Rheumatology Guidelines on Your Mobile Device

The American College of Rheumatology (ACR) represents rheumatologists and their patients here in the United States. Founded in 1934, their stated mission is “to empower rheumatology professionals to excel in their specialty.” Their website is filled with information for their members as well as non-members including clinical practice guidelines, diagnostic criteria, and medical calculators.

They have previously released a mobile app for their official publications like their primary journal. But you must be an ACR member to access those publications. Recently, they have released a mobile app of their guidelines/criteria called Guidelines and Criteria. This app has the CPGs for the treatment of rheumatoid arthritis (RA), steroid-induced osteoporosis, treatment of psoriatic arthritis, and more. The criteria section covers topics from classification criteria for RA to gout. It is worth noting that the complete set of guidelines and criteria are only available on the ACR website at this time. Finally, many of the ACR guidelines are currently undergoing revision (again see the ACR website) so keep that in mind when reviewing information in the app as some of these manuscripts are now 5-10 years old.

Evidence-based medicine

The ACR creates its guidelines via working groups who evaluate the literature and use the GRADE criteria. Although not as ideal as say the approach of the USPSTF/Cochrane collaboration, the guidelines are evidence-based. Each guideline includes the methodology, GRADE recommendations, working group panel members, etc. Nonetheless, the concern for outside influence from pharma is certainly real. The bigger issue is the age of many guidelines/criteria with most between 2010-2017 publication dates.  

Who would benefit from this App?

Students, residents, mid-levels, primary care providers, internists, rheumatologists, any provider who treats patients with rheumatic conditions.

Price

o Free

Likes

o Interface easy enough to navigate between guidelines and criteria

o Includes full guidelines on device and helpful calculators/tools; nice tutorial

o Available for Android

Dislikes

o Does not include all ACR guidelines/criteria (only on ACR website) plus many are old

o Some formatting issues throughout the app, calculators can be difficult to use

o Some pharma funding of app though no obvious advertisements/bias

Overall

The ACR CPG/Criteria app brings some (but not all) of the ACR guidelines/criteria to all providers for free. The app includes the entirety of each guideline, criteria lists, and calculators (gout for example). The app is not as easy to use as it should be but nonetheless may prove popular to primary care providers and rheumatologists. Finally, the app does have occasional pop-ups “thanking” several pharmaceutical companies for partial funding of the app.

Overall Score

o 4.0 stars

User Interface

o 3.5 stars

Functional but certainly not ideal with a layout that is not great for mobile and calculators that are difficult to use.

Multimedia Usage

o 4.0 stars

App includes a number of the ACR guidelines and criteria with entire guidelines on the app as well as handy calculators.

Price

o 5 stars

App is free.

Real-World Applicability

o 5.0 stars

The ACR CPG/Criteria app puts the most current ACR CPGs and criteria in every providers’ hands even if not an ACR member. The app, however, is not perfect with some challenging formatting issues, but the entire guidelines that are included are on the app. The app would be improved by including all currently available ACR CPG’s and some updating to those CPG’s as well as improving the look and feel of the app (especially the calculators).

Device Used For Review

o iPhone 8 running iOS 11.3.1

Available for download for iPhone, iPad, and Android.

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.