by: Sumeet Banker, MD, MPH
For many years, the Harriet Lane Handbook has been a trusted reference text for trainees and practitioners in terms of diagnosis, management, and treatment of childhood illness.
Edited by the pediatric chief residents at the Johns Hopkins Childrens Center, this pocket guide can often be found in the white coats of medical students and pediatric residents. The text undergoes frequent reviews and reflects the latest understanding of pediatric literature.
The mobile version nicely reworks the print edition to an electronic interface that is portable and accessible. Though it’s not perfect, it is a fair adaptation of the text-based diagnosis and management sections, while maintaining a great conversion of the extensive formulary, for which the handbook is well known. The app also offers some extras such as drug interaction checking and a listing of current pediatric news and literature.
This review will primarily focus on the layout and additional features of the app’s adaptation of the Harriet Lane Handbook rather than the content itself, which has been validated and reviewed in countless online book reviews.
That being said, the Handbook presents a comprehensive overview of topics in pediatric medicine ranging from cardiology and gastroenterology to dermatology and rheumatology, focusing on etiology, diagnosis, and management. There is an abbreviated outline of each topic, and notable exclusions are common pediatric surgical topics such as hernia and orthopedic syndromes (slipped capital femoral epiphysis, and tibial torsion).
The app allows users to browse the table of contents which is arranged by organ system, or scroll through an index of topics, similar to an index at the back of the book.
Once you have chosen a chapter, navigation is not always the quickest due to the need to scroll through the sheer volume of content, but a drop-down menu of sub-captions for the chapter facilitates mobility.
Overall, the content reflects the text from the print handbook, with identical tables and figures. These items are not embedded, but one click enlarges them for easy viewing. Navigability is easy within chapters, with quick links back to menus.
There is also a search function for tables and figures, which is convenient since so much information is presented in these formats. However, the tables and figures did not seamlessly make the mobile conversion, in that most tables do not fit on one screen and still require a lot of scrolling around on the screen to follow a row.
This same problem holds true for the text portion, which is not completely optimized for the mobile device. Chapters are essentially long screens of text that require lots of scrolling, with formulas that do not wrap.
One of the best features of this app is the easy-to-use formulary, with convenient medication search function. Medication information is displayed in a familiar Harriet Lane Handbook format with information on breastfeeding/pregnancy compatibility, as well as hepatic and renal excretion. Drug dosing is provided by age group and by indication, with additional medication instructions. The only thing that would make this portion better is a convenient in-app calculator to help calculate exact dosing.
There are additional features in the Harriet Lane Handbook for Mobile and Web that are not included in the print book. First, A-Z Drug Facts provides extended information on medications, including over the counter medicines. The layout mimics the drug’s monograph, and includes trade names, indications, adverse reactions, and much more. The database may be searched by name or by therapeutic class.
Second, Drug Interaction Facts allows cross-checking of drug-drug interactions among multiple medications to ensure safety.
Third, MEDLINE Journals keeps users up-to-date on the latest abstracts from the medical literature. It comes pre-loaded with JAMA, Journal of Pediatrics, New England Journal of Medicine, and Pediatrics, with the option to customize additional journals.
One additional feature of this app is the ability to search across multiple indexes. This option returns search results from the handbook, formulary, and drug facts, which can be a very useful function.
- One of the best pediatric formularies on the market
- High volume of pediatric medical content, arranged by organ system
- Ability to search along multiple indexes and databases
- Table of contents lack major common surgical/orthopedic topics
- Charts/tables don’t often fit on one screen and can become difficult to maneuver
- The handbook’s text and tables are not optimized for the mobile device
- Overall, this is a valuable app for pediatric caregivers given the wealth of information it contains
- Though the text portion of the handbook is just a fair adaptation of a great resource, the convenience of having all the information on a mobile device rather than a bulky “pocket” guide is a redeeming quality
- What it lacks in text content readability, it makes up in the amount of drug information contained in the drug facts, interaction checking, and formulary
- These drug resources alone are worth the book’s weight in gold, and anyone who has lugged around a “Harriet” in their white coat pocket knows what that’s worth