For the busy primary care provider, deciding what imaging test to order for various medical conditions can be challenging. Some guidance about what to order and what not to order can be found piecemeal via the Choosing Wisely Campaign website. The American Academy of Family Physicians for example does not recommend imaging for low back pain in the first 6 weeks unless the patient has red flags. The American College of Radiology (ACR) gives five different Choosing Wisely recommendations including not to get a CT in children with suspected appendicitis until ultrasound is considered and not to image uncomplicated headaches. But what about other conditions? The ACR publishes their Appropriateness Criteria online, but only basic search functions are allowed for non-members and there is no mobile version available.
So where should primary care providers turn to find current imaging recommendations on their mobile device? Radiology Consult 2015 is a new app from a group of radiologists at the State University of New York at Buffalo. It appears to be a large group effort involving radiology faculty, a family physician and even medical students were able to participate in the creation of the content. The app aims to guide physicians in choosing the most appropriate imaging study for the suspected patient diagnosis/symptoms. Currently, the app contains algorithms for 34 common conditions including exam preparation for patients with contrast allergies and even a few built in calculators.
Evidence based medicine
The app includes some basic statistics on some of the studies such as diagnostic accuracy, but doesn’t give references for the recommendations. They appear to be graded via the Level 1, 1a, 1b approach, but that is not explicitly mentioned. They do not perfectly mirror the ACR criteria though they are very similar. The app does mention that the content was inspired by a book entitled Cost Effective Diagnostic Imaging: The Clinician’s Guide, but the app authors have provided updated information.
What providers would benefit from this App?
Students, residents, mid-levels, Family Medicine, Internal Medicine, and Emergency Medicine providers. The app could really benefit any provider who orders diagnostic imaging studies.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Easy to use, intuitive interface utilizing algorithms and medical calculators.
- Gives information for study prep in patients with contrast allergies..
- Includes alternative workup recommendations for children and pregnant patients.
- Some recommendations are questionable for first line choices such as MRI for LBP*.
- 34 conditions included, but certainly far fewer than the ACR Appropriateness Criteria.
- Price is somewhat steep for the content.
- Not available for Android
* We have highlighted specific clinical scenarios where we don’t agree with the app’s recommendations.
A good, but not yet great addition to the growing list of radiology apps. This app has a lot of potential to assist primary care providers in ordering the right test at the right time on the right patient, but it falls a little short due to some questionable recommendations and some key topics are not yet included.
- Overall Score
- User Interface
Simply, intuitive, built in calculators, but nothing fancy.
- Multimedia Usage
The app could be improved with links to key references. Does have some built in calculators.
Price may be too steep for experienced providers.
- Real World Applicability
A nice to have, but not must have app for providers who want clear recommendations when ordering diagnostic imaging studies.
- Device Used For Review
iPhone 6 running iOS 8.3
- Available for DownloadiPhoneiPad