devices.
Key ways to use this app. Use this app if you need the latest information on the medication regimen for an STD, if you have a pregnant patient and need to figure out what medication would be OK during pregnancy, or if you have a patient who is allergic to penicillin and needs an alternative treatment regimen.
ePrognosis: Cancer Screening
ePrognosis is a decision support app created by the authors of the popular GeriPal blog in collaboration with health experts at the University of California, San Francisco and Harvard Medical School. This cancer-screening app focuses on colorectal and breast cancer screening for geriatric patients.
One of the key tenets of the app is the understanding that screening and testing can lead to harm. The authors list, for example, some potential harms of colorectal cancer screening, such as severe abdominal pain and the need for hospitalization. These potential harms have been well documented in medical literature, so one goal of the app is to help physicians and patients determine whether screening would benefit them or cause more harm than good.
ePrognosis lets you choose colorectal or breast cancer screening or both and then presents you with a standard set of questions. These questions take approximately two to three minutes to fill out. It would be much quicker to flip through the questions while you’re with the patient. For example, one question asks whether the patient has difficulty walking a quarter mile without help from other individuals or special equipment.
Once you go through all of the prompts and questions, you are presented with a meter that ranges from “Harms” to “Benefits.” The meter’s arrow shows to what extent the decision tools within the app recommend screening for that particular patient. My favorite part of the app is the “Learn More” section. In this section you are able to tell your patient their chance of harm if the path of screening or testing is chosen. ePrognosis presents this in an easy-to-explain format with a graph that shows 1,000 units (to represent patients) and highlights how many of those units would experience harm in the first year due to testing. It’s a great graphical representation that makes sense for patients.
Ways the app could improve. It would be great if more data about the decision tools ePrognosis uses were presented in the app. You are able to access information about the decision tools used in the “Information” section, but the “Calculations” section isn’t very detailed and can be difficult to go through. Additionally, there is currently not an Android version.
Key way to use this app. Use this app with elderly patients for whom you are considering colorectal or breast cancer screening. Discuss the results with your patients and show them the graph in the “Learn More” section to help them see how many individuals would be benefitted versus harmed by testing based on their individual variables.
Statin Intolerance by American College of Cardiology
The American College of Cardiology has a great number of medical apps in the App Store. One of my favorites is Statin Intolerance.
This app is useful because the fact that a patient reports muscle aches does not necessarily mean he or she is truly intolerant to statins. If a patient has side effects to the first statin prescribed, cardiologists will often try utilizing other types of statins. Statin Intolerance helps you determine which would be best.
The app has three basic sections: Evaluate, Follow-Up and Compare. The “Evaluate” section is the most comprehensive; this is where you input risk factors, medications, patient demographics and symptoms. This section takes a few minutes to complete and is pretty detailed. In the “Follow-Up” section, you are presented with more specific advice such as titration of meds and other types of statins to use. In the “Compare” section, you can learn significantly more details about statins, such as their half-lives and whether they are lipophilic or not.
Ways the app could improve. The “Evaluate” section could be designed significantly better. Overall this section feels cumbersome to use.
Key way to use the app. If you have a patient who is having side effects to the first statin prescribed, you should consider using this app.
Iltifat Husain, M.D., is the editor-in-chief and founder of iMedicalApps.com, the leading physician publication on digital medicine, and an assistant professor of emergency medicine at Wake Forest University School of Medicine.