Your Cell Phone and Searching PubMed: Full Text May Not Work

Wow time flies when you are having fun, or staring at the screen of your cell phone.  Did you know it has been over 10 years since the first iPhone was released?

According to an article in Computerworld “Nine of 10 healthcare systems plan significant investments in smartphones and secure unified communications over the next 12-18 months.”  (April 4, 2018) More and more hospitals systems are providing cell phones to their care givers and integrating their usage into their workflow (access the EHR, lab results, pharmacy orders, etc.) The cell phone is the individual’s portable computer. An older (2013) report stated 74% of their surveyed physicians used a smartphone for professional purposes which included using diagnostic tools, drug information, and reading articles. Back in 2013 they stated the most often used app on a tablet was an app for medical journals/newspapers/magazines followed by diagnostic apps. In 2017 the Physicians Practice 2017 Tech Report, shows that reading journals on a mobile device is still very popular. In this survey it was the second most reported activity physicians did when using their smartphone at work.  Looking up drug information was first, reading articles was second and looking up diagnosis and treatment information was third. Of the responding physicians, 64% reported using mobile technologies for reading journals online (slide 12). The need to read articles on a mobile device has remained important to physicians over the years.

Not surprisingly medical libraries have been adapting to this for some time. Many libraries have optimized their websites to be more mobile friendly. Lots of libraries have web pages or libguides dedicated to mobile apps (just a few examples: HSLS University of Pittsburgh, Becker Medical Library Washington University, Health Sciences Library UNC) The demand for reading journal articles on mobile devices is big. Browzine and Read by QxMD are the two main apps for reading journal articles online.

Our patrons rely upon full text information being available. They want to access the full text of an article quickly and easily. Why do you think Sci-Hub got so popular? Science reported “many users can access the same papers through their libraries but turn to Sci-Hub instead – for convenience rather than necessity.” Given this information, it is important that access to the library’s full text article be easy to access when searching the literature databases, regardless of the device used. So it surprised me the other day when I was struggling to help a physician access the full text of an article when they were using PubMed on their cell phone. We tried everything, but it always resolved out to the publisher (not always the way we own the article). It did not use not our Outside Tool that we set up.  I even tried finding a way tap the link that says go to full website. No dice.  We could not access the library’s subscribed journal article in PubMed on the cell phone. Surely I was missing something obvious.  Surely NLM has figured out away in 2019 to connect physicians to their library’s full text collection while searching PubMed on their cell phone.

Well I was wrong. I reached out to NLM and a person from the MEDLARS Management Section responded they “don’t currently offer a way to populate library links (via Outside Tool or LinkOut for Libraries) on the mobile PubMed site. If the URL to the publisher happens to activate IP authentication on the publisher end, your users will get access via your subscription.” Basically that means IF your user is ON your IP range AND you get the article from the publisher (not via consortia, full text database, or other means) THEN your user can get access. That is not good. Even on campus, a lot of articles are inaccessible. Off campus…well nothing is available.

So what are other librarians suggesting to their patrons?  Our patrons use Browzine to keep current with their favorite journals and they love it. But what do you suggest for people who search for articles on a topic? Are you still encouraging them to use PubMed from the cell phone even though access to full text articles will be difficult and frustrating for them? Are you suggesting other sites or apps for searching MEDLINE? What about Ovid MEDLINE? Or is this question pointless because everyone searches Google, gets frustrated accessing the full text  and runs to Sci-Hub?

I am very interested in hearing other librarians’ thoughts on what mobile apps or mobile friendly sites they use to search MEDLINE that preserves the library full text linking. Leave a comment.

 

Odds & Ends of possible interest

Useful FireFox extensions :

  • Distill

This allows you to monitor a web page  for any changes. You can highlight just part of the page (handy as some pages  change a lot  with tweets or whatever so you want to avoid that) and it will track changes only in that section – useful if looking for a report to appear, update to a publication. The only tricky thing with it is that  when you highlight a section the Save changes icon you want is bottom right (took a while to find that)

  • Lightshot and Awesome Screenshot  Plus

Both of these make capturing and annotating screenshots  very easy which is useful for training  materials, highlighting problems  via emails etc

  • Copy as plain text

Just a little  thing but find it useful. Adds a  right click option to a highlighted  items in the browser  such that  you can copy as  plain text and don’t have formatting carried over  into whatever you are  copying into

  • Vimperator

Essentially it converts links into numbers and you can “click on the link” by typing the relevant number so in a sense  creates  keyboard shortcuts  for websites. Could be useful with any web interface used frequently.

  • Lastpass

Oldie but a very goodie – only ever have to remember one password.

 

Other bits and pieces:

PubMed for Nurses  tutorial

UpToDate now more useful  for those that subscribe

There is now a specific ClinicalKey app (rather than just a mobile optimised site) but apparently only available in the US for the moment

Booko price alert. Booko is useful for finding the best prices for books (including delivery). It now has a feature where for a given item you can set a price target and be alerted when price drops below your nominated figure. This feature is below the book cover image.

Move between browser tabs. It is quite easy to get caught out using alt-tab when all you actually want to do is move between tabs of the browser. Ctrl-tab works for most browsers so you just have to think ctrl instead of alt

On the Wards. This is a website for junior docs containing podcasts, blogs and videos. The podcasts are interviews with senior clinicians that discuss common questions and case based scenarios that junior doctors will face on the wards etc

A few new useful(?) MeSH headings for 2015 – Legendary creatures, Long term adverse effects, Smartphone, Spirit possession, Giraffes, Hoarding disorder

Continuing with MeSH. MeSH On Demand identifies candidate subject headings from text pasted into the search box

Two newish PubMed alerting services – Medumail and MedSubscriber

Papers, the reference manager, for iPhone and iPad is now free

British Medical Library Association book prize winners 2015 for possible book purchases

WriteCite Builds citation as student enters details so they can learn the structure

The Cloud Catalog: One Catalog to Serve Them All

And with that it is time now for a coffee

Quality and Safety Concerns for Medical Apps

I just read a brief perspective article in the journal Evidence Based Medicine, “Medical apps for smartphones: lack evidence undermines quality and safety.”  It is a quick little read and it brings up some very real and interesting points which I will try to summarize.

  1. There is no official vetting system for medical apps – Some apps are blatantly wrong and dangerous, some are out of date therefore also dangerous.
  2. Lack of information and clinical involvement in the creation of the apps – There is a paucity of information regarding the creator of the app. Some apps have no physician involvement.
  3. Companies (authors specifically mention Pharma) creating apps could create conflicts of interest and ethical issues – Pharma apps could produce drug guides or clinical decision tools that subtlety push their own products.

The FDA will regulate some apps but not all.  The FDA will regulate apps that control a medical device or displays, stores, analyzes patient data (example: electrocardiogram).  They will also regulate apps that use formulas or algorithms to give patient specific results such as diagnosis, treatment, recommendation or differential diagnosis.  Finally they will regulate apps that transform a mobile device into a medical device (example: apps that use attachments or sensors to allow the smartphone to measure blood glucose).

That still leaves a ton of medical apps hanging out there in the app stores which are largely unregulated.  The article states, “Until now, there has been no reported harm to a patient caused by a recalled app. However, without app safety standards, it is only a matter of time before medical errors will be made and unintended harm to patient will occur.”  Basically it is the Wild West in the medical app arena.

There are two groups that are trying to evaluate medical apps.  iMedicalApps.com and the Medical App Journal review various apps directed toward medical professionals.  I take issue with the article authors who state these sites are a “good starting point for peer-reviewing apps, the current assessment criteria do not address the scientific evidence for their content, but rather matters of usability, design, and content control.”  While I don’t use the Medical App Journal as often,  I use iMedicalApps.com quite often and they do more than just assess the usability and design. I have read reviews where they question the medical correctness of apps, intended audience, and have even pushed for more information regarding authorship/responsibility.  Several of their reviews questioned an app’s update schedule and updated content.  They have also investigated, questioned, and reported instances of fraud and plagiarism with medical apps.  I think iMedicalApps does a very good job in a very flooded market, but there are areas for improvement.  As with any website that relies on a large number of reporters/reviewers, there is some variance in the quality based on the reviewer.  I haven’t found any reviews that are bad, just some are better and more thorough than others.  Perhaps a little more explanation or transparency regarding how they determine the accuracy or validity of medical app might be helpful, or a standardized checklist about the things they look at.  I realize evaluating the latest UpToDate app is different compared to an app on EKGs.  UpToDate already has an established proven product where as there is more to investigate and validate with an app that isn’t a version of an already established product.

The authors believe the medical community needs to be more involved with regulating medical apps.  They suggest:

  1. Official certification marks guaranteeing quality
  2. Peer review system implemented by physicians’ associations or patient organizations
  3. Making high quality apps more findable by adding them to hospital or library collections

1.  I like the idea of having an official certification indicating quality, but there are two things that must be addressed prior to that.

First you have to get the organizations to actually take responsibility for looking at apps that are in their area of expertise. The field is already cumbersome, I am not sure many organizations are able to handle that. Although I have found that several journals have now included app reviews.  While they can’t come close to scratching the surface of medical apps, these journals often have MDs, RNs, MPTs writing reviews and evaluating the content.  Specifically I have found some good reviews in the physical therapy and nursing journals.

Second, there is growing problem with fake certifications. If an app is created by a company or people who already don’t care about its accuracy or is a plagiarizing a product, they probably have no qualms about lifting the image of the certification and posting it on their website.  They could create their own certifications to fake (but legit sounding) orgs and post those on their app’s site too.  Official certification is a good idea and I like it but there needs to be more to it to make sure it truly represents quality.

2. I personally believe the writers at iMedicalApps.com are on their way to something of a peer review system.  Right now they only have one person review an app.  While that completely makes sense from a writing perspective, perhaps they can implement some sort of peer review process where more than just one person is reviewing the app, yet still retain the one voice post for ease of reading.  Perhaps they could  reach out to a few medical professionals who are leaders in their field to review specific apps.  Thus giving the reviewed app a little bit more weight.  This along with astandardized check list or illustrating how they review the medical accuracy of an app would make the information on their site even more important and provide an excellent way of separating the wheat from the chaff.

3. An online repository of approved apps would be great.  Some hospital IT departments that have mobile device policies have this, but they seem to be only hospital type apps like Citrix or database subscription apps like LexiComp, PubMed, UpToDate, etc.  While these apps are important, there is little worry about apps like LexiComp, UpToDate, or PubMed because they were well established medical information products before their app.  Their app is just an extension of their verified product.  I don’t see a lot of  IT departments that have investigated having a pool of apps that aren’t hospital specific or from database subscriptions.  Additionally, IT would either need to rely on an outside sources like iMedicalApps or content experts within the field in that hospital to build the app pool.  IT would have no way of verifying the authenticity and validity of an app on pediatric emergency medicine.

Finally, getting hospitals to buy bulk licenses to apps is tricky at best.  With exception of a few places like Epocrates, Unbound Medicine, Inkling, and Skyscape (many of those companies dealt with institutional subscriptions before app stores….remember PDAs?) there are very few places that sell or license apps to a group of people.  The purchasing of apps was created as an individual service.  Now academic medical centers may have a foot in the door with iTunes U, but I have heard that discussions with Apple and their app store and hospitals is an “interesting” process.  The same principle applies to library repositories.  Instead of IT aggregating the apps, the library would do that.  There are a lot of library’s that already have great lists suggesting various medical apps.   But the vast majority of medical libraries have app resources guides, suggesting apps that the individual must buy.  Also just like with an IT repository of apps, the librarian must rely on sites like iMedicalApps.com or their own physician suggestions to ensure they are listing quality apps.

Like I said it is the Wild West when it comes to medical apps.  That is because the whole app industry is a new frontier.  There are quality and accuracy problems with other apps in the app stores. A pedometer app with errors is not going to kill somebody, but an inaccurate medical app can.  Yes, the medical community needs to get involved in evaluating apps, but so does Apple and Google.   Right now Apple’s iTunes store feedback and ranking system while good for games, is not adequate for medical apps and can easily be subject to fraud.  Additionally, Apple is extremely tight lipped about its app store rules and regulations.  Some apps have extreme difficulty getting approved, while others fly through approval process only to be mysteriously removed later.  There is no transparency to the Apple App Store.  For example, there is no information about the app Critical APPraisal which was determined to be a plagiarized version of Doctor’s Guide to Critical Appraisal.  The app was available in the App Store July 2011.  However, if you searched today for the app, you wouldn’t be able to find it in the App Store, it simply disappeared.  Unless you happen to read the article in BMJ, iMedicalApps.com, or a few other British publications, you would have no clue as to why the app was removed.  When it comes to dangerous apps, disappearing them from the App Store is not good enough. You must have transparency when it comes to medicine.

**Update**

According to an updated BMJ article, the doctors accused of plagiarizing The Doctor’s Guide to Critical Appraisal to use in their app Critical APPraisal, have been cleared of plagiarism by the Medical Practitioners Tribunal Service.

“A regulatory panel rejected charges by the General Medical Council (GMC) that Afroze Khan, Shahnawaz Khan, and Zishan Sheikh acted dishonestly in knowingly copying structure, contents, and material from a book, The Doctor’s Guide to Critical Appraisal, when developing their Critical APPraisal app, representing it as their own work, and seeking to make a gain from the material.”

Shahnawaz Khan and Afroze Khan were also accused of dishonestly posting positive reviews of the app on the Apple iTunes Store without disclosing that they were co-developers and had a financial interest in the app.  The GMC found that Shahnawaz Khan  no evidence that he knew that the app, which was initiallly free, would later sold for a fee. His case was concluded without any findings.  However, the GMC panel found that “Afroze Khan’s conduct in posting the review was misleading and dishonest.” Yet they considered this type of dishonesty to be “below the level that would constitute impairment of this fitness to practise.”  The GMC panel said it was an isolated incident and did not believe it would be repeated in which they “considered his good character and testimonials attesting to his general probity and honesty and decided not to issue a formal warning.”

 

Plagiarism of Medical Text in Medical Apps

In a recent post, Timothy Aungst from iMedicalApps.com sheds more light on the trend of copying established medical textbooks and repurposing it in a medical app that they sell on iTunes.  Aungst cites a recent report in BMJ, where three doctors, “Afroze Khan, Zishan Sheikh, and Shahnawaz Khan face charges of dishonesty in knowingly copying structure, contents, and material from the Doctor’s Guide to Critical Appraisal, by Narinder Gosall and Gurpal Gosall, when developing the app, representing it as their own work and seeking to make a gain from the plagiarised material.” Not only did the doctors plagiarize the text, but according to Aungst and BMJ the doctors also sought to increase their ratings within iTunes by writing reviews of their own apps without disclosing an conflict of interest.

This type of plagiarism is not new. In fact as Aungst states iMedicalApps.com Editor, Tom Lewis, discovered several apps in iTunes that plagiarized other works.  (I wrote a brief post about Tom’s finding while I was on vacation last year.) I can see from Tom’s comment that while he never heard directly from Elsevier regarding the issue, YoDev apps LLC had all of their apps pulled from the App Store.

Copying and re-posting a book online or through bit torrents for free is so 2005.  Welcome to the new world where plagiarizing can make you money. All you have to do is steal the content and sell it in an app.  They are also sneakier than they were in 2005.  They aren’t selling the app under the original book title, they are changing the name and trying to market it as something totally different.   Hmm it seems requiring users to use personal logins to view the PDF is really working to curb copyright violations.

***Update***

According to an updated BMJ article, the doctors accused of plagiarizing The Doctor’s Guide to Critical Appraisal to use in their app Critical APPraisal, have been cleared of plagiarism by the Medical Practitioners Tribunal Service.

“A regulatory panel rejected charges by the General Medical Council (GMC) that Afroze Khan, Shahnawaz Khan, and Zishan Sheikh acted dishonestly in knowingly copying structure, contents, and material from a book, The Doctor’s Guide to Critical Appraisal, when developing their Critical APPraisal app, representing it as their own work, and seeking to make a gain from the material.”

Shahnawaz Khan and Afroze Khan were also accused of dishonestly posting positive reviews of the app on the Apple iTunes Store without disclosing that they were co-developers and had a financial interest in the app.  The GMC found that Shahnawaz Khan  no evidence that he knew that the app, which was initiallly free, would later sold for a fee. His case was concluded without any findings.  However, the GMC panel found that “Afroze Khan’s conduct in posting the review was misleading and dishonest.” Yet they considered this type of dishonesty to be “below the level that would constitute impairment of this fitness to practise.”  The GMC panel said it was an isolated incident and did not believe it would be repeated in which they “considered his good character and testimonials attesting to his general probity and honesty and decided not to issue a formal warning.”

The Journal App Wars

I have doctors asking about all four journal browsing apps; Docwise, Docphin, Read, and Browzine (click links for reviews on each app. The reviews were either done by me or guest librarians who had access to the app).  A few of the requesting doctors have used one of the above products, but it seems the vast majority of the doctors haven’t used any of the apps and are asking based on word of mouth. 

The four apps are very similar.  To me it is a bit like comparing PubMed vs Ovid Medline, both do the job well but differently.  You also have people who prefer one over the other.  One is free while the other is not. 

The biggest difference is that three of the apps show the abstracts and tables of contents to almost every medical journal known to man (I over exaggerate of course).  The full text is provided if the library/institution as a subscription to that journal.  However, there is no clear branding or explannation of what journals the library/instituion owns because Docwise, Docphin, and Read don’t know.   If a doctor views the table of contents for the Journal of Big Toe Science in Docwise, Docphin, or Read  (which is not owned by the library), the doctor is denied the full text.  Last time I checked, there was no clear message as to why they can’t get the full text. Docwise, Docphin, or Read didn’t say soemthing like, “Your library doesn’t subscribe to this journal therefore you can’t access the full text.” Docwise, Docphin, and Read do not know the library/institutions holding or access methods.

Browzine does know what the library/institution owns.  Because the library submits the list (with access methods) to Third Iron (the company that owns Browzine).  Browzine only shows those journals to doctors. There is no guessing as to whether it is available full text to the doctor.  If it is in Browzine, it should be available full text.

Let’s pretend that my hospital library provided proxy access to resources. (Most hospital libraries don’t have proxy servers to provide access to journals or other resources.)  I could have my pick of these apps to provide to my users.  My question for librarians is: Do I list all four apps and let them decide what they want?  I have a very strong feeling (based on 15 years of answering doctor’s library questions) that doctors are going to be complaining about Docwise, Docphin, or  Read not providing the full text.  After all, if the library recommended a product that connects users to the full text, shouldn’t everything be full text?

What do other libraries do?  Do you list all of the apps and let the users decide?  Do you worry that there might be confusion among the apps because they are so similar but slightly different? Do you worry that doctors might feel frustrated when they can’t get the full text? Would doctors even bother ordering the unavailable article (going outside of the app to do this) through the library? 

I appreciate your thoughts and comments. Because sometimes I feel with these journal apps I am being asked to pick between Coke and Pepsi, Ovid and PubMed.  I know the difference between them, but my users don’t. Does it matter?

The Doctor’s Instagram

The app Figure 1 has been getting a lot of press recently.  I learned about it a few weeks ago but I am just now getting around to mentioning it here.

Figure 1 is being called the Instagram for doctors.  It is a crowdsourced  images database app.  The crowd happens to be doctors, and the images happen to be medical images.  The app is a collection of medical images submitted by doctors to share, collaborate and learn from.  Doctors are verified using their institutional email address.  The app takes patient privacy very seriously.  It has a face detection program that automatically blocks out the face in a submitted photo and it includes other editing tools to remove other identifying features.  A HIPPA authorization digital consent form is also included.  Patients click the agree button then sign screen/form.

You don’t have submit any images to benefit from the app according to their site. “First of all, you can still access the images that others are posting so that you can learn from them, use them as a reference for your own practice, or comment on them so that others can learn from you.”

David Ahn at iMedicalApps posted a great review describing the positives and negatives of this novel app.  He notes some of the limitations of the app are the indexing of the images and lack of identifying information.  Ahn discovered upon doing a search for heliotrope rash that the first seven results were “clearly not a heliotrope rash.” As librarians know, indexing images is tricky.  Ahn noted Figure 1  also pulls images from outside medical websites (non-user submitted images) and a link to the website instead of the submitter’s name is listed.  However the outside images have “no captions, markings, or even any clear diagnosis listed.”  Besides the obvious problems with lack of identifying information, Figure 1 displays user submitted images before web scraped images.  As Ahn illustrated with the heliotrope rash, this can cause problems because the correct image (scraped from the web) was buried below the 7 incorrect ones (user submitted ones).

Additionally, I find doctors not only want to see and share images, but they often want to include them in presentations and slides for teaching purposes.  Right now you can only share the images through the app.  Emailing a colleague an image gives them a simple email (below) requiring them to use Figure 1 to see the image.  Making it so Figure 1 images can be used in presentations would make this Instagram like app even more useful to doctors and medical professionals.

 figure1email

This is a very new app. It appears they launched in May 2013, so it isn’t surprising that there is some room for improvement.  I don’t know of any products or apps that are perfect 3 months from their launch.  Yet as of today, it is the 5th most downloaded app in the Medical category of iTunes and according the MedicalApps post, the app is outpacing Landy’s projections.  So, given its popularity I expect to see some improvements relatively soon.

What I found to be interesting was Dr. Landy describing to Ahn his reason for creating this app.

Dr. Landy wondered how he could quickly access a medical image database to assist in identifying new clinical pathologies. This question eventually led him to create Figure 1. Like many physicians, he was not satisfied with the paywalls of private medical image libraries or with Google Images’ lack of medical selectivity.

Furthermore, when it came to sharing medical images with his peers, he found e-mail inefficient, as images would often get drowned out amidst ballooning inboxes. As a result, he helped create Figure 1, a free, crowdsourced medical image sharing resource that is quickly and easily accessible for health care practitioners.

Finding good medical images has always been a booger, and Dr. Landy is right about the frustrations of pay walls.  I would extend it a bit further to say that not only is the paywall part is a barrier to finding medical images, but the siloed nature of these medical image sites is a massive barrier as well.  Even if somebody has paid for these medical image sites, there is no repository or online catalog of all the image packages bought from different companies.  That makes searching for images difficult even if you paid for them.

I am curious to see how Figure 1 evolves and what impact it will have on doctors finding images.  I am also curious to see how/if subscription companies with medical image silos might adapt as a result of apps like Figure 1.

#Medlibs App & Tablet Share Site

There have been quite a few people who have emailed me personally saying they are looking forward to the discussion and they have things to share or want to know if anybody has something to share.

So from now and until we chat (tonight 6pm Pacific/9pm Easter) please comment with your URLs and other things you want to share to the group.  I will do my best to approve comments quickly so you can see them.  I promise that I will also add the comments as well as other URLs mentioned in the chat to the #medlibs blog.

Chat About Apps and Tablets Tomorrow on #Medlibs

Tomorrow (Thursday 3/7/13) at 9:00pm est, I will be hosting the #medlibs chat on apps and tablets.  What are you doing with apps? Are you creating a library specific app, catalog app, etc? Or do you have a good app guide that you want to share with others?  Is there a push for tablets within your institution, if so which one?  Can tablets access the EMR so that your docs & nurses can treat patients and do research with one device?

What other trends do you see or want discussed about apps and tablets?  Let me know?

Here are some sites you might be interested prior to the #medlibs chat.

Setting up iPad lending program
  • Nova Southeaster University Health Professions Division Library http://bit.ly/HApZqW – tips, resources
  • University of Groningen Central Medical Library http://bit.ly/15vCVqE -finding medical apps, information on adding bookmarks, (side bar has a lot of info)
  • Setting up a library iPad program: Guidelines for Success – http://crln.acrl.org/content/72/4/212.full Full text article in ACRL News by Sara Thompson at Briar Cliff University
  • Continuing the conversation: Integrating iPads and tablet computers into library services http://bit.ly/wgnMRS -ALA Tech Source article by Daniel Freeman

Policies and Procedures

App Stuff

Hope to see you on the chat tomorrow!  If you haven’t participated in a chat before, the easiest way to do it is use the cite TweetChat, login with your Twitter password and the follow #medlibs.

Docwise: The Fourth and Final Journal App Review

If you are reading this review please make sure you read the reviews on Browzine, Read, and Docphin to make an informed decision as these products are all very similar to Docwise. These apps help users view and read journals on the iPad. Docwise is another such app and the review below by Joey Nicholson is the last of the apps to be reviewed in genre. I want to thank Joey for his very thorough review. Hopefully after reading over the four reviews you will learn about each of the products and have the information to choose a product.
Docwise Revew
by Joey Nicholson
Docwise comes from new contenders in the medical journal app market. It is co-founded by two MIT alums, who both went on to pursue further education in healthcare (one is a practicing surgeon). They bill it as “a personalized e-journal for physicians” and as “the efficient way to stay up to date on all your medical news”. Currently, this app is only available for the iPad.
Once you download the app, you need to register for an account by adding your personal information. Since it is designed as a “physician, dentist and NP community”, the app will link to your National Provider Identifier (NPI) profile so that it can create a beginning journal collection tailored to your speciality. For those of us that aren’t physicians, we can still get in by using the manual registration option.

Image1

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In the manual registration, you are asked to provide your specialty and subspecialty. These items are required so that the initial journal collections you are shown are tailored to what you do and your interests. Theoretically, this should take some of the effort out of pulling together all those journals that someone may want to read by already having them grouped by topic. I selected preventive medicine and public health to start.

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Once you’ve indicated your speciality, the next screen presents your starter collection. For public health, the collection isn’t very large and should probably be expanded to include something like the American Journal of Public Health as a core title. But, the three titles that come up are relevant.
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From here you can tailor what it is you want to see in docwise. They have this broken down into three categories. You can add specific journals, you can add news feeds, or you can add topic areas.
Adding new journals to your personal collection is very easy, assuming you know in what category the journal of your choice is placed. Under Preventive Medicine, you can quickly hit the plus signs to add AJPH, BMC Public Health, and several other relevant journals. A search box here would be nice, I couldn’t find Academic Medicine under any of the journal specialty categories.
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A feature that I really like is the ability to add news stories to this, not just academic journals. There is a decent selection of top health-related news sources, including New York Times Health, Fitness, and Medical Research, and feeds from ClinicalTrials.gov and the CDC.

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Next you can enter topics in which you are interested. By using key words that you put in, docwise will create a topic feed and pull in articles from any journal on these terms. What isn’t clear about this from a librarian perspective, is where these key words are being searched. Title? Abstract? Full text? MeSH terms? PubMed? GoogleScholar? Once you are done adding journals, news, and topics you swipe that menu away and click done.

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While you can start reading abstracts and free articles that you happen upon right away, the next logical step is to add your institutional login information. To do this, you have to hit the Menu icon in the top right and then hit the gear icon in the bottom right to access your settings.

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Currently not all institutions are available in the institution login drop-down menus. While it doesn’t say this outright, I assume that you can use the link to email them and they would add your institution. Fortunately for me, one of the developers is a surgeon at my institution, so we are already in there.

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Once you’ve set up your institution, you can start reading your articles. In my case, I am routed to my library’s remote access login web page when I try to read a full article. I enter my user name and password and am taken directly to the article. Since this service is based on how the library sets up their remote access, this will vary depending on the institution. After I enter my login information once, it does retain it for a while. I can continue to read articles without having to enter my login information again. But, if I put it down for a while or come back to it another day then I had to enter it again.

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The home screen default displays headlines from a variety of your selected resources. The layout looks much like Flipboard or Read by QxMD.
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When you click on an article title/abstract of interest, you are taken to see the full abstract in a built-in web browser. One downside of this is that you must be connected to WiFi or 3G to browse or read articles, there is no clear way you can save them for reading offline. The available options are to share on Facebook or Twitter or to email to yourself.
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It would be nice to be able to open the PDF of the article in iBooks (or whatever PDF reader one chooses to use) to save it for offline reading and reference. You are also given the option of adding an abstract to your reading list or to your library. However, when I tried to access these offline I was unable to access the library at all and the reading list only provided the abstract, not the full article (even though I had already opened and read the PDF).
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The default sort order in the headline view is date of publication. If you’d like to browse within a particular issue of a journal, this is fairly easy. You can click on your menu on the top right and select your journal of interest. When you go into an individual journal, you can click on the journal title at the top to see the table of contents arranged by date. Page numbers would probably also be useful to display here, but I still often see references to specific pages and like to double check.
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Once you click on an article, you will see an intermediary window where you are given options to add the article to your favorites, add it to your library for offline reading, or set up an alert to tell you when it is available for free. However, this is not perfect. Through no fault of the developers, information on when and where specific articles become free is often spotty and incorrect. Several of the articles I tried are currently available for free, but the journal as a whole is not.
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Coming back around to the topic search that I set up on medical education, it is very unclear why these articles come up in the search. I do get a lot of articles, but I am unclear why. Not everything from Academic Medicine or Academic Emergency Medicine is included, and what is included only shows you the journal title in the Flipboard-type view, not in the table of contents view. This is a confusing feature that could be improved by a few tweaks, such as including the journal titles and page numbers in the table of contents view and specifying where and what you are searching.

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One confusing point is that depending on the journal, you are given a different look when you click to read the abstract. The caveat to this may not be immediately noticeable to any given physician. Articles that are in open access journals (BMC Public Health, PLoS One, etc) will link directly to that journal’s web site from the main view. This does not give you the option of adding an article to your reading list or saving it to your library. There is a work-around if you want to do those things. You can go into the individual journal’s table of contents, select the article from there, and then you are presented with the same view you will see for other articles.

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Unfortunately for many, there is no indication of which journals/articles are open access and which journals would be behind a pay wall. Users who do not have an affiliation that will pay for their access will have a more difficult time accessing articles and navigating which ones are freely available. It does seem that most of the health and medical related news items are freely accessible. One potential improvement could be a “Specialty” area that includes any open access journals or free content, although I’m sure that would be burdensome and complicated to maintain accurately.
Overall, I think the app has a very nice design and is easy to use. It integrates well with a variety of library remote login systems and is free to both users and libraries. It could definitely use a few improvements to enhance the quality and reliability of the features, but this will probably come in time. From my point of view, having news items included is one of the best features. I find that our users often read the popular media health care stories anyway, so it makes a lot of sense to include them in this app. This app will likely continue to improve as users suggest additional helpful and new features.

Review of Docphin: App to View & Read Journals on iPad

Previously I reviewed two apps (Browzine and Read)  that help users view and read journals on the iPad.  There are two additional apps that I will be profiling on this blog.  Docphin and DocWise are similar journal apps for the iPad.  Thankfully Alison Aldrich has agreed to test and review Docphin (below) and Joey Nicholson will be reviewing DocWise.  My hope is to get all of the reviews posted then later try and do a comparison chart of the products.

So without further ado, her is Alison’s review of Docphin.

Review of Docphin
by Alison Aldrich

Earlier this month, Krafty reviewed Browzine and Read, two journal reader applications for iPad. Today I’m writing about Docphin. Docphin is of similar ilk to Browzine and Read but with a few interesting differences. 

The “phin” in Docphin stands for personalized health information network. Docphin was founded in 2010 by some entrepreneurial physicians looking to address that all-too-familiar information overload problem. Docphin users customize their experience by choosing the journals and news sources from which they would like to receive updates.Sounds like an RSS reader, right? Docphin attempts to add value over something like Google Reader by suggesting sources based on specialty, simplifying access to full text, and making it easy to comment on and share sources via social media channels. 

Access to Docphin is restricted to those with email addresses at one of approximately 100 U.S. academic institutions that have requested activation. Activation is free and does not necessarily involve anyone from Docphin communicating with the library, so you may have access to Docphin without knowing it. Check by entering your university email address.

 Once your institution is on board, signing up for an account is straightforward. Enter your level of education (attending, fellow, resident, medical student, or other) and between one and three medical specialties of interest to you. Docphin suggests news feeds based on your selections, but you have the final say over the sources you choose.

An important note: Docphin does not cover every journal. It draws content from around 250 journals, so about 5% of the journal titles indexed in PubMed. A Docphin representative explained to me in an email message that journal titles were selected after consultation with hundreds of practicing physicians, including Docphin’s official team of Ambassadors, about what would be the highest impact titles in each specialty. 

In addition to journals, Docphin also draws content from about 250 twitter feeds, many from organizations (publishers, government organizations such as the CDC, AAMC, etc.) and a few from individual physicians. There are a handful of mainstream news media feeds available, too. 

I set up my profile to watch four internal medicine journals, two public health journals, and news feeds from ABC and the New York Times. My home screen looks like this in a regular web browser:

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And here’s how it looks in the iPhone app:

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Back to the regular web version, in the right column, I see articles that are trending among Docphin users right now. Clicking a journal title smoothly overlays this screen:

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I have the option to view the article (this prompts me for my proxy server login), share the citation via social media, like it, comment on it, or mark it as a favorite. I have the option to create my own keyword tagging scheme to keep the articles I tag as favorites organized.

From my home screen, clicking to the Search tab allows me to search by keyword within all of Docphin’s Journals and News collections, practice guidelines from the National Guidelines Clearinghouse, UpToDate, News, Images, and Videos. The UpToDate search does not prompt me for a proxy server login.

Docphin sends regular email alerts about new content from the sources you chose. Email alerts can be turned on and off under Privacy Settings.

Things I Like

The interface is clean and navigation is smooth.

For the journals it covers, Docphin works quite well with my institution’s proxy server as long as our subscription access is direct from the publisher. The system breaks down when it comes to journal content we get through a third party vendor such as EBSCO or Ovid. Those articles were unavailable to me through Docphinfrom off campus. 

I like the integration of Twitter feeds and trends data. Docphin does well to acknowledge these alternative modes of information discovery.

I also like that mainstream media feeds are included. I don’t know many residents who have time to catch the evening news. Docphin could help them stay a step ahead of what their patients are hearing and reading.

 
Things I Would Like To See

Right now, Docphin can only be accessed through a web browser or an iPhone app. There is no iPad-optimized Docphin application yet, although one is coming. An iPad app will make it much easier to interact with Docphin PDFs on the go.

I would also like to see a collection development policy of some sort.It’s difficult to get a global sense of what Docphin covers because journal titles and Twitter feeds are siloed into lists by specialty. I would like to see a master list of journal titles somewhere.

Docphin does cover a number of open access journals, and of course abstracts are freely accessible. Why not open up this level of content to those outside of registered institutions? This seems like a strategic decision, I’m just not sure what’s behind it.

 
Other Thoughts

In many ways, Docphin reminds me of another social scholarship website making headlines lately: Mendeley. Both work with proxy servers to simplify full text access. Like Docphin, Mendeley attempts to encourage discussion around individual articles and to expose metrics about who’s reading what. Granted, the discussion part has not exactly caught on yet. There are many, many articles and few discussions. Still, I like the idea of a discussion platform that is independent of publishers—sort of a universal online journal club.

I have been impressed with Mendeley as a PDF and bibliographic citation management tool. These features combined withDocphin’s newsfeed personalization capabilities would make for a very unique product I think.

 
Bottom Line

Docphin is worth a look, and another look once the iPad app is released. The developers have been quite successful at growing the business through their networks of newer physicians and medical students. Your physicians and medical students need to understand, though, that while Docphin is an excellent current awareness tool, it is not the place to go for a comprehensive literature search due to its limited journal coverage and limited search functionality.

For further reading:

TechCrunch article: http://techcrunch.com/2012/05/11/docphins-dashboard-for-doctors-expands-nationwide/

 An interview with Docphin co-founderMitesh Patel: http://www.imedicalapps.com/2012/08/questions-mitesh-patel-docphin-medical-journal-tool/

 Another Q&A with Mitesh Patel: http://www.healthtechinsights.com/emerging-health-technology-spotlight-qa-with-mitesh-patel-of-docphin/