EKG/ECG Interpretation



It may not be real-time but at least this freebie, Ekg-wave, helps one interprete various ECG abnormalities. I guess it would be too much to hope for a software-hardware combo for the Palm which can record the ECG and perform real-time analyses! Now that would be a powerful tool.....

Review of Handheld Software for Medical Professionals

Got this email recently:

--------------------------------
Hi,

I wanted to inform you about the availability of our review of handheld software for medical professionals. Our reviews are available for free download at the links below. We hope that you may consider posting these links on your site.

“Palm Reading”: 2. Handheld Software for Medical Professionals.

Feisal Adatia, Philippe L. Bedard

http://www.cmaj.ca/cgi/reprint/168/6/727.pdf

This is a follow up to our article:

“Palm reading”: 1. Handheld hardware and operating systems.

Feisal A. Adatia, Philippe L. Bedard

http://www.cmaj.ca/cgi/reprint/167/7/775.pdf

Both of these articles are also available in the Canadian Medical Association Journal (CMAJ) which is mailed to over 60,000 subscribers. The full text free electronic version www.cmaj.ca has about 100,000 user sessions each week. The Journal's Impact Factor is 2.8 making it the 5th leading international general medical journal.

I hope that you enjoy the articles,

Feisal Adatia.
------------------------------

Well, I downloaded the review and glancing thru it, it looks good. Quite alot of recent stuff covered here and would make good reading for health professionals new in the Palm/PDA arena. Worth a read IMO.

Medical Approaches
Dr. Mohammad Al-Ubaydli emailed me about his free medical textbook Medical Approaches, a resource "for juinor doctors by juinor doctors". It requires the Mobipocket reader. I have downloaded the book but have been unable to download the latest Mobipocket reader as the website was down the last couple of days. The book looks interesting and I hope to review it a bit later.
Here's the description from their website:

As young doctors we have to transform from being knowledge capacitors to clinical decision makers. A clinical decision about a problem just can't be made until one has reasonably reduced the diagnostic uncertainty about it and appreciated the utility or the dysutility of action. One just can't do this unless one has a structure which guides one through the problem allowing one to rapidly and reliably arrive at a set of diagnostic hypotheses which one can work with. The Approaches Project is designed with this in mind. We have constructed a set of "Approaches" to common symptoms, signs and clinical states that serve as "frames" for starting clinical reasoning and decision making. They are informal guides that help one navigate through a problem, reduce its diagnostic uncertainty and select a reasonable course of action. The content is unoriginal - it is synthesised from scattered sources (see references) and may be seen as the hand-me-downs of seasoned physicians combined with guidance from systematic studies. What we have tried to do is organise the approaches with a unified structure in mind and for the needs of a doctor starting out (we started them as final year medical students) and put them into a single resource freely available for all.

The approaches are designed to cross-refer and cut across specialty divisions and clinical settings. This associative structure is aided greatly by hyperlinks and aims to simulate the way that effective clinicians have their knowledge organised.

Dr James Bailey MBBS
Dr Anatole Menon-Johansson MBBS
Dr Gareth Owen MBBS
E-mail - editors@medicalapproaches.org

Medical Stats Calculator for the Palm
Statistics lie at the heart of evidenced based medicine. Doctors need to understand stats in their work and in their assessment of published studies.
I am aware of these two Palm OS applications for stats calculation:


Journal Club v2.0
Description:
Journal Club calculates common statistics and defines common statistical terms.
Version 2 includes a Windows desktop, which lets you do the same calculations on your computer.
A Palm Os 5 version is planned for 7/03
(I haven't evaluated Journal Club since there isn't an OS5 version yet)

EBM Caculator
EBM Calculator is designed to calculate relevant statistics for Diagnostic studies, Prospective Studies, Case Control Studies, and Randomized Control Trials (RCT). This is a palm version of the Stats Calculator.

Both of these are freeware.
What would be really nice if there were some stats program for the Palm which could run off the data present in an existing Palm table eg Handbase or Docs2Go Spreadsheet. Otherwise what I normally do is collect data in Handbase, export to Excel and then run SPSS on the data.....

US to Test Bioterror Alerts on Doctors' PDAs
WASHINGTON (Reuters) - The U.S. government said Friday it will begin testing a system using handheld personal digital assistants, or PDAs, to deliver urgent messages to doctors, nurses and other health-care workers in the event of a biological attack.
The three-month test will evaluate how often health-care workers download the information to their handheld devices and whether they find the system useful, the Department of Health and Human Services said.
The project will be tested with health-care workers who use a system created by ePocrates, a privately held company based in San Mateo, California, that sends alerts to more than 700,000 health-care workers, including more than 250,000 doctors, an HHS statement said.
A test messages will contain a memo about particular biological agents and Web links to information about diagnosing and treating related conditions, the health agency said. Health-care workers will be able to save the information to their PDAs for future reference.

Source: Yahoo News


Hmm. All I can say is: cool!

Medical Hardware Add-Ons
This may be somewhat old news but I think its worth mentioning again. The Palm may turn out to be a useful portable medical monitoring tool. If you are a physician on the go, it would be quite handy to know precisely what rhythm that irregular pulse is. This is where ActiveEcg comes in.
Description:
ActiveECG is used to record and display ECG (electrocardiogram, EKG) strips for the purpose of analyzing heart rhythms and performing a quick assessment of a patient's cardiac health. The ECG strips can be transferred to a Windows compatible PC where a report can be displayed and printed or forwarded to a physician or other medical professional
Great idea.
I wish there were more hardware add-ons for the Palm. One I could do with is a portable pulse oxymeter - a clip on device which interfaces with the Palm. The Sa02 readings are recorded in the Palm and the database can later be retrieved in the PC. Graphical displays of trends would be useful too.

Your Palm and that glass of wine
Drinking and driving don't mix. That we know (or at least I hope you do).
There are formulae out there such as "Widmark's formula" which can estimate the blood alcohol content after a certain number of drinks.

Someone has come out with a program for the Palm, Alcootest, which can do so.

Decription:
Alcootest is a software that allows you to assess the waiting time you need before driving your vehicle after having taken some alcohol.It takes into account the kind and quantity of the beverage absorbed, the sex and weight of the person in order to obtain an alcoholic rate lower than 0.5 gr.However, other factors may intervene to influence this minimum waiting time.This must only be considered as a piece of information. Nevertheless, there is but one rule : Drink or drive, the choice is yours.

Special Operations Forces Medical Handbook


Sigh. Now that Bush has issued an ultimatum, I think war is an eventuality. Special Forces must already be operating in Iraq.

As an aside, I wonder whether the Special Ops guys carry PDAs with them?
There's an interesting Special Operations Forces Medical Handbook from Skyscape with information on how to handle medical emergencies.

Description

Special Operations Forces Medical Handbook for the Palm OS and Windows CE offers the user the most incredible single-source resource of medical information written in plain straightforward language.

-Treatment protocols are organized by symptoms and affected organ system. Features:
-Heavily illustrated with anatomical drawings and full-color images which assist in identifying dermatologic conditions, insect bites, stings, and exposure problems.
-Specialty areas such as trauma, infectious disease, toxicology and more
-Step-by-step illustrated critical procedures, surgeries and basic medical skills under hostile and/or primitive conditions.
-Specific environmental hazards including altitude and temperature related illness, chemical injuries and exposures.
-Extensive Index

Full of practical emergency information about coping with any kind of medical emergency in less than optimum situations. Created by Editorial Staff of the Special Operations Command, Office of the Command Surgeon and over 80 medical specialists from all branches of the military, as a primary medical training resource and field guide for the Special Operations Command. It is the work of 70 contributors both from the military and civilian practice.

Palm reminder for Medication
One fellow KVPUGer told me he was thinking of programming something for the Palm in order to remind himself to take medication on time. I told him there's already software out there which can do this. I did test out On-Time-Rx, a software programmed by a Pharmacist which comes with a medication schedule complete with alarms which you can carry with you in your PDA.
Taken from a review on On-Time-Rx:
"Requiring just 96k of memory, the On-Time-Rx software sets the user's Palm or similar device to beep when it's time to take medicine and vitamins and record which doses were taken and which ones were skipped. It displays the form, dosage, route, and indication for all mediations. Handling up to 200 alarm events per day, it also signals when it's time to get scripts refilled and the 911 feature stores a complete medical history. It will even beep so Fido can get his heartworm pills on time."
Is it really useful? Personally I think blister pack medication with dates are more handy but as many medicines don't come in that form of packing, software like On-Time-Rx may be a useful reminder. It also helps you keep track of missed doses.
You can download a 30-day trial here.

e-Books
When it comes to reading e-books, it's definitely easier on a PDA compared with a PC, either desktop or notebook. For the latter, you are stuck in one position. You have to put up with boot-up times.
With the Palm, it's "instant on". Recent e-books I have read include Michael Crichton's Prey which is excellent reading. Interesting to note that "swarming" by robotic life-forms is actually a possibility now.

Spotte this free e-Handbook on Pregnancy in freewarepalm.com
Description:
"The Prospective Mother", by J. Morris Slemons in Palm Reader eBook format.
A Handbook For Women During Pregnancy.

Body Mass Index Calculators

Definition: Body Mass Index (BMI) is a relationship between weight and height that is associated with body fat and health risk.
The equation is BMI = body weight in kilograms/height in meters squared.
Research has identified the health risks associated with a wide range of BMIs (both high and low values.)
Obesity is taken to start at a BMI of 30 and gross obesity at 40

If you want a free calculator to work out your Body Mass Index, you can check out BodyMI from Freewarepalm.com
Description:
Worried about your weight?
BodyMI is a program for calculating personal body mass indexes and interpreting both them and the concept of body mass index in general.

If you want a more powerful all in one free medical calculator utility, get Medcalc. This has BMI, Body surface area and much much more. I personally find Medcalc invaluable in daily practice.
Introduction
MedCalc is a medical calculator running on Palm-compatible handheld devices ( Palm, Sony, Handspring, Handera, and more... ). It is designed for rapid calculation of common equations used in medicine (including anesthesiology, pediatrics, emergency, intensive care and internal medicine).



Medcalc Features

-free
-easy to use
-frequently updated (see version history)
-comprehensive (75 formulas and counting, see complete list)
-formulas sorted by categories (including a fully customizable favorite category)
-units available either in S.I. or local units (defaults can be set for each item)
-most formulas come with bibliographic references and clinical tips
-includes (no need for commercial alternatives):
-full-featured infusion management tool
-pregnancy wheel
-results can be saved for later retrieval
-available in english, french and spanish versions
-fully compatible with Palm OS 5 (with high-density application icon)
-takes advantage of HandEra 330's QVGA capabilities (increased resolution and virtual silkscreen area)

MedCalc is a well-established tool used daily by thousands of physicians all over the world. It is distributed amongst other clinical tools in many hospitals and has received many favorable reviews

eponym
noun
1 a name, esp. a place name, derived from the name of a real or mythical person, as for example Constantinople from Constantine I
2 the name of the person from which such a name is derived
example: in the Middle Ages, ``Brutus'' was thought to be the eponym of ``Britain.''
[ETYMOLOGY: 19th Century: from Greek eponumos giving a significant name]
"epo'nymic adjective

Medical eponyms are a plenty - they are sometimes obscure and it may be difficult to remember what they relate to.
Andrew Yee MD has come to the rescue with his Eponyms v1.68 available from Freewarepalm.com.
Description:
Rovsing's sign? Virchow's node? Here is a list of over 1,375 medical eponyms, common and obscure, with descriptions.
Update Description:
v1.61-1.68 (3/10/03):
- Added over 175 more eponyms since ver 1.5, corrected some spelling errors; over 1375 eponyms total.
- Minor improvement with navigation in ver 1.68 for Palm OS 5.0 (mainly scrolling up and down after look up).
- New icons thanks to Dr. Karam with 1.65.

It's available in Doc and Jfile formats.

Palm or PocketPC?
The eternal debate. As a long time PalmOS user, I may be a little biased ;). But Handheldmed has this little shootout which seems pretty balanced to me. I think the bottm line is that PalmOS is for serious PDA work. PPC is for tinkering around (with add-ons) multimedia. PPCs have the edge in WiFi - that is until the much awaited WiFi SD cards are available.

I still prefer a device which is small, good battery life, able to launch basic PIM functions with speed and no fuss navigation to get at applications quickly. Multimedia is not important for medical palm computing. There used to be many more Medical apps for PalmOS than PPC but PPC is fast catching up. At the end of the day we are spoilt for choice.

Diet with the help of your Palm?

I am kinda sceptical this is possible. At the end of the day, humans are humans. After the work-out in the gym you are still gonna be tempted by the delicious nasi lemak. Well, on the other hand, I guess having some data in the palm of your hand would be a grim reminder on what you should and shouldn't do!!
Here's info on eDiet Manager from Palm Boulevard
Description:
eDietManager application was designed to help users manage their daily nutrition, exercise, and health. It helps to set and achieve fitness and weight loss/gain objectives by providing the tools necessary to track and analyze users' daily records.
The application helps you to create your personal diet profile and set your own targets for loosing, gaining and maintaining current weight. For targets created eDietManager offers daily nutrition schedule and keeps track of your meals. Dynamic change of schedule, according to the achieved results for each day.
eDietManager supports extensive libraries of various foods and sport activities. 734 foods are maintained in 22 basic categories. Calories and fats contents for each food is provided. Choose among 84 different sports. eDietManager allows you to create your own definitions for foods and sports. Use the daily chart to view your progress. The weight for a particular day is compared to the desired target weight. eDietManager is your personal assistant on your way to healthy nutrition, always helpful and at hand!

Breaking news....DiagnosisPro will be released soon for the Palm platform. I emailed the authors and was pleased to hear from them they have developed and tested this on a Sony Clie. They hope to release the PalmOS version by the end of March!!

Description:
DiagnosisPro, developed by Dr. Charles Meader, a board certified internist and Dr. Hugo Pribor, an internationally recognized clinical pathologist, is today’s most powerful, interactive tool which allows you to quickly generate differential diagnosis, based on multiple entries. By entering findings such as signs, symptoms, lab values, X-ray or EKG results, DiagnosisPro generates a hierarchical list of diseases from its database of 10,000 diseases, 20,000 findings and 250,000 relationships.

This comprehensive program provides a detailed review of each disease, including clinical presentations, abnormal lab values, rule-outs, complications, treatments and much more. It also includes 15,000 ICD and CPT codes, a hot link to MEDLINE, and a hot link to Harrison’s Principles of Internal Medicine CD-ROM. You can also compare the characteristics of any 2 diseases side by side.

Wifi Wifi everywhere. This is the year of wireless networking. We have Time Broadband, Airzed, TM Hotspots, Maxis. We have succesfully got Wifi up at my workplace for the medical staff. Now I can access the Internet from my clinic and staff room. I am wishing for the day when I can access lab results, imaging reports, records on my notebook too! But I guess that is wishful thinking, not for another 5-10 years I'll bet.
Back to the Palm. With WiFi being a "hot" thing now, I am getting impatient for WiFi SD cards. Sandisk has announced the impending release of their version of WiFi SD cards soon so I guess it won't be long now. Bluetooth which is what the TT has is cool - I use it mainly for SMS but Internet access via GPRS costs a bomb here so it really isn't feasible apart from the occasional email. So it's back to WiFi. Please launch the card soon, Sandisk!!

Planning pregnancy with your Palm?
Spotted NFP v2.0 in Freewarepalm.com.
Description:
A Palm OS program for tracking fertility, known as the Sympto-thermal Method, Fertility Awareness Method, Natural Family Planning, or Billings Method.
NFP allows a woman or a couple to track her fertility using a set of simple daily measurements.
NFP can be used either to avoid or achieve pregnancy.
It can be an effective chemical-free method of contraception, or it can be an inexpensive method of conception.

I really don't know how effective the Billings Method is nor the accuracy of the implementation of the BM with this program so use at your own risk. The Billings Method was developed by Drs. John and Evelyn Billings of Australia. You can get more information from their website.

Track your Blood Pressure
Source: Palm Boulevard
UTrackSys.com Adds Features to Blood Pressure Tracker
UTrackSys.com has released version 1.1 of its Blood Pressure plug-in for its Universal Tracking System for the Palm OS.
The plugin is designed to help Palm OS users track blood pressure and pulse measurements, offering. various interactive charts, reports, and filters, as well as the ability to export data to UTS database and to Excel through a conduit.
According to the company, the new version extends the flexibility of its blood pressure and pulse charts. Now users can setup axis bounds, define scale parameters, customize grid options and other charting preferences.

All this sounds cool. Checking out the UTS webpage you can see that the program gives you a nice way to keep a record of blood pressure and also outputs line and bar charts as well.
I think the UTS would be great for things also like blood sugar monitoring, INR records, Peak flow measurements and other medical measurements.
What would be even better IMO, would be a hardware interface - a Blood Pressure measuring device which can plug into the Palm and the UTS takes the reading and date/time stamps it. Now that would be even more cool.

Medical e-books
Sigh. So may Palm e-book formats - Doc readers, Tomeraider, Tealdoc. But I think the best-of-the-best has got to be iSilo. It's got good compression, speed, great handling of files stored on the memory card and converts text and HTML to a format which is highly readable. It also can read standard Doc files too so you get teh best of both worlds.
If you like iSilo, there's a large repository of medical e-books which you may want to check out:
Medical iSilo Depot
There are of course other medical e-books you can get from Memoware

One of the early adopters of PDAs amongst the medical community would be anaethetists and intensivists. No suprises here since often complex decision making and calculcations are necessary in the ICU.
ICU Math 1.0 is freeware and available for download here

Description:
50 adult ICU applications that assist with 78 medical equations.

Including pulmonary, cardiac, BNP CHF nomogram, pharmacokinetic drug dosing, renal, electrolytes, nutrition, TPN, biostatistics, unit conversions, rules of thumb, plus an RPN scientific/financial calculator.