Coags Uncomplicated is a free “educational app” with a hidden agenda

Purpose of App Review

How well does Coags Uncomplicated teach physicians to identify and manage coagulation disorders?

Introduction

Coags Uncomplicated is an iPhone App that aims to provide “simplified testing and diagnosis of coagulation disorders.” Novo Nordisk designed the app, and also manufactures NovoSeven (recombinant Factor VII).

NovoSeven is an expensive treatment for rare coagulation disorders that costs more than five thousand dollars per dose for an average adult. Of note, the company recently settled a federal lawsuit alleging unlawful off-label marketing of the same drug.

User Interface

First, users must input their name, address, email and other demographic information before they can start any of the app’s five activities.

Next, the Lab Value Analyzer, Diagnostic Algorithm, and Neonatal Module allow the user to input a patient’s lab values and guide them through a differential diagnosis of coagulation disorders.

In the diagnostic algorithm, the provider inputs the patient’s PT and aPTT results and answers a series of questions to work through the differential. Based on the answers, the app recommends a specific diagnosis to consider.

Face the Case and the Coag Challenge are learning modules with multiple choice questions focused on identifying specific coagulation disorders, like acquired hemophilia.

Many of the questions are very simple and not of significant educational value.  The cases focus on acquired hemophilia, Factor VII deficiency, and Glanzmann thrombasthenia. All are rare conditions that are treated with recombinant Factor VII. The app mentions other coagulation disorders like DIC, but does not provide a complete or comprehensive review of coagulation disorders.

Price

  • Free, but requires users’ demographic data.

Likes

  • Well designed multimedia.

Dislikes

  • No transparency about the authors motivation to promote using recombinant Factor VII, an expensive and rarely indicated drug.
  • Complicated algorithms without a clear summary of the entire differential diagnosis.
  • No evidence base supplied

Healthcare providers that would benefit from the app

  • None.

Conclusions

  • Unlike the name of this app, coagulation disorders are complicated. This app does nothing to clarify that confusion. The developers are not transparent about their conflict of interest as the manufacturers of recombinant Factor VII, an expensive drug with few clinical indications.
  • This app has a thinly veiled proprietary agenda to gather health provider demographics and to promote prescribing Factor VII by familiarizing clinicians with the few rare diseases that it is actually indicated to treat.

iMedicalApps recommended?

  • No.

iTunes Link

Rating: 2.5/5 

  1. User Interface – 3 – Relatively straightforward navigation, but too many popup warnings and not enough comprehensive summaries in the algorithms.
  2. Multimedia usage – 2 – Uses multiple choice questions.
  3. Price – 4 – Free, but requires demographic data
  4. Real world applicability – 1 – Not reliable enough for clinical use.

Disclaimer:
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your health care provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or health care provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your health care provider.

Author:

Shannon McNamara, MD
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