Brian A. Wells, MD, MS, MPH
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I have reviewed this iPhone medical application for iMedicalApps.com.
The full review can be read here: http://www.imedicalapps.com/2010/10/md-ezlabs-iphone-medical-app-free/
Filed under: Apple iOS, Medicine, Reviews, Technology | Tagged: apple, diagnosis, ios, iPhone, labs, Medicine | Leave a comment »
Magical. Revolutionary. Incredible. Insanely great.
Or so Apple’s marketing tells us.
However, no one can deny that the iPad is a powerful, transformational device. The iPad has seen the fastest adoption rate in electronics product history with 4.5 million units per quarter. Apple has succeeded in doing what no other company has done: creating a true third category of device to bridge the smartphone to the laptop. The iPad is geared towards content consumption but also has application in content creation. And in recent months, it’s capabilities have expanded even more. Continue reading
Filed under: Apple iOS, Medicine, Reviews, Technology | Tagged: apple, computer, ios, ipad, linux, LogMeIn, microsoft, RDP, remote, remote access, software, tablet, Technology, VNC, Windows | Leave a comment »
See Part 1 of the iPhone Medical Software Review
Well, I just finished up Internal Medicine, so I’ll go over a few of the software programs that I found useful during the rotation. These are programs for the iPhone but there may be similar versions for Droid or other platforms. This review will cover three programs: Lab Tests, MedCalc and ECG Interpret. Continue reading
Filed under: Apple iOS, Medicine, Reviews, Technology | Tagged: cardiology, iPhone, laboratory, Medicine, science, software, Technology | Leave a comment »
As some of you know, I spend a great deal of my time in the hospital as a medical student, helping about where I can, doing blood work, running things around, talking with patients and answering random questions from residents and interns (a process called “pimping” which is kind of like a right of passage for medical students). I’ve already seen a great deal at the hospital; however, the one thing that has struck me more than any other is the patients I have seen.
I’ve seen a number of older patients, some just in for minor problems but others in as long-term residents. These are the people that have stuck with me. Elderly patients on ventilators, contracted, non-communicative, total care dependent with little to no hope of ever making a recovery. Elderly patients with varying forms of dementia brought on by old age, infection and improperly managed care. Continue reading
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Well, 2.5 weeks have gone by in the internal medicine training program at Coney Island hospital. I’ve seen a lot of interesting patients which I can’t discuss due to HIPAA and I’ve got to do some procedures. I’m hoping over the next few weeks, I’ll get to do more but it is what it is. I’m learning a lot at times but it really seems like self-directed study. My residents are good about teaching the treatment protocols for the patients but you really have to push to get involved. A lot of times, all I can do is take a history (assuming the patient speaks English – there’s a huge Russian population here) which, at first, was fun but now it’s pretty routine. I could sit in a chair with my eyes closed and probably do it just as well. Continue reading
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Well, now that the USMLE Step 1 and two years of medical school are out of the way, I thought I’d write a brief reflection on the experience including my thoughts on what was good, what was bad and how it can be improved. I’ve actually been meaning to write this for some time but my thoughts have been concentrated on other matters. Continue reading
Filed under: Medicine, Personal/Life | Tagged: doctor, education, medical school, Medicine, USMLE | Leave a comment »
Every so often, there comes a time when it is necessary for new ideas to challenge the old. A time when the edifices of the past should be swept away to make room for new ways of thinking, new approaches to problems and new perspectives as has happened countless times in history.
They once said that the Earth was flat. Explorers and scientists proved that it was round. Continue reading
Filed under: Medicine, Technology | Tagged: innovation, Medicine, Technology | Leave a comment »
So I’ve decided to be productive on the plane trip home and write a review on some of the medical applications for the iPhone (which, by the way, is by far the best mobile platform on the market – in fact, about 90% of this review was written on an iPhone).
I’ll be reviewing five of the more useful applications this go around: Eponyms, DxSaurus, Lab Values, ECG Guide and iMurmur.
Eponyms (http://code.google.com/p/eponyms-touch/) – Medicine loves eponyms. Sure, we could call it reactive arthritis but we’d rather say Reiter’s Syndrome. Maybe it’s an ego thing with doctors, maybe not but that’s the system we have. Eponyms provides an easy-to-use, searchable index of medical eponyms with a description of each. Nothing more, nothing less. Example listing: Ball’s disease – Intracerebral leukocytosis, a potentially fatal complication of acute leukemia (especially AML) when peripheral blast cell count >100,000/uL; leukemic cells capable of invading through endothelium and causing hemorrhage into brain. Condition not generally seen with CLL or CML.
Diagnosaurus DDx (http://www.unboundmedicine.com/store/iphone) – This is a differential diagnosis software package. The user can choose by disease, organ system or symptom and a list of differential diagnoses and etiologies are provided.
Pocket Lab Values – Quick reference for medical lab values broken up into categories such as cardiology, CSF, drug monitoring, endocrinology, hematology, etc. The program allows for seaches, marking of favorites and a catalog of recent lab views.
ECG Guide (http://www.QxMD.com) – This is a comprehensive ECG package providing everything from tutorials on ECG Basics to ECG Interpretation with segments, chamber enlargements, conduction and bundle branch blocks, arrhythmias and special pediatric cases.
iMurmur (http://phalanxdev.com) – This is a great program for learning how to detect and correctly diagnose murmurs. The reference murmur list is long and includes such murmurs as aortic regurgitation, aortic stenosis, atrial septal defect, Austin-Flint murmur, Mitral regurgitation, Paradoxical S2 split and many others. The program includes reference recordings that can be listened to to teach you what the various murmurs sounds like as well as a quiz where a murmur is played and you are asked to make a diagnosis. It’s a great, easy and accurate way to learn your way around heart murmurs with the learning being reinforced with the quiz function. Highly recommended for anyone that needs to learn proper auscultation or for those needing to brush up on their knowledge.
Filed under: Apple iOS, Medicine, Reviews | Tagged: apple, clinical, doctor, health care, hospital, ios, ipad, iPhone, Medicine, software, Technology | Leave a comment »
Think about the following the next time you read a medical journal.
“Rethinking the Admissibility of Medical Treatises as Evidence” . JP Lipton, M O’Connor, BD Sales. American J Law & Medicine 1991 17:209-248
“…there are scarcely any bars to eventual publication. There seems to be no study too fragmented, no hypothesis too trivial, no literature citation too biased or too egotistical, no design too warped, no methodology too bungled, no presentation of results too inaccurate, too obscure, and too contradictory, no analysis too self-serving, no argument too circular, no conclusions too trifling or too justified, and no grammar and syntax too offensive for a paper to end up in print.”
Sheps & Schecter: The assessment of diagnostic tests: a survey of current medical research. JAMA 1984, 2418:2420-21. This paper found a great potential for plagiarism and fraud. I’m sure there are many other examples, these are just the first two that come to mind for me.
The moral of the story? Read carefully and take the time to see if the article is really credible and, also importantly, passes the “so what?” test. Was there a sufficient sample size? Were the appropriate methodologies used? Where the correct statistical tests used? Do they support the conclusion? Does the conclusion matter, i.e. is it adding something important to the literature? If the conclusion seems suspicious, does the author have a history of publishing research in the field supporting the theory or method of thinking?
Follow the above questions each time you read a journal article and you may be amazed at some of the things that stand out in the literature.
As a side note, another good way to look at scientific claims is the 10 questions of the Baloney Detection Kit from Michael Shermer which are:
1. How reliable is the source of the claim?
2. Does the source make similar claims?
3. Have the claims been verified by somebody else?
4. Does this fit with the way the world works?
5. Has anyone tried to disprove the claim?
6. Where does the preponderance of the evidence point?
7. Is the claimant playing by the rules of science?
8. Is the claimant providing positive evidence?
9. Does the new theory account for as many phenomena as the old theory?
10. Are personal beliefs driving the claim?
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Bennet’s Classification for Reading the Medical Literature JAMA 1992, 267:920
Med student
Reads entire article, doesn’t understand what any of it means
Intern
Uses journals as pillows during nights on call [osmosis technique]
Resident
Wants to read entire article, eats dinner instead
Chief resident
Skips articles entirely, reads classified ads for jobs
Junior attending
Reads & analyzes everything so he can pimp the med students (See Imagining the Possibilities)
Senior attending
Reads abstracts only, quotes liberally to impress students and housestaff
Research attending
Reads and analyzes everything, including stats, in lieu of sex
Chief of service
Reads references only to see if he was referenced anywhere
Private attending
Reads Time & Newsweek for medical articles to keep up with patients
Emeritus attending
Reads entire article, doesn’t understand what any of it means
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The Voice of Reason 