Doctor’s Toolbag app is an excellent evidence based clinical decision support tool

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One of the main uses for medical apps on mobile devices is as tools to support clinical decision making.

These apps can range from medical calculators such as Calculate to clinical prediction tools such as Doctor’s Toolbag from the BMJ group.

Doctor’s Toolbag contains a range of common clinical calculations and appropriate management which is supported by a wealth of evidence.

Doctor’s Toolbag contains information on 74 common clinical prediction tools for prognosis and diagnosis.

Each tool offers information related to salient clinical features to look for with a complete explanation of why.

The app provides a results summary for each tool based on the data input by the user. Sometimes this results in a clinical management recommendation regarding what to do next.

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Any information/management information is well referenced with a range of evidence which is accessible using the in-app browser. This is an impressive feature and one I feel is crucial for any clinical decision app. Other information which may be found within the results section is likelihood ratios and potential risks. Key core information is linked from BMJ Best Practice which is directly relevant and contains information regarding which tests to consider, key treatments and relevant guidelines.

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Where possible, the app connects to the internet and downloads the relevant national guidelines. These are often UK specific; however, the information is useful for assisting in management decisions.

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It is relatively simple to find the clinical tool you are looking for with the ability to search by title, specialist area and condition. Alternatively, you can select a favorite to choose the tools you use most frequently. I felt the range of tools was good although there were some omissions such as the mini-mental state exam and Oxford Hip/Knee scores. The user interface was excellent and straightforward to use, being particularly intuitive. There are useful options to adjust the text size as well.

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One particularly interesting feature which I could not test fully was the Doctor Toolbag’s update feature. Paying a subscription fee will ensure that the information in the app is as up-to date as possible. The BMJ evidence group regularly scans a range of sources for the new prediction rules or new evidence on existing rules. While I was not able to personally test and verify this feature, I was impressed by its addition.

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Price:

  • $6.99 with update subscription $14.99 for one year

Likes:

  • Excellent user interface
  • Good accessible evidence base associated with each tool including guidelines
  • Information related to next step in management of each condition

Dislikes:

  • Not enough clinical tests covered compared to other medical calculators

Overall Rating:

  • Doctor’s Toolbag app is an excellent app to help understand, calculate and manage patients with specific conditions
  • The user interface is clear and it is easy to find relevant information
  • The strong evidence support provided with each test will help assist doctors make clinical decisions

iTunes link

Discussion ( 7 comments ) Post a Comment
  • I am being told by my hospital that apps of this type need FDA approval. I disagree, as the Mobile Health policy for FDA is still in draft form and not yet implemented, I believe FDA approval is not necessary. Anyone else dealing with this?

  • Is the hospital saying you aren’t allowed to use these apps until FDA approval, or is it saying “use at your own risk”?

    Iltifat Husain, MD iMedicalApps Editor
  • I dont understand the point – according this reasoning, you should have FDA approval for every medical reference literature, journal, textbook ? iPhone app is not a medical examination apparatus for which such an approval is clearly needed. It is only a source of information you use at your personal discretion and responsibility.

    • I am just tellig you what FDA is saying and what the lawyers are intrpreting. I do not agree with it. I think we need to b head before all the rogress we have made is reversed.

  • FDA will definitely regulate mobile medical apps, including clinical decision support tools. These discussions are ongoing now. An excellent person to contact is M. Jason Brooke of the CDS Coalition in Washington, DC at *****@ebglaw.com.
    His advocacy group is actively discussing with the FDS how certain types of CDS (for example, clinical calculators) should be exempted from regulation. A meeting is being set up for May 2012.
    Tim Richardson, PT
    http://www.PhysicalTherapyDiagnosis.com

    Tim Richardson, PT
  • Does the FDA’s charter even authorize it to supervise medical information?

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