Joslin Chest Atlas App Helps You Learn Your Chest Films [App Review]

Joslin Chest Atlas (v2.5), made by IdiogenicOsmoles, and costing $14.99, was just updated. This medical app aims to help healthcare providers improve their ability to read chest x-rays.

Learning how to read chest x-rays is one of the most essential tasks you learn in your clinical years. If you’re in the wards late at night and your patient is decompensating, often one of the first tests you order is a plain chest film. In these acute settings, you don’t have time to wait for a radiologist to read your results. That’s one of the reasons why having the ability to properly read a chest film is essential if you’re a healthcare provider.

In this review I’ll go through the features this app provides and explain how it can be used as a learning tool.

Learning how to read a chest film is hammered into you during your clinical years in med school and your residency years. You learn by seeing thousands of chest films and repetition of certain radiographic pathologies. Learning by repetition is what this app provides. It has 78 common radiographic images, with short explanations for each.

When you open this app, you are presented with a catalog of radiographic images, organized “by disease” or “by findings”. There is also a quiz mode toolbar if you want to test yourself. The “by findings” section is further organized into categories such chronic hypertension, foreign bodies, and more. For some of the more common radiographic pathologies, such as a pneumothorax, there are multiple radiographic images.

Once you select on a pathology, such as a pneumothorax, you are presented with an Anteroposterior(AP) chest x-ray view and sometimes a lateral view. You can zoom in and out using the iPhone’s native touch controls. To find out the location of the pathology, you can tap the “show me” toolbar and arrows will point you towards the key area of the radiographic image. You can also tap on the “info” toolbar to get a short blurb about your selected radiographic disease with the option of getting more information using google and wikipedia.

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What we liked about this app:
  • Excellent way to learn key radiographic pathology (pneumothorax, aspirational pneumonia, etc) and key radiographic terms (Peribronchial cuffing, Kerley B lines, etc)
  • Has a lot of the common radiographic pathologies you encounter on the wards.
  • Simple User Interface, although navigation needs to be worked on
  • Links to Wikipedia and Google if you want more info about the particular radiographic finding.
What we don’t like:
  • Price, pretty expensive if you compare it to other more polished apps, notably the Blausen Human Atlas App.
  • In Quiz mode you can’t zoom in on the images
  • The Wikipedia and Google links open in Safari, not within the app, so you have to open up the app again and scroll to your previous selection (not ideal).

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What we’d like to see in future updates:
  • A search feature would be essential.
  • Bookmarking your favorite images.
  • Having the ability to see the images in landscape mode.
  • More Lateral views, not just AP views. Ideally, we’d like the option to see the patient’s AP image paired with their Lateral image.
  • Continue to add more images
Conclusion:

The Joslin Chest Atlas is truly an innovate medical app and definitely has the capability to improve your ability to read chest radiographs. We think the price of $14.99 is a bit high, especially since there are 78 images offered right now and the navigation needs to be worked on. However, if you’re a resident and you get an education/books stipend, then go for it.

We can’t emphasize how much potential this app has. This current version taps into some of this potential, but we can’t wait for the day when we open up this app and there are hundreds of images available. The developers of this application are open to healthcare providers sending them their own collection of radiographic images and we’d encourage users to do this. Until then, we’re looking forward to seeing more updates of this app.

[itunes]

[website]

Update: We forgot to list who we would recommend this app for(as we do in other posts): Healthcare providers in general, especially those who are fresh out of residency or training. Also a definite must have for residents.

Author:

Iltifat Husain, MD

Founder, Editor-in-Chief of iMedicalApps.com. Emergency Medicine Faculty and Director of Mobile App curriculum at Wake Forest School of Medicine.

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13 Responses to Joslin Chest Atlas App Helps You Learn Your Chest Films [App Review]

  1. Jeremy Joslin, MD August 26, 2009 at 1:12 pm #

    Thanks for the review and kind words. We actually do plan to upgrade navigation in the next major release (3.0). In the meantime, we continue to add images as small updates. Indeed, we would love to feature images from users whenever appropriate! You’ll find though, that more images does not mean a better product. There are dozens of websites which offer thousands of CXR’s to review. Our product is unique in that each film is hand-selected to provide a teaching point about a particular FINDING, not just a unique film. Thusly, this is an app of CXR findings, not of CXR images. The distinction is deeply conceptual to the app and the reason why there are “only” 78 images at this time.

    I’d also like to comment on two ideas you discuss in your review though:

    1.) The reason we now open Wikipedia and Google links in the Safari browser and not within the app is because Apple has adopted a policy of mandatory 17+ ratings for any app which utilizes Google within an app. This is the rating that adult material apps are required to post, and not a rating I am interested in applying.

    2.) Pricing is an issue about which many developers feel that reviewers and the public are considerably misguided. Discussions about apps being priced too high, such as the one you posted above, are opinion based on the errant premise that iPhone apps are somehow worth 99 cents at default, and should go up from there based on multiple, subjective criteria. The fact is that this app required many months of long nights and countless dollars to produce. If the images and information in this app were published as a reference book, the cost would easily exceed $100. Yet, for about $15 you can have an interactive version with the same material that you can carry with you at all times. You quote a completely unrelated app as a seemingly random point of comparison, but I could also quote an unrelated app (Netter’s Anatomy) that is priced at double this app’s cost. I personally believe that Apple has created a monster by allowing thousands of valueless 99 cent apps which have unfortunately created this dangerous paradigm.

    Nevertheless, I’m glad your review hit on the strengths of the app, and we’re always open to good suggestions as you provide. Plus, we’re still looking for a representation of Westermark’s Sign… does it even exist?

    Looking forward to your reader’s comments…

  2. M.A.R. August 26, 2009 at 5:47 pm #

    Dr. Joslin-

    Thanks so much for your response. As we’ve mentioned before, we’re always happy to hear from the developers of the medical applications we review.

    1) Thanks for clearing up the issue of the Wikipedia and Google links. It’s a shame that Apple is tying down developers in this sense.

    2) Your explanation of the unique nature of the

    images is noteworthy, and as such, makes the pricing of the app make more sense to us.

    As we mentioned in our review, we find your application very innovative and it definitely has the capability to improve a healthcare provider’s ability to read chest films. We’ll be putting your app to good use for our own learning and continue to look forward to the new additions you make to this app.

    We urge those who have read this review and purchased this app to contribute to Dr. Joslin’s cause of collecting key radiographic findings. Also, make sure to leave comments with your experiences from this truly unique medical application.

    -Med App Review Team

  3. pinkie August 26, 2009 at 8:18 pm #

    I have been waiting for someone to review this app before I invested $15 into it. After reading this review, I think that it is completely worth the money. I am a Physician Assistant who is practicing in an Urgent Care outpatient setting. We read about 10-15 Xrays per day, and I think this application would serve as a quick reference guide. Our employer has provided all his staff with itouch’s for the sole purpose of getting useful and helpful medical apps that will help us with our patients on a daily basis. I am going to recommend this application to a few of my colleagues as well and bring it up at our next meeting. Thanks so much for a thorough review ~ look forward to reading more!

  4. Heidi August 27, 2009 at 1:12 pm #

    Sounds like a very useful app!

  5. neeti August 27, 2009 at 6:22 pm #

    appreciate the review, seems to be a “high yield” application, especially on wards. The link to wiki and google is also a nice feature. I can see this being useful during my clinical years…

  6. deaugie August 28, 2009 at 3:55 am #

    This app looks like a good addition to the list of clinical education applications. My only question at this point is, how much space will it occupy on the user’s hard drive? I imagine the addition of many more high resolution images in the future could occupy a fair amount of space on the device’s hard drive.

  7. Jeremy Joslin, MD August 28, 2009 at 4:39 am #

    The app currently uses 00.122% of my 16GB iPhone’s drive space.

  8. guitarpalooz August 29, 2009 at 12:00 pm #

    Looks like a solid app, should be useful to study on the fly.

  9. John August 29, 2009 at 12:09 pm #

    Thanks for the review. I came across this application while browsing for medical review apps and wasn’t entirely sure if it was worth the $15. It seems to be worth it – perhaps as boards get closer.

  10. Andrew August 31, 2009 at 6:48 pm #

    Thank you for the review. Seems like a great learning tool for students such as myself.

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