Archive for the ‘Evidence Based Pediatrics’ Category

Essential Evidence Plus

Thursday, June 18th, 2009

The great evidence based tool, Essential Evidence Plus previously known as infoPOEMs is reviewed on the Pocket PC platform in the following video;

This is a filtered synopsized graded evidence based clinical knowledge database right on our PDA. The content is derived from more than 100 high profile medical journals that are continuously monitored for the latest that matters.

It also include some other tools check out Pda4peds for reviews of the following sections:

What’s great about it, is that it talks in simple language making all those Cochrane reviews easy to read and easy to understand. POEM in fact stands for Patient Oriented Evidence that Matters; it really is. They present the complicated literature articles in a clinical question format answered in the most simplest way.

Targeting primary health care physicians, the app certainly is useful for us pediatricians as we essentially work in a primary care setting.

Free from pharmaceutical companies support makes it independent and free from bias.

The application automatically syncs itself with the desktop as the PDA is connected retrieving the latest updates of the database which is done quite frequently on a monthly basis sometimes.

However, there are some features that can still make the EE+ even greater and here’s a list of suggestions:

  • It would be great to include the daily or monthly infoPOEMs emails in the form of recent updates or what’s new into the app. And perhaps some FDA alerts.
  • The EE+ podcasts would better be included into the application not only on the website.
  • More extensive cross linking among the articles needed
  • An Over the Air update is more convenient than the desktop updater.
  • Intergration with Lexi-Comp & Tarascon is great but how about more options such as Epocrates or Skyscape.

Like the EE+!  you can vote for it in the Best Evidence Based applications poll.

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Posted in All, Evidence Based Pediatrics | 4 Comments »

Pediatric Clinical Practice Guidelines & Policies on the PDA

Thursday, May 28th, 2009

Certainly, it’s a great idea to have all those evidence based policies and guidelines endorsed by the APP in the palm of hands!

Pediatric Clinical Practice Guidelines

The AAP’s compilation of the latest guidelines and policies is available in the form of Mobipocket document.

The PDA version of the Pediatric Clinical Practice Guidelines and Policies “9th edition” offers more than just the policies and statements, it includes some other very useful features. Turn your audio on and see the following video for more details.

The addition of a bilirubin assessment tool, the vaccines scheduling, patient guidance, and some ICD codes makes this great evidence-based PDA reference a repository of the all tools that a pediatrician may need in practice.

However, as mentioned in the video above, the app need to be available in other medical readers that we are all familiar with such as Skyscape or Unbound Medicine.

For $55 [members] and $60 [non-members] the stand alone PDA version only it can be downloaded from the AAP’s Book store

We can also buy $100 the book+CD Rom+PDA version from Amazon, or $105 [members] -$90 [non-members] directly from AAP’s Bookstore.

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Posted in All, All-in-one Applications, Coding & Billing, Evidence Based Pediatrics, Vaccines | 6 Comments »

NGC Guidelines on our Handhelds

Sunday, December 28th, 2008

The National Guideline Clearinghouse [www.guideline.gov] an initiative by the AHRQ is the largest and most trusted collection of evidence based clinical guidelines that we can ever have.

Fortunately we can download these guidelines one by one to our handhelds whether its the Palm, Windows Mobile, or even the iPhone.

The video above demonstrates the steps on how to download these .pdb files on Windows Mobile and view it using any .pdb reader like Mobipocket or iSilo [the above example].

All you have to do is to visit the website www.guidline.gov on the windows mobile using Internet Explorer Mobile and then choosing the guidline that you want, then navigating down to Palm download link and saving the file to your handled local directory [in this example I saved the file to a folder that previously created in the storage card and named it iSilo] and that document can then be opened via iSilo. Of course similarly these documents can also be downloaded via the desktop and then can copied to mobile directory.

It’s a good idea to rename these downloaded files [as shown above] into something that makes sense because there original names are only numerical which will make it difficult for us to find files later when the list grow.

For Palm; the same process applies and is even easier as the Palm reader itself can read .pdb files.

In the case of the iPhone; we have to first download these files using the desktop then we can download them into the iPhone iSilo from the desktop [read this post for details].

Here’s how it looks like on the iPhone:

The website also offers these same guidelines in Microsoft Word and Adobe PDF file formats both of which can be viewed on Palm and Windows Mobile but not as easy and as readable as the .pdb files.

Unfortunately this is not so easy to download each and every guideline that we want to refer to on the bedside, and we wish that in there near future the NGC will come up with some kind of a reader or at least a more mobile friendly website to makes it easier for us.

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Posted in All, Evidence Based Pediatrics, General Issues | 4 Comments »

The Pediatric Care Online (Part 1 of 2)

Monday, November 3rd, 2008

We have been waiting for a such a complete and integrated PDA resource from the AAP for a while, and finally they made it and it’e here The Pediatric Care Online [PCO].

As the name implies this is designed to reside online which means frequent updates, interactive contents, universal platform, access anywhere, and an electronically delivered digital resource that matches the transformation into the IT era of today’s medicine and pediatrics.

Sponsored by Mead Johnson and is available for AAP members at a rate of $250 and for non members for $290 yearly subscription a price that may seem to be on the expensive side but when we consider the number of resources it includes the price might be reasonable.

Fortunately a free trial from Mead Johnson check this link is available:

  • Three months for pediatricians
  • One year for pediatric residents

PCO encompasses a number of excellent resources and references that are all evidence based and authenticated content right from the governor of our practice the American Academy of Pediatrics.

As it is the most common and arguably the most important PDA function; it included a pediatric drug look up and this time from the highly trusted Lexi database [It is also the drug reference of UpTodate]. The drug guide is integrated and fits well into the rest of software and it is even better than the original Pediatric Lexi Drugs! However, it should have included a built-in calculator and an interaction analyzer to be complete. Also included is a section of antimicrobial therapy which is an extract from the Textbook and provides a focused pediatric antibiotic guide.

The collection also sports a reference in the form of AAP Textbook of Pediatric Care, a News and Updates service, a quick reference tool, Bright Futures, and other resources. For a detailed review of all of these  check out the Pediatric Care Online pda4peds review.

Once installed on the PDA you can feel the Unbound Medicine touches throughout the website and the PDA interfaces such as the automatic updates upon synchronization.

This online server link not only updates the content but also updates “myPCO” an online library where search keywords executed on the PDA are transferred and listed there. This is a popular Unbound Medicine technology that has been there since the days of CogniQ Peds. However, that would be much more useful if it is complemented with an online search that can actually be executed on the PDA via wireless connection. This last point is also applicable to related content links which in the native PDA version do not link to the online links it is just said “more content available online”. The search function is much better on the wireless version [To be dicussed in Part 2].

The native PDA version is missing several of the features available in the Web and Wireless versions these are:

Probably they omitted these sections so as to avoid a drastic growth in the size of the PDA program [currently 6 MB only] but that can be true only for the reference and images while the other sections listed will not consume lots of MBs because they are simply links to external online resources. They could have easily included these and the visual library in the form of links to external pages.

The PCO could have been fantastic if they added the following:

  • a labs reference, a multifunctional PDA program is NOT complete without this.
  • a DDx analyzer , the Signs and Symptoms search section only lists causes that are mentioned in the quick reference and there’s no multiple symptoms analysis tool.
  • a journal access, this is a copyright issue of course but at least listing the TOC of the several AAP periodicals that we all crave for.
  • a CME tool: The AAP already have great resource in the form of Prep Audio but it would have been nice if CME is collected ‘in-house’ as we are going to use this tool often, check EE+ for such a CME solution.
  • and a drug interaction tool; they could have added the Lexi-Interact tool to the collection and if that doesn’t work on the Unbound Medicine platform then they could have added the Drug Interaction Facts already developed by Unbound Medicine.

These shortcomings may be rectified by us in the future as The Pediatric Care Online is supposed to be community driven and they welcome comments and suggestion sent to pco@aap.org

to be continued in Part 2 …

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Posted in All, All-in-one Applications, Best, Evidence Based Pediatrics | 2 Comments »

The AAP Textbook of Pediatric Care

Tuesday, October 28th, 2008

Finally a textbook from the AAP; it has been feeling awkward to refer to Nelson or Forfar when we pediatricians want to check on a trusted pediatric reference!

The American Academy of Pediatrics as a regulator and as a national symbol of pediatric care would have to come up with a reference for all pediatricians and finally it’s here.

What’s interesting here is that the book was made available for the PDA/wireless/Web even before the print edition was released! As of the time this post was written Amazon did not release it and is scheduled for release in November. This reflects the fact that it’s essentially designed for electronic use rather than a traditional paper textbook and also means that the AAP is determined to make serious steps towards the transformation of pediatric literature into the electronic format matching the 21st century digital era.

The textbook is packed within the Pediatric Care Online [PCO] which contains a number of other great resources and references for the pediatrician and is the product of AAP content plus Unbound Medicine development.

The AAP Textbook of Pediatric Care is available through the online and wireless version of PCO and is not yet available for the native PDA software.

The textbook looks like this on a Windows Mobile screen using Internet Explorer Mobile to log in to http://pediatriccareonline.org and then working on AAP Textbook

The Textbook is composed of 10 Parts and 361 Chapters covering Pediatrics from A to Z. Even a chapter on Online resources and the use of PDAs in clinical pediatrics. Each topic is followed by a wonderful When to refer and When to admit sections specifically targeting and guiding primary care providers and junior peds but it is also styled in a format that is useful to any pediatrician regardless of the practice setting.

It is so detailed that the AAP decided to make a summerized version for the PDA platform and correctly named Point-of-Care Quick Reference to make it easy for us finding the required information.

It is also rich in guidelines and chapters are followed by live links AAP policy statements when relevant and being an electronic reference it will be frequently updated as new guidelines are added or changed. Not only AAP contents links but also CDC, FDA, and Pub Med live links making it an incredible evidence based pediatric resource.

As part of PCO it is also cross linked to Bright Futures and Pediatric Lexi Drugs making it even more comprehensive and a reference where you can find all answers.

The price for the print edition alone is $165 you can buy it from Amazon here and for the online version is $250 [members] and $290 [non-members] and if you want both then the price is $350.

This is undoubtedly the ultimate pediatric reference and a must have resource for every practicing pediatrician.

Check out AAP Textbook of Pediatric Care pda4peds review and you may also vote for it in the Best Pediatric PDA Reference poll.

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Posted in All, Best, Evidence Based Pediatrics, References & ebooks | 5 Comments »

The AAP Textbook of Pediatric Care

Tuesday, October 28th, 2008

Finally a textbook from the AAP; it has been feeling awkward to refer to Nelson or Forfar when we pediatricians want to check on a trusted pediatric reference!

The American Academy of Pediatrics as a regulator and as a national symbol of pediatric care would have to come up with a reference for all pediatricians and finally it’s here.

What’s interesting here is that the book was made available for the PDA/wireless/Web even before the print edition was released! As of the time this post was written Amazon did not release it and is scheduled for release in November. This reflects the fact that it’s essentially designed for electronic use rather than a traditional paper textbook and also means that the AAP is determined to make serious steps towards the transformation of pediatric literature into the electronic format matching the 21st century digital era.

The textbook is packed within the Pediatric Care Online [PCO] which contains a number of other great resources and references for the pediatrician and is the product of AAP content plus Unbound Medicine development.

The AAP Textbook of Pediatric Care is available through the online and wireless version of PCO and is not yet available for the native PDA software.

The textbook looks like this on a Windows Mobile screen using Internet Explorer Mobile to log in to http://pediatriccareonline.org and then working on AAP Textbook

The Textbook is composed of 10 Parts and 361 Chapters covering Pediatrics from A to Z. Even a chapter on Online resources and the use of PDAs in clinical pediatrics. Each topic is followed by a wonderful When to refer and When to admit sections specifically targeting and guiding primary care providers and junior peds but it is also styled in a format that is useful to any pediatrician regardless of the practice setting.

It is so detailed that the AAP decided to make a summerized version for the PDA platform and correctly named Point-of-Care Quick Reference to make it easy for us finding the required information.

It is also rich in guidelines and chapters are followed by live links AAP policy statements when relevant and being an electronic reference it will be frequently updated as new guidelines are added or changed. Not only AAP contents links but also CDC, FDA, and Pub Med live links making it an incredible evidence based pediatric resource.

As part of PCO it is also cross linked to Bright Futures and Pediatric Lexi Drugs making it even more comprehensive and a reference where you can find all answers.

The price for the print edition alone is $165 you can buy it from Amazon here and for the online version is $250 [members] and $290 [non-members] and if you want both then the price is $350.

This is undoubtedly the ultimate pediatric reference and a must have resource for every practicing pediatrician.

Check out AAP Textbook of Pediatric Care pda4peds review and you may also vote for it in the Best Pediatric PDA Reference poll.

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Posted in All, Best, Evidence Based Pediatrics, References & ebooks | 4 Comments »

Dynamed: The World of EBM in your pocket! Part2

Friday, May 30th, 2008

The pediatric content of Dynamed is more than enough and includes all the diseases and conditions that a pediatrician may need in clinical practice. However Dynamed is designed with family physicians and primary health care professionals as the target audience but nevertheless it is still very useful for any peds even sub specialty peds.

Dynamed is so vast that its reviewed in more than 10 categories at the pda4peds website because it has enough information to be listed as a child psychiatry resource for example.

Dynamed could be the best 55 MB of memory that you will invest into your memory card, don’t lose the opportunity to have informed decision and to practice evidence based pediatrics. Go to Dynamed PDA version download page.

One of the fabulous features of Dynamed is the patient information section with links to handouts and online content, a feature which is particularly useful for pediatric residents in dealing with parents.

Another nice feature is that information can be looked up by index by recent updates and also by carefully arranged categories of medical specialties (each with its own drugs sub category), drugs, diagnistic testing, …etc. But I wish to see a text search tool just like the online version though we should ask Skyscape for that not Dynamed.

Dynamed indexing

Another cool feature is that each topic is adequately cross linked to other topics and drugs and is thoroughly referenced to articles and guidelines, some topics have 250+ references! with fabulous grading of evidence of each recommendation.

Enough said with the good stuff and now let me list some bad stuff about Dynamed:

  1. Price: is quite expensive compared to other similar services
  2. Pediatric Topics: pediatric versions of common diseases are needed such as a dedicated pediatric asthma topic
  3. CME: credits are available online but not for the PDA version, hopefully they will consider adding this service in the future.
  4. Images: Just imagine a pediatric dermatology reference without images! pictures are really needed in Dynamed (UpToDate has images), and don’t tell me that there are links to online pictures this is scanty and not enough.
  5. Labs and Tests: To have a complete resource you need to have some labs and test database.
  6. Diagnostic Approach Topics: Much more needed of the type like (anemia differential diagnosis)

Finally if you would like to have more details about Dynamed for pediatricians have a look at this pda4peds review page or the video demonstration page.

Also if you like Dynamed don’t forget to vote for it in the best Evidence Based Pediatrics and References categories.

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Posted in All, All-in-one Applications, Evidence Based Pediatrics | 2 Comments »

Dynamed: the world of EBM in your pocket! Part1

Friday, May 30th, 2008

Ever wondered what was the reason there were concerns about the risk of autism with vaccine administration OR have you ever asked yourself where do I found that systematic review which stated that amoxicillin is safe in pregnancy OR did you face the scenario when you want to treat your acute seizure patient in line with the national guidelines!

All these questions and much more are answered by this HUGE knowledge base of evidence based medicine delivered right into our hands at the very point and moment of care.

Dynamed: a name which originates from “Dynamic Medical” is the way we should think of our references in the near future (or perhaps now!), information is updated on a daily basis and by 100s of doctors throughout the world and all of that collected in a single online treasure. In fact you yourself can edit the information if you find a mistake or if you want to add some information (of course editors will moderate your contribution and have to approve it before it is posted). It is just like a professional medical wikipedia perhaps they should call it medipedia!

Dynamed

So as the name implies this is a transformation from the classic conventional static information database to the dynamic online content of the technology era.

This vast database is available for the PDA (Blackberry, iPhone, Palm, and Windows Mobile) and although is not updated as frequently as the online counterpart but it is updated every week thanks to Skyscape SmartUpdate technology.

The first sentence with each Dynamed topic mentions the date when the topic was last updated and you will be amazed about how fresh is the information in your hands. Since we are talking about the first page I have to say that I did not like having the Rx page as the default page for all topics it should be the introduction and ICD codes.

Every fact and every decision is backed up by its reference giving us confidence and informing us of the origins of today’s modern medicine.

Not only diseases and conditions but also a comprehensive drug database that is constantly updated and revised as well as topics about symptoms and presentations, latest developments, important research studies, and others.

Dynamed acquired by EBSCO in summer 2006 offers an online platform which if you subscribe to it you will be entitled for a free PDA version developed by Skyscape but amazingly if you search Skyscape for Dynamed you won’t find any results!

Another amazing story here is that if you go to www.dynamed.com you will find a bogus website!! So don’t get confused and go to www.dynamicmedical.com. Also, unfortunately there is no mobile version of the website which is a great disadvantage when compared to UpToDate “one of the few competitors”.

However dynamed supersedes UTD in two major features 1) more frequent updates 2) links to references and resources are live and when clicked (desktop) or tapped (PDA) they will take the user to the original online content as apposed to inline excerpts of Pub Med references of UpToDate.

This article is continued in part2

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Posted in All, All-in-one Applications, Evidence Based Pediatrics, References & ebooks | No Comments »

Bright Futures (The AAP Guidelines) on the PDA

Thursday, March 6th, 2008

It’s a great idea to have such an important and credible handbook on our handhelds. Thanks to Unbound Medicine the mobilization of the latest 3rd edition of Bright Futures has become a reality, and this time exclusively by Unbound Medicine (No Skyscape, USBMIS, or Mobipocket format yet).

Print edition cover

The price is $69.95 and one might argue that the print edition is available for 10 Dollars less but to have it all in a PDA eliminating extra weights from the white coat and having an easily searchable digital format will let us really use this important reference in our daily practice.

Banner from Unbound Medicine

The book is the authority to which we should consult as fas as childrens’ well visits are concerned. Everything about children health supervsion and protection is there including anticipatory guidance, safety precuations, well-child visits, nutritional advice, developmental monitoring, and much more.

This time Unbound Medicine did not offer their usual package of web and wireless access and this is justified becuase the online version is already there free to use “check the Bright Futures website.

Here’s the Unbound Medicine download/purchase web page

and here is the AAP’s book store web page.

For Pda4peds links click on the following:

Review AAG page Video Demo

Posted in All, Evidence Based Pediatrics, References & ebooks | 2 Comments »