An Outstanding Open-access Rheumatology for All
The diagnosis and treatment of rheumatologic diseases can be daunting to primary care providers. Some common conditions such as osteoarthritis and gout can be almost entirely managed by primary care. But conditions like rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) typically required consultation with a rheumatologist. Not only can these diseases be challenging to correctly diagnose, the treatments for them have rapidly advanced in the past 10 years.
Some of these new treatments, the “biologics” of TNF inhibitors, JAK inhibitors, and IL-1/IL-6 drugs are best managed in consultation due to their side effects and cost. Most management guidelines for rheumatologic conditions are produced by the American College of Rheumatology (ACR).
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, medical calculators, etc. They have previously released a mobile app for their official publications including their primary journal; however, you must be an ACR member to access those publications. Recently, they have released a mobile app of their guidelines/criteria which we reviewed mostly favorably. Currently, this app includes the CPGs for the treatment of rheumatoid arthritis (RA), steroid-induced osteoporosis, treatment of psoriatic arthritis, etc. 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.
A Canadian rheumatologist at McMaster University , created an open-access educational website covering common rheum topics and procedures. Dubbed RheumTutor, the website provides brief overviews of ten common rheum conditions along with the related lab, rad, and medical treatments. Additionally, he provides outstanding “tutoring” on rheum x-ray interpretation, MSK exams, and MSK injections with high-quality videos. Although not available as a dedicated app, RheumTutor can be viewed on any web-browser and can be added to an iPhone screen as a web app.
Evidence-based medicine
The author of RheumTutor combines ACR guidelines with current medical evidence and expert opinion to create a comprehensive open-access website on common rheumatologic diseases. Part quick reference guide, part teaching tool, RheumTutor provides the basics on common rheum conditions with in-depth text and videos on MSK exams and MSK videos. The app appears to be free of any bias or pharma funding. Some of the content is from 2014, but these tend to be the videos which teach techniques that have not likely changed; although some newer DMARDs/medications are missing from that section
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 to use, but requires internet connection/no native app
o Video tutorials on MSK exam and MSK injections are fantastic
o Comprehensive sections on each disease, associated meds, labs, and rads
Dislikes
o Does not include common rheum conditions such as gout and osteoarthritis
o Some formatting issues for mobile devices
o Section on Assessment Tools needs expanded as only contains one tool: CDAI for RA
Overall
RheumTutor brings a rheumatologist to your computer or mobile device for free. The web app includes an overview of common rheum conditions, ACR guidelines, information on biologics, and tutoring sections on radiographs, MSK exam, and MSK injections that are outstanding in their production. As the production of a single Canadian rheumatologist, RheumTutor is an amazing achievement.
Overall Score
o 4.5 stars
User Interface
o 4.5 stars
Easy to use despite being a website (scales well-enough for mobile), fast, intuitive and comprehensive.
Multimedia Usage
o 4.5 stars
Webapp includes numerous graphics, tables of ACR guidelines and criteria with outstanding training videos on MSK exam and injections. Requires an internet connection.
Price
o 5 stars
Website is free.
Real-World Applicability
o 5.0 stars
RheumTutor feels like having a rheumatology consult on your mobile device. The web app works great on a laptop and good enough on mobile. The open-access information can be applied at the point of care but also serves as a free online teaching resource for anyone who treats patients with rheumatologic conditions. The videos on MSK exam and injections are outstanding and worth reviewing. The app could be improved with slightly more in-depth content for the covered rheum diseases, but a quick reference it works. Highly recommended.
Device Used For Review
o iPhone 11 Pro running iOS 13.5
Website is available for all internet-connected devices. No dedicated app available at this time.
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.
