Essential Guideline Apps for the Primary-Care Doc

These days, being a physician is tough due to the ever-increasing and ever-changing number of guidelines that seem to come out on an almost weekly basis. Having an understanding of critical guidelines helps ensure we provide the best and most current recommendations about the many conditions patients come to us with.

As one might expect, there are literally hundreds of such apps out there (not including the massive number of websites one can review). Today, we highlight three that are of significance to the primary-care specialties.

ASCCP Cervical Screening Guideline App (ASCCP)
Guidelines for screening of women for cervical cancer and subsequent management protocols have changed dramatically and multiple times in the last 12 years. With the advent of better HPV testing and review of longitudinal data, physicians are able to make better decisions about how to approach screening and pathologic findings. But the amount of information and options are dizzying - unless you download the ASCCP app.

Designed to be used quickly, the application has four buttons at the bottom of its main page. Clicking on these buttons takes you to screening, management, algorithms, and definitions. One can quickly type in data about a particular patient (or their results) and come up with ASCCP strategies for clinical approach. The number of algorithms provided covers almost every possible situation (including specific patient types, such as pregnancy). The app is clean, simple and quick and I find myself using it on a daily basis. While the $9.99 cost seems prohibitive (and, indeed, there are other apps that do the job for free - just not as comprehensively), the fact that I use this almost daily in my practice more than justifies the expense. I recommend this for anyone who performs or manages cervical cancer screening.

Rating: 4.5 out of 5 stethoscopes

USPSTF Preventative Services Database App (AHRQ ePSS)
The USPSTF (a division of AHRQ) has created one of the most extensive and data-driven list of screening guidelines for patients based on demographic data (age, sex, sexual activity, pregnancy and tobacco use). If you’ve ever wondered exactly WHAT your patients need to be screened for (and what is most likely to increase their morbidity or mortality in a particular age group), this app is for you. Starting with simple demographic data, the app will spit out a laundry-list of recommended screening tests along with a ‘Strength of Recommendation.'

Clicking on a screening will provide further information, including risk factors, rationale and tools related to the recommended screening protocol. Guidelines can be bookmarked to a favorites list as well. Like the ASCCP app mentioned above, the interface is quick and simple. If there is any issue I have with the program, it is that it might be TOO comprehensive. Adding my data yielded at 41 recommendations ranging from “Recommended’ to ‘Uncertain.’ Despite this, I cannot emphasize the value of this program for providing preventative care that is evidenced-based. The low, low cost of ‘Free’ is just icing on this cake.

Rating: 5 out of 5 stethoscopes

Guideline Clearing House App (Guideline Central)

What if you could have an app that covers multiple guidelines from multiple sources? This is the aim of an organization known as Guideline Central, whose eponymous app is designed to provide access to the most relevant guidelines for your specialty. Per their description, the company partners with over 35 medical societies and government agencies in the US to provide a comprehensive guideline database that is searchable. The app allows you to tailor guidelines results to your specialty or particular conditions, as well as provide access to useful tools and calculators relevant to the guideline in question. In addition to guideline tools, the app provides access to drug information and quality measures, as well as the ePSS stuff mentioned in the AHRQ app.

As a clearinghouse and ‘one stop’ shop, this app is truly comprehensive - so much so that navigating can be somewhat difficult as you may not know where to start. Playing around with the app increases familiarity quickly and it becomes second nature to find what one needs with time. The app does seem accurate (it did only come up with 40 recommended screenings in it’s ePSS section, as opposed to 41 from the AHRQ app), but can be a little slow to load /retrieve the information. The only catch is that not every guideline is free - while there is a rotating list of free guidelines each month, many are behind a paywall which ranges from as little as $4.50 to $9 for a single guideline. It is true that most of these guidelines can be found for free online - what you are paying for is the convenience of having it available when offline or at point-of-care. The ‘nickel & dime’ approaches has its pros and cons, but overall I found the app more impressive and faster than using the web to find what I needed. Now I just keep looking out for the rotating, free guidelines and download them when available.

Rating: 4 out of 5 stethoscopes

Conclusion
All physicians use guidelines daily to make the best judgements for patients - with the apps mentioned above, you’ll be able to do so quicker and more accurately no matter what your specialty of need.