Comparison of a venerable medical textbook on Inkling for iPad verses Access Medicine

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Navigation in AM is based on a side-bar with hyperlinks for intra-chapter movement. Within the text, there are also links to other parts of the book. Inkling shares this feature as well.

In AM, for the entire text, there is a table of contents page that one must go back to each time to move to another chapter in the text.

Inkling, on the other hand, has nested navigation tabs allowing intra-chapter and book-wide navigation from any point in the text.

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Both AM and Inkling have search capacities. Inkling’s is confined to the book of interest and AM allows selective search of Harrison’s alone if so desired. In Inkling, I need only click on the search icon and enter a term. In AM, I have to specify that I want to search in Harrison’s by using the dropdown menu next to the search bar, or by using advanced search. Otherwise, I will get results for all of AM.

The main distinction lies in results that come back from the search and the way those results are presented. To illustrate this, I did a search for the term ‘heparin’ in both AM and Inkling. What I get back from AM is a list of chapters that contain ‘heparin’ and some tables. Those results are organized by relevance by default. If I want to hone in on specific aspects of ‘heparin’ there are some suggestions on the left side bar that allow me to narrow the search, such as mechanism of action or dosage. If I want to just see media related to the search term, there is an option to see images, video and audio results alone. This feature is useful when one wants something other than text.

Inkling, on the other hand, gives me search results that include figures, tables, and chapter sections rather than whole chapters. I find the chapter section results to be most valuable. By giving me chapter sections, I can select the specific context in which I want to read about heparin, which can be incredibly useful when I have a targeted clinical question that I need answered. This helps me from having to wade through the gigantic chapters of Harrison’s in order to find the most pertinent instance of a broad term like ‘heparin’. Furthermore, because Inkling’s search is more granular (chapter subsections), the number of results I got was greater than in AM. More is not always better when doing searches, but I do like to have more and more specific choices than fewer.

Inkling also allows one to sort the search results by relevance, content order or type. I like having this level of control. The content order filter, for example, gives me the chapter in which the term is and a list of specific sub-sections within the chapter where I can read about my search term. The type filter gives me a choice between images and readings.

Both AM’s and Inkling’s search functions have their merits. For my needs, Inkling’s search stands out as the better of the two because of the ability to go directly to chapter sub-sections and the ability to organize the search results at my choosing. I did find AM’s search based on relevance to be, well, more relevant. Whether this is true for all search terms, I cannot say, but at least in my testing, it seems that AM’s relevance filter gives back more reasonable top choices.

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Note-taking while reading is something that many students do. Inkling makes annotation easy with an annotation function and highlighting capability built right into every page of Harrison’s (and all their books).

AM does not have such features, and so one can not place notes at specific points within the book. Here too, Inkling wins out.

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AM’s Harrison’s does have some extra features, however, that Inkling does not. AM includes some useful ancillary material that is absent on Inkling. Nearly every chapter in AM’s Harrison’s has powerpoint lecture slides that have figures and tables from the book. This is not of great importance to most students I suspect, but instructors would find this useful.

Another important point has to do with updates. AM provides continuous updates of material as they become available. In this way, readers need not wait for publication of the next issue to get the latest information. This updating mechanism has been one of the strengths of AM, and online publish in general. I am told that Inkling will also push updates for Harrison, but I have not actually seen that happen yet on my device. If it is happening in the background, Inkling would do well to promote the fact that updates are taking place. AM, to its credit, does this well. Whenever there is new material, there is a prominent notice in the side bar.

Taken together, I think Inkling has unveiled the best version of Harrison’s Principles of Internal Medicine to date. In many ways, it’s even better than the physical text itself. 4,012 pages of dense text fit right into my pocket, and can be read and navigated with ease. AccessMedicine’s web-based version of Harrison’s is functional but falls short of Inkling’s version in most respects.

If one has to choose between the AM version and Inkling’s, Inkling wins out, in my opinion. And, even if one already has access to Harrison’s through their institutional subscription to AccessMedicine, I think students and physicians alike will be better served by Inkling’s version for all the reasons mentioned above.

Comparison Summary:

Inkling

  • Available for offline viewing
  • Simple and powerful search function
  • Full-chapter presentation of text with integrated images, tables and video media
  • Native annotation and highlighting capabilities
  • Easy navigation through text
  • No updates or ancillary material

AccessMedicine

  • Web-based only
  • Useful search function; lacks in ability to navigate to specific chapter subsections
  • Only chapter sections can be viewed at once; full chapters cannot be accessed
  • No annotation or highlighting capabilities
  • Multi-click navigation and a table of contents page
  • Continuous updates made to text
  • Ancillary material (powerpoint lecture slides) available

Conclusion:

  • In most respects, Harrison’s Principles of Internal Medicine on Inkling is superior to the web-based version found on AccessMedicine
  •  Students and physicians alike will be well served by Inkling’s version even if they already have institutional access through AccessMedicine.
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Discussion ( 4 comments ) Post a Comment
  • You have an error in your review about the searching Harrison’s through AM. You absolutely can just search Harrison’s online only.
    If you use the search box at the top of the page, the default is All AccessMedicine, but you failed to just pull down the arrow to search only Harrisons Online.
    This is an unfortunate error. The arrow on the search box is common knowledge in the web world that it is a pull down menu. And if you had clicked on it you would have noticed you get the option to search Harrison’s only or other titles on AM.

    • This post has been updated to reflect the things mentioned in your comments Michelle. Thanks for bringing this to our attention

      Iltifat Husain, MD iMedicalApps Editor
    • @ Michelle

      Thanks for the comments. You rightly noted that there is a selective search for Harrison’s for AM. When I was testing Harrison’s on AM, I used the advanced search box and then selected Harrison’s. Despite that, I still got back results for all of AM (see the image in the article). This has happened to me a couple of times before. I figured it was a glitch because the selective search is clearly an option. The same thing happened to me with the dropdown menu. After your comments, I went back and tried again and the selective search did work for me. So I’ve updated the post. I don’t want to propagate incorrect information.

      Rather than saying that AM doesn’t have a selective search, I should have mentioned the dysfunction.

      I’ve also updated the post to reflect what Tracey (below) said about the updates. I have yet to be notified about the updated content on my Inkling app, but it may be happening in the background. Regardless, the so-called e-chapters are on the Inkling app. The only thing that’s different between AM and Inkling at the moment is the powerpoint slides.

      Keep the comments coming if you see anything else. I appreciate the feedback.

  • Hi Alex,
    Great review. I just wanted to point out something regarding updates on Inkling. To clarify, because Inkling has Harrison’s as software, they are actually able to update it on the fly too. This was demoed by their CEO’s at the Tools of Change presentation last week: http://www.youtube.com/watch?v=z5bborgjHF4.

    As a result, Inkling users do not have to wait for the next edition of texts to be published, and publishers can already today push updates or corrections as they see fit.

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