eRoentgen App Helps Physicians Choose Appropriate Imagine Studies [App Review]

Diag and sx 1Update: In response to iMedicalApps editorial and reader feedback, the folks at Iatros Software have lowered the price of this app to $19.99. They have also given us a few promo codes for our readers. Check out the comments section for the codes!

Advances in imaging technologies and skilled radiologists now allow for routine diagnosis of many previously mysterious disorders. Listening for obscure heart sounds and subtle neurological exams still hold a cherished position in medical education but, as one old saying goes, you can replace a whole room of neurologists with an MRI machine.

However, such aphorisms not only raise the ire of card carrying neurologists but ignore the basic problem of knowing which imaging test to order. Many a diagnosis has been delayed or missed in a patient who had a “negative” MRI – the problem was that the MRI was of the wrong body part.

So, what do you do if you are a busy primary care practitioner and a patient presents with, say, hydronephrosis or neck pain or urinary incontinence? There are so many imaging modalities, it is difficult to avoid ordering the wrong or unnecessary test. It is this important problem the eRoentgen applicaton by iAtros software is trying to address.  In this review we’ll see if this iPhone medical app is worth the high asking price of $49.99.

The author of eRoentgen, Constantine Brocoum, MD was a neuroradiologist by training and surely had first-hand knowledge of the challenge. The application is a straightforward compendium of textual information that lists recommended imaging studies for each item from a voluminous list of symptoms and diagnoses. The main drawback of the application is the high price of $49.99, which seems out of line with comparable medical iPhone applications.

What I liked about this application:
  • the breadth of symptoms and diagnoses is impressive
  • the relative and absolute contraindications for each imaging modality are provided so that incompatible tests can be avoided
  • the additional information on pre-medication for patients with allergies is appreciated

allergy 2 recommend 23

What I did not like about this application:
  • the navigation between diagnosis, test contraindications and recommended tests is a bit awkward
  • the price is set too high
What I would like to see in future updates:
  • perhaps rather than providing such a breadth of symptoms, a deeper explanation of expected normal and abnormal imaging findings for some important diagnoses would provide more clinical value
  • some indication of the order in which to order tests, rather than a simple list
Conclusion:

The eRoentgen application achieves its stated goal of guiding physicians in ordering imaging studies and will probably spare the busy clinician a few phone calls to radiologists. However, whiles the author identified an important problem, I feel that the application does not always live up to its own promise. Perhaps with the addition of some deeper clinical knowledge, it may better serve as quick and effective radiology pretest consult.

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Addendum from iMedicalApps Team:

We completely agreed with Dr. Wodajo’s excellent review of this medical application. Just wanted to add that we ran this app by residents and fellows, including a rad/onc fellow, and for the most part they agreed with the points made in this review. The biggest complaint we received was the high asking price for a relatively simple application. This is the most expensive app reviewed on this site, yet it will not make our top medical app lists. Many of the residents also mentioned how the EMR systems in hospitals and the clinic already point out the contraindications and indications for much of the imaging. One of the main reasons we reviewed this app is because it got a lot of sponsored publicity, and we wanted to make sure our readers had an objective review to go by.

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Comments:

  • Andrew
    Took #1 - thanks!
  • paul
    thanks imedicalapps and iatros. i grabbed 9XYF3TMTH3YR

    cheers,
    pr
  • SMisra
    Here are the promo codes - remember to leave a post saying which one you took. Thanks to Iatros Software for this generous offer!

    R9NFJAYPAHNL
    F7FXPJRJ7AMY
    9XYF3TMTH3YR
  • MedAppReview
    Hi Dr. Joslin-


    Thanks for your comment, as always, we love to hear feedback from our reviews!! I frame the following response from the perspective of an iPhone user. One of the reasons I started this website was because no one was doing objective reviews of medical apps and I was picking apps based on trial and error. I knew a lot of the comments on iTunes aren't objective, as my developer friends have told me they give away promotional codes for good reviews in the App Store.



    1) We understand that designing an application by yourself takes hard work. Also, if you're paying someone to design an application it can be costly. We especially admire developers who work by themselves to produce medical apps, such as yourself and many more.



    2) It makes a HUGE different what the price of an application is, at least to our readers. When you are buying a product, and you are reading reviews for the product, you are going to naturally compare the prices. You are going to buy the product that gives you the best benefit for the cost. Even though a product might be great, you're not going to buy it if the price does not deliver a huge benefit. Why would I buy a $50 well written medical pamphlet that contains only 15 pages of material?



    3) Dr. Wodajo's review echoed what what we heard from our colleges, in terms of the price. I showed this app to multiple medical students, residents, and even a rad/onc fellow and allowed them to try it out. The main issue almost every person complained about was the large cost vs the benefit. The purpose of our site is to provide objective reviews, and enable our readers to have an insight to a product before they actually buy it. Excluding the multiple complaints about the high price that we received from people in the medical field would be disingenuous of us, and thats not what this site stands for.



    4) I also understand the supply and demand aspect of pricing, I was a finance major in undergrad and was pre-med at the same time. We're not interested in supply and demand curves and price points, but if you use this argument it's hard to transfer to this case. One of the issues is that the end consumer does not get a chance the "try" out the application. You either buy it or you don't. If you don't like it, your loss, no refunds. So I can walk into a bookstore to compare medical textbooks, but you can't do this with the App Store.



    5) Most medical students and residents have enormous debt, and are careful on how they spend their money (I'm one of them). These two classes have tight budgets so informing them of costs vs. benefits of an application is absolutely critical, especially when they are using loan money.



    6) We've reviewed plenty of expensive apps that we absolutely loved, and in the same way we steer people away from over-priced apps, we steer people towards expensive apps that are great to use and worth the cost.



    At the end of the day we just want our readers to be able to make the best decision based on objective opinions and reviews, if that makes us the "price police", then all reviewers can be called that, and so be it. Avoiding price vs. benefit issues would not be doing a complete objective review, and I have yet to read an objective review of any sort of product or service where these pricing issues have been ignored.



    Again, thanks so much for your comments!! I'd encourage our readers to check out our review of Dr. Joslin's app, the Joslin Chest Atlas, we definitely liked his app!



    -Iltifat Husain

    MD/MPH student, MS 4

    Editor, iphonemedicalappreview.com
  • Jeremy Joslin, MD
    Thanks for the review. I have no affiliation with, or knowledge of the author of the review or app, but I do want to make a defense to one of your criticisms of the app- the price.


    I don't know the circumstances of this app, but designing, gathering hard data for, and then developing an app takes an enormous amount of work. I know because I've done it (Joslin Chest Atlas)!



    What difference does it make if someone creates an app that makes a fart noise and sells it for 99 cents? Why does that create some sort of perceived benchmark for how apps should be priced?



    The appropriate price for an app is a multifactorial decision involving the time spent creating it, the estimated sales volume, the perceived value, and most importantly, what the market will tolerate.



    If people are buying it, then good for the developer. If they aren't buying it, the developer will reduce the price soon enough.



    Since when do we need price police?
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