Over the past six weeks, I have been working some shifts in our new urgent care clinic. The fast pace and seemingly endless patients made me appreciate again the approach to the undifferentiated patient. For example, fever and rash are common complaints seen in both adults and children in the UCC. Does that child have a simple viral exanthem, strep throat, or something a bit more exotic such as measles or even Ebola? Recent outbreaks in Washington and Congo, along with easy and fast travel to virtually any place on earth, makes these diagnoses unlikely but not impossible. Keeping a broad differential diagnosis is wise with just about any complaint, but can be especially useful when dealing with infectious diseases, cardiorespiratory, and neurologic complaints. Does that patient with a cough have an upper respiratory infection or pneumonia? Community-acquired pneumonia or Legionella or something even worse like Hantavirus or multi-drug resistant TB?
Previously at iMedicalApps, we reviewed several excellent decision-support tools including the outstanding IDdx: Infectious Disease Queries, the popular (and my go-to app for such things) VisualDx, and the venerable, easy-to-use, Diagnosaurus.
The latest app to enter the market is called docLogica. The goal of the app is to aid providers in taking the undifferentiated patient by building an evidence-based differential diagnosis while providing quick access to the evidence-based statistics of common diagnostic tests, disease symptoms, and epidemiology on hundreds of diseases. The app was created by Dr. Michael Garfinkle, a Canadian internist/nephrologist. It helps providers of virtually any specialty, but especially those of us in primary care to easily recall the symptoms of combinations of symptoms for over a thousand (currently over 1600) diseases.
docLogica is a peek into the future of point-of-care apps that use "big data" and the wealth of medical literature to aid providers in the diagnosis and treatment of medical conditions. Although the app's author clearly states its limitations, docLogica is a blast to use and contains thousands of helpful primers on tests and symptoms, and can create a virtually endless combination of differentials similar to VisualDx (just not quite fully developed yet). The only downside is the monthly subscription, but overall, it's likely still a bargain.
Likes
- Comprehensive collection of symptoms, signs, tests, and disease probabilities with sens/spec, pre-/posttest probabilities
- Intuitive interface with rapid information retrieval plus hyperlinks to references
- Available for Android
Dislikes
- DDx Maker doesn't seem to prioritize information on likelihood or frequency (lots of zebras for even common scenarios).
- Layout of main page not optimized
- Monthly subscription fee will be a barrier for some, but likely justified based on content
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense, or the U.S. Government.
This post originally appeared on iMedicalApps.com.