Nearly 200,000 people get pacemakers every year. And when they show up to the ER or clinic with syncope, palpitations, dizziness, or any number of other symptoms, interrogating these devices can provide a lot of information. Even just figuring out the type of device can be helpful; if someone has an ICD but deny a history of VT/VF, there’s a good chance they have systolic heart failure.
To interrogate a device though, you generally need to know the device manufacturer so you can use the appropriate equipment to read the device. And somehow, people tend to lose those little information cards with the device information (I’m pretty sure I’d lose that in about a week).
You can figure it out through trial & error or calling each device company’s help lines. But another useful trick is to look at the chest xray, which can actually tell you a lot about the device including potentially the device manufacturer. That’s what CRMD Finder helps you do.
The app’s design is refreshingly simple though there are some tweaks that would help. It starts with an obvious question, basically reminding the user to ask the patient if they have their device card.
If they don’t, you can use the chest x-ray to try to identify the device. First, you look for a manufacturer sign on the device. If you can see it, the app give you close ups of the alphanumeric codes unique to each manufacturer.
If you can’t see that code, it then looks at device characteristics and tries to help identify the device. First, it asks whether there are one or two shadows – a trick to try to separate pacemakers from ICDs or CRT-D devices. The app then provides close up images of the devices made by different manufacturers to match to the image of your patient’s device; the presentation of these images and information works but could be improved.
A useful addition would be guidance evaluating the leads: number of leads, lead locations, shocking coils. That would help define the type of device i.e. single chamber pacemaker, dual chamber pacemaker, single chamber ICD, CRT-P, etc.
The app would also benefit from information on information source. The app’s information page does note it was developed by Dr. Ines Sherifi, a cardiology fellow at Mount Sinai in New York with a background in engineering, who worked with a friend, Tarun Kotia, to develop the app. She came up with the idea after getting the call that every cardiology fellow in the country gets – “We need this device interrogated but have no idea what kind it is.”
As for information source, we contacted Dr. Sherifi to verify the source of information for the app; according to her, the app builds on a paper published in 2011 outlining the identification of implantable cardiac devices on chest x-ray. It was a very practical paper that wasn’t available in a very usable form.
- Simple and straight to the point design
- Makes a resource that’s not in a very usable form (paper) useful at point of care
- Free, so can be downloaded & filed until needed
- Lack of references for information sources
- Would add information on looking at leads to identify device features
- Missing some more nuanced device identification features
CRMD Finder targets a very specific need, being able to identify an implantable cardiac device manufacturer & type, where a big part of the task’s difficulty is simply because the needed information wasn’t really in a usable, accessible form. The simple, to the point design is appropriate. Given the app is free, if this is a scenario you have or could encounter, then the app is worth downloading.
- Overall Score
- User Interface
Simple design but would benefit from some UI improvements (like improving need for lots of scrolling)
- Multimedia Usage
Not as relevant for this app’s use case
- Real World Applicability
Targets a specific & real clinical need
- Device Used For Review
- Available for DownloadiPhone