In this edition of Tech Notes, we’ll cover three great evidence-based medical apps for doctors: one for determining whether a patient is suffering from a gout flare or something more serious, one for screening for substance abuse, and one that may help your patients quit smoking. All three apps are free to download.
App #1: Gout Diagnosis
When a patient presents with joint pain, there is always the concern that an acute infection is the cause of the pain. Often a physician will perform a joint fluid analysis by doing an arthrocentesis of the joint—a procedure that can be very painful—even though he or she suspects gout is the etiology of the symptoms. The Gout Diagnosis medical app utilizes evidence-based algorithms that are straight from the literature to help physicians determine without a joint fluid analysis whether gouty arthritis is the source of a patient’s pain.
This medical app is based on research by Hein Janssens, M.D., and Jaap Fransen, Ph.D., et al. Their original paper is called “A Diagnostic Rule for Acute Gouty Arthritis in the Primary Care Without Joint Fluid Analysis.” With the permission of the authors of the original study, Joshua Steinberg, M.D., a prolific physician app developer, turned their decision algorithm (which has been validated in the literature and is widely used) into a point-of-care medical app.
The Gout Diagnosis medical app is very easy to use at a patient’s bedside. It offers you seven Yes or No fields, six of which can be answered just by talking to the patient. The decision algorithm then gives you a score along with recommendations about whether or not a joint aspiration may be necessary.
The app is free and easy to use. Unfortunately, it is not available for the Android platform right now. In the past, I’ve asked Steinberg and other medical app developers why they often don’t create analogous Android versions, and they’ve said they see tremendously fewer downloads on Android than iOS.
Key ways to use this app. Use the app to determine if a gouty flare is causing joint pain or if an arthrocentesis should be performed. You can also use it to learn more about the original research by Janssens and colleagues and how it can be applied in clinical practice.
App #2: Ohn Sbirt
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based method to help identify and reduce dependence on alcohol and illicit drugs. Given the current opioid crisis, this methodology has been gaining huge traction in the clinical arena.
Though specific SBIRT training is available, it would be difficult to learn the method simply through reading about it. The SBIRT app, however, provides a great means for learning how to use the method.
Created in partnership with the University of California San Francisco (UCSF) and the Substance Abuse and Mental Health Services Administration (SAMHSA), the app not only takes you through the steps of SBIRT but also provides the evidence behind the methodology and offers informative content (such as in the Epidemiology section) to foster an understanding of the opioid crisis and other substance abuse problems plaguing the general patient population.
One of the coolest features of the app is the video modules included. These video modules (found in the Key Resources section) show you examples of SBIRT evaluations and help you understand how to use the approach with your patients.
Because the app has screening sections built in, it can be used at the point of care with patients, so even if you don’t have extensive training with the SBIRT process, you can use the app at a patient’s bedside. It even gives you scripts to help you ask key questions of your patients.
The medical app also has questions at the end of the app that allow you to track your progress with SBIRT. You are able to denote your comfort level with the process and do self-checks to see if you are mastering the technique.
Key ways to use this app. You can use this app to learn the SBIRT methodology, to go through the SBIRT process at a patient’s bedside and to learn more about substance abuse and how it’s affecting your patient population.
App #3: QuitGuide
Apps to help patients quit smoking have been around since the launch of the smartphone. Not all are created equal, however, and not all use evidence-based techniques in their processes.
QuitGuide is a free smoking cessation app launched by the National Cancer Institute. It’s great to see a medical app from such a reputable source, and unlike several of the currently popular smoking cessation apps in the App Store, this one follows the practice recommendations for smoking cessation from the Tobacco Control Research Branch. Though the app has been around for a while, there have been many iterations over the years that continue to improve its overall functionality.
Some of the key highlights of QuitGuide are its ability to integrate social networks (such as Facebook) into the decision to quit smoking. Users can even post custom messages about why they want to quit smoking. The app also has a personal, customized touch to help patients with smoking cessation.
Key ways to use this app. This app is a great resource for educating patients about why they should quit smoking. If patients are ready to quit smoking, consider prescribing this app to them.
December 1, 2017
Iltifat Husain, M.D.
