By Tom Stibolt, MD, Mobile Musings Column Editor

As we all are using mobile devices in our everyday lives and likely our practices as well, it seems time to once again look at what is available. I would like to start with a caveat. An article in Evidence Based Medicine published in 2012 (volume 18, number 3, page 90) investigates the quality and safety of available medical applications. They note a number of problems. First, there is an unfortunate lack of clinical involvement in medical apps. Authors, manufacturers and distributors are not listed and references are unavailable or out-of-date. They looked at several clinical apps to help with arterial blood gas interpretation and found that most are irrelevant, non-evidence-based or even dangerous due to inaccurate content. Second, these apps risk harm in a clinical setting. An app designed to assess disease severity, was recalled from app stores because it gave erroneous scores in comparison with those calculated using the published formula. Fortunately, there seems to be no evidence of patient harm from an app so far but this could well occur. Third, regulatory agencies including the U.S. Food and Drug Administration are trying to come up with reasonable guidelines for which applications they need to regulate. The article goes on to suggest changes in the application development process that should result in better, safer, and more useful applications.

An article the same year in the online Journal of Medical Internet Research (volume 14, number 5, page e128) notes that more high-quality studies are needed to better understand the role these apps will have in our practices. They recommend several popular smartphone applications for physicians that are lacking in evidence but promising, and they discuss future studies to support their use. This list is difficult to improve upon, so I will go through it with a few of my own thoughts. Most apps are available for both iOS and Android.

AHRQ ePSSa is an app from the U.S. Agency for Healthcare Research and Quality. It is designed to help primary care clinicians identify clinical preventive services that are appropriate for their patients. One can use the tool to search and browse U.S. Preventive Services Task Force recommendations on the web or on a mobile device.

Diagnosaurus is a differential diagnosis application that I had seen many years ago as a standalone program for a desktop computer. It is now available as a mobile app. It provides a list of potential diagnoses based on symptom, organ system, or disease. It requires an AccessMedicine subscription which may be available through your institution or can be purchased for $395 a year.

Doximity is a social networking service for physicians. It allows connection with colleagues from various times in your career. It also provides the ability to communicate with your contacts. The service is free.

DynaMed is a medical and pharmacologic reference created and supported by EBSCO, a publisher and provider of research databases. It provides a range of useful information to health care professionals at the point-of-care. The original development began in 1995 by Brian Alper, MD, at Hahnemann University. It employs a systematic evidence-based process to keep information current.

Epocrates, I suspect, is an app that nearly everyone is already using. It is a free, up-to-date pharmacologic reference which can be upgraded to a paid medical reference which includes drug interactions and information about numerous herbal and alternative remedies. It has actually been studied and demonstrated to have value. In my view, it is an excellent mobile application as it provides concise information well formatted for a small screen which can be used at the point of care.

Johns Hopkins’ Antibiotics Guide is an antimicrobial reference as is the Sanford Guide to Antimicrobial Therapy. These are also apps that work well as they provide information easily handled on a small screen.

Medical dictionaries including Taber’s Medical Dictionary, Stedman’s Medical Dictionary, and Dorland’s Medical Dictionary are all available as applications.

MedPage Today is a medical news service. They provide an app that offers access to current breaking medical news. The service also offers CME. The application and service are free.

Medscape is a medical reference, education website, news site, and mobile app. It provides a wide range of information targeted at many medical specialties including pulmonary medicine and critical care medicine. Subscriptions are free for licensed physicians.

QuantiaMD is a free resource that provides access to short, narrated Power Point presentations. These are arranged by topic and are designed to allow users to earn CME. The cases are interactive and developed by the user community.

Washington Manual of Medical Therapeuticsis the spiral bound medical reference book many of us used early in our careers. The most recent edition is available as an app which provides clinical counsel regarding diagnosis and treatment of common medical conditions from any location. The price is around $60.

I expect other apps to be created over the next several years. Hopefully some of these will prove useful.

Editor’s note: The ATS does not endorse any of the programs or products mentioned in this column.