by:Joshua James Harding BSc Hons (MS2)

Building on the success of the trusted and popular Case Reviews Online series, Elsevier has now brought the series to the iPad in the form of five individual apps.

The Case Reviews series utilizes various imaging techniques that allows the user a comprehensive and interactive way in which to test their knowledge of a full range of diseases. Here we take a look at how this series fares on the iPad.

There are currently five apps available in the Case Review series on the iPad.

1. MSK imaging case reviews (with over 600 images across 200 cases)

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2. Thoracic imaging case reviews (with over 300 images across 164 cases)

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3. Brain imaging case reviews (with over 600 images across 200 cases)

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4. Spine imaging case reviews (with over 400 images across 183 cases)

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5. Pediatric imaging case reviews (with over 500 images)

Review

The first thing to note is the user interface, which requires minimal explanation as it is a very basic layout and simple to use. Nothing to complain about here.

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You select the “chapter” from the contents on the left of the screen. This will allow you access to a set number of cases e.g 1-50, 51-150 and so on. Once selected, the individual cases will appear with associated images to its right. You then simply select the case you wish to view.

Each case provides you with a handful of relevant scrollable images, each with a legend. The image, whether it be a CT or plain film, once selected, can be explored with the pinch and zoom finger technique to give you a better view.

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It is possible to toggle on and off the legend for each image as well as image labels. These are quite useful if you are struggling with a differential as it will give you a little bit more information or will literally point you in the right direction.

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Alternatively, having this information in the “off” position may present a more realistic challenge to the more astute users.

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As you might expect, each case comes with a question. You can start answering the case questions at any point by pressing the Q at the bottom of the screen. The questions are in a multiple choice format and generally ask you to determine the most likely differential diagnosis from the images you have been presented with.

Once an answer has been submitted, you will see the correct and incorrect answers and an explanation for each. This is very helpful if you have not been successful in answering the question as the text below the incorrect answer will explain why it should have been included in your DDx.

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Other features of the app include the ability to bookmark certain cases. This feature can be used to either log your progress or allow you to return to the next case at a later date. Alternatively, you could use it to flag common or important cases as you wish.

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It is also possible to make notes on each case by clicking the pen and paper button. The notes section can be used to add any information that might be of use to you, whether it is a pneumonic or an extra detail surrounding the subject.  This is a worthwhile feature in my opinion.

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Once you are satisfied with your progress, or upon returning to the app, you can access the overview screen. This screen shows you your current progress in terms of questions unanswered, questions answered and of those, how many correct or incorrect. This section is headed with an assessment start date, which can be reset along with the questions answered.  This effectively allows you to wipe the slate clean and see if you can improve upon your old score the second or third time around.

This screen also provides you with a list of your bookmarks and notes. Each section — Incorrect, questions unanswered or bookmarked — is all selectable, meaning you can view and navigate to, for instance, your saved bookmarks or questions you still need to get right.

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While this app doesn’t break the mold when it comes to novel and intuitive ideas, it does provide you with a huge resource of high yield self-tests which will be invaluable to many.

I cannot help but feel, however, that all these images are not being fully utilized. A single question on choosing a DDx is all that most cases have, and I feel that simpler questions such as clinical anatomy relating to the case or pure spotter anatomy could easily be added widening the user base of the app. In its current form, I feel it would lend itself well to newly qualified doctors or those studying for board exams.

Cost:

  • $19.99 each

Likes:

  • The ability to add notes to each case
  • High yield cases can be bookmarked
  • Overview section adds a competitive edge (even if you are only competing with yourself!)

Dislikes:

  • The contents of each case are not optimally organized
  • The UI is somewhat dull

Conclusion:

  • This app would really benefit from better content organization, currently bunched into cases 1-50 with no real relevance to their organization it is difficult to compartmentalize the cases into certain topics or regions of anatomy.
  • Simply putting the cases under categories, whether they are clinically orientated e.g “fractures”, or anatomically organized e.g “upper limb” would make a huge difference and the app a lot more user-friendly.
  • All in all, though, this series of apps are reliable and absolutely packed with high yield cases. For the price, you are definitely paying for the volume of content with these apps and not a lot else.
  • Put simply, the apps get the job done.

iTunes MSK Imaging Case Review

iTunes Thoracic Imaging Case Review

iTunes Brain Imaging Case Review

iTunes Spine Imaging Case Review

iTunes Pediatric Imaging Case Review