By: Philip Xiu, MB BChir (Cantab)

The 5-Minute Clinical Consult (5MCC) BlackBerry medical app from Unbound Medicine gives rapid-access to: evidence based guidance on diagnosis, treatment, medications, follow-up, and associated conditions of 900 of the most common medical conditions.

Often as a physician in training, you are left to clerk a patient who comes in with a disease, and you frantically try to remember what the professor in Medical School said regarding the management of it. This medical app allows you to quickly and easily check up on management and may prove to be of value for a budding physician or even practicing physicians who want a clinical refresher of various topics.

The 5MCC program is also available online and in print form, and has been around since 1994. The app edition we are reviewing today is the latest 2012 edition Blackberry smartphones.

The home screen lists a Table of Contents contained in the 5MCC reference.

1[1]

On selecting the 5MCC, you are presented with a list of indices: Topics, Medications, ICD-9 codes, SNOMED codes, Algorithms, Images, Appendix of immunization schedules and US Preventative services taskforce.

2[1]

Selecting the Topics section, we have an alphabetical list of disease topics.

3[1]

By searching for chest pain, we can see that it comes with a very useful feature which I want to take you through, the algorithm. You are able to zoom in and explore the treatment algorithm for managing NSTEMI and STEMI.

4[1]5[1]

6[1]

Sadly, the algorithm suffers from poor picture quality, which renders some of the words unreadable. Moreover, the lack of interactivity makes the app feels much weaker in comparison to its competitors in the marketplace. In essence, they have just attached a pdf of a picture to a particular disease — and not really customized the pictures for a smartphone.

More importantly, by searching for Myocardial Infarction, we can get to the NSTEMI and STEMI topics.

7[1]

The medical app has the usual details you would expect – Basics, Diagnosis, Treatment, Ongoing Care, Codes, and Clinical Pearls. The level of detail is slightly less than what you would see in Epocrates, and 5MCC does not use a lot of primary literature as references. One unexpected but a fantastically useful (and fun!) feature that Epocrates does not have is the Clinical Pearls section.

8[1]

In this feature I found there were some very useful clinical facts (that may be outside a usual textbook), and are just plain interesting to read when free for 5 minutes, or when the ward round was winding down. This feature is of value as it has tips from clinicians that might not be so evident in textbooks or guidelines. I have not seen this been applied in any other medical app for the Blackberry.

9[1]

There was a special bonus which proved to be extremely useful for this new physician that just graduated; the Diagnosaurus 2.0 section. Imagine that you are in the ER and that a patient suddenly comes in with bitemporal hemianopsia, you form a quick differential list, but think that you need to be more thorough. You tap out “bitemporal hemianopsia” on Diagnosaurus 2.0 and a list of possible differentials pop up:

10[1]

Pricing and technicals:

  • You can buy this app for $99.95
  • This app requires 21MB of memory on the BlackBerry
  • It is available across the board apart from the BlackBerry platform (iPhone, Android, palm and Windows based phones)

Likes:

  • Algorithms section where you will find flowchart images for the management of hundreds of various signs and symptoms
  • Ability to automatically sync with the latest news updates from the CDC
  • Cheaper than Epocrates (rent at $159/year, compared to $99 for 5MCC to buy)

Dislikes:

  • The Diagnosaurus 2.0 section would be much more useful if they could allow multiple signs/symptoms in, and come up with a differential list based on the number of matches (in order of diagnostic probability)
  • Currently only 1 symptom can be put in at a time, (the iPhone version has this option enabled)
  • Currently only a small proportion of the differentials are linked to the 5MCC topic lists, it would be very useful if there are more extensive cross links
  • Epocrates has much more disease monographs compared to the 900 that exists for 5MC, however 5MCC is improving (in 2010 it only had 715 disease listings)

Conclusion:

  • The 5MCC app offers a very useful Diagnosaurus 2.0 feature that proved to be unexpectedly useful in the ER situation when forming a diagnostic list
  • This is a powerful and user friendly app for the physician in training, that needs answers on the trot
  • Physicians with more than a couple of years of experience will not find this as useful due to the lack of breadth of the coverage of diseases.

Link: 5 minute clinical consult for Blackberry