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16.12.10 | Medical Apps For The iPhone and iPod Touch: Neurology and Ear-Nose-Throat
Filed under: Education & Specialization, Medicine — Tags: , , , , , — Dr. Ivan @ 18:48 — Comments (0)

Yet another semester of the medical school has gone by and it’s again time to review some of the apps I have found useful in my studies.

Introduction

As a matter of fact it was a friendly email from Mr. Neal of Software Advice that reminded me that it was perhaps a time for a new write-up on medical apps for the iOS-based devices. He mentioned furthermore that the number of medical apps in the App Store increased from 1,544 to 10,275 in just one year, a statistic that pleasantly surprised me. This trend is certainly a welcome one – as I wrote in my previous blog entry it enables clinicians to have a wealth of information in their pockets which in the end hopefully will increase quality of care for the patients and help doctors avoid mistakes.

As the market for mobile medical apps grows, so does the need to be able to pick the best tools available – which was in part what prompted me to write this article. The semester I have just finished comprised two main subjects, namely neurology and ENT (ear-nose-throat), therefore I will be focusing only on these two specialties in the following review. If you wish to view a more complete list of medical apps, take a look here.

While neurology appears to be well represented in The Store, ENT is practically not represented at all, at least by stand-alone apps. In light of this I have chosen five apps to review:

The Apps

Merck Manual (Professional Edition) – yet again, this is probably on of the best all-around references available for the platform. It contains a number of useful and to-the-point articles on both neurology and ear-nose-throat disorders. As always, articles are somewhat hit-or-miss, but at least in the case of neurology cover most important topics. However, some omissions are still made, for example in describing various subtypes of ALS as well as Parkinson plus. ENT is somewhat more questionably covered and articles are noticeably shorter. However, Merck Manual is the best (and only) app to go into details about the various ear-nose-throat disorders, so in the end there perhaps might not be much choice for the practitioner. Otherwise it is also worth noting that the new version of this app has been upgraded with screen rotation, multitasking and more images, which all in all markedly improve reader experience and make it easier to get overview quickly. Priced at 34.99 USD.

Oxford Handbook Of Clinical Medicine (OHCM) – Strictly speaking, this handbook’s strength is its coverage of internal medicine. Surprisingly, it also holds up when it comes to certain neurology topics. Among such topics are internuclear ophthalmoplegia, stroke, hemorrhages as well as (even more unexpected) epilepsy. These are very well covered, both in discussion, simplicity of presentation and illustrations. Similarly to Merck, this app has been updated since my last review. Reportedly the dev team has been working on improving cross-referencing and layout. Unfortunately old bugs in browsing history and many of cross-references are still not fixed, which is completely unacceptable – at least at the asking price of 55 US dollars.

Dissection throat – Anatomy is best learnt at the dissection table together with an anatomy atlas. At some point medical soft devs realized this and tried to combine the two in one app. Some have succeeded, while others have not. This app is unfortunately an example of the latter. It is admittedly cheap – priced at 4.99 USD dollars, however the value is questionable at best. The interface is confusing. Photographs of dissected cadavers seem actually to be very nice, had they only been twice the resolution they are (and no, these pictures are so lo-res that it cannot be blamed on hardware limitations). Furthermore, far from enough structures are named. Although this is not a major concern, I prefer latin nomenclature instead of the americanized one.

Neurology i-pocketcards – This is an interesting app presenting B├Árm Bruckmeier neurology pocket cards (seven in total) in a digital format. Cards can be browsed in “classical” view, i.e. one by one, or single topics can be chosen from a specially designed table of contents. The TOC is unfortunately mostly useless due to poor organization. Cards are in vector format and can be zoomed and panned as desired. There is some lag in the classical view, but it is by no means a deal breaking flaw by any means. Contents is of high quality and includes schematic representation of innervation of upper and lower extremities, dermatomes, myotomes, mental status examination (SLUMS), various relevant scales (GCS etc), CSF analysis guidelines and more. This is a very nice pocket card collection and I have used it frequently as a quick reference in clinical practice. Price at the moment of writing is 3.99 USD.

3D Brain – This is a brilliant little app, free to download and packing an impressive amount of useful anatomical information. On startup user is greeted with a 3d-rendered brain. One can then rotate it freely, peel it layer by layer and color the various structures selectable from a list. Such interactivity is invaluable in learning the various structures of the brain – a versatility which an ordinary paper atlas cannot offer. This is especially important when it comes to the anatomy of the brain since many of the structures have challenging localization and form.

My recommendations

The two apps I use most on my iPod are Merck and OHCM which have time and again shown to be able to cover my needs within most fields. Lack of specific ENT apps is, however, disappointing, although the Merck Manual covers this topic in some depth. Neuro ipc and 3D Brain are nice supplements to the aforementioned handbooks which can be easily recommended.

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