ACS Trials Iphone App

[littlelebowski]

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Members do not see this ad.

A couple of residents, cardiology fellows, and myself put together an iphone app ACS Trials. It is a catalog of around 70 landmark ACS trials. We have everything from VA Cooperative study of Aspirin in 1982 to ATLAS-ACS 2 (rivaroxaban after ACS) which is to be published in the NEJM this week. Each trial has a take home message, summary, design, baseline characterisitics, results, ACC/AHA guidelines related to that artice, a pubmed link and free full text link when available.

You can sort them by subject, date or title and filter by NSTEMI/UA or STEMI. We also have a search feature so if you cant remember what study was about integrelin you can just search "integrelin" and it will bring up all of them.

There is a cardiology specific calculator wth TIMI risk, GRACE Risk, Crusade bleeding risk etc.

Check it out when you have a chance. The full version is $2.99, but we also have a free version with 1/2 the trials and ads which should be released by apple this afternoon or tomorrow.

We would love some feedback as we are constantly updating the trials and adding more trials.


http://www.acstrialsapp.com/
http://prmac.com/release-id-34597.htm
http://www.imedicalapps.com/2011/11/exclusive-interview-creators-acs-trials-app/

 

[jmeyers52]

Hey all. I'm the cardiology fellow that created this app with Mike (the above member who posted). We created this app because when we were residents we would be rounding with an attending in the CCU or on cards firm and constantly be trying to remember what the landmark dabigatran trial was called or what doses of bival were studied, etc. We thought an app like this would be really useful and no one had created it, so we did. Since the above was posted by a new member with one post (not that I have many more) and sounded kind of like an ad, I just wanted to post to let you know there were real physicians behind it and why we created it. I hope everyone finds it useful. As Mike said, we'd love to hear feedback as we're constantly refining and updating.

 

[BlackNDecker]

Hey all. I'm the cardiology fellow that created this app with Mike (the above member who posted). We created this app because when we were residents we would be rounding with an attending in the CCU or on cards firm and constantly be trying to remember what the landmark dabigatran trial was called or what doses of bival were studied, etc. We thought an app like this would be really useful and no one had created it, so we did. Since the above was posted by a new member with one post (not that I have many more) and sounded kind of like an ad, I just wanted to post to let you know there were real physicians behind it and why we created it. I hope everyone finds it useful. As Mike said, we'd love to hear feedback as we're constantly refining and updating.

I just don't see how this trumps a google search on a real computer or computer cart? I think lots of people thought of this...then continued thinking about it and saw it as high effort, low yield. I'm sure the med students will buy this though...they'll buy anything. Good luck👍

 

[vicious]

I just don't see how this trumps a google search on a real computer or computer cart? I think lots of people thought of this...then continued thinking about it and saw it as high effort, low yield. I'm sure the med students will buy this though...they'll buy anything. Good luck👍

I kinda had the same thought but then I checked it out (always looking for more apps to overload my phone!) and it actually has been super useful. At my IM program, the cardiology attendings love talking about the old trials and even though I've tried my best to keep up with my reading it's not always easy to (1) remember the name of that one important trial, (2) find the actual manuscript on google amongst the numerous post-hoc analyses, reviews, and emedicine articles, and (3) quickly find the actual results, relevant patient populations, and protocol-related details that these attendings love to harp about. Before now, when I've wanted to reliably find the trials I had to slog through 100 pages of guidelines, find the citations, and then log-in through my school's proxy to access the articles. If I really wanted to find the details of ISIS-1 or the VA cooperative study though, I'd have to truck it to the library and find it on *paper*. Seriously?

I actually found this thread on google and wanted to reply cause I'm so glad you guys actually did take the time to compile and organize this info in a really easy to use format. It's especially nice that you have all the super-old trials on aspirin, heparin, betablockers, etc. from the 80's that never get talked about but are obviously super important and will never be repeated (aspirin vs. placebo?). I also like how you put these things in the context of what other treatments were "standard" at the time and how the results inform current guidelines and what we now consider to be standard of care.

Best of all, I started getting some subtle nods of approval from my attending and fellow when I drop knowledge on them that they didn't know or maybe forgot. This dude has high-risk NSTEMI but can't make it into the cath lab today, are you sure you want to start integrillin? Instead of heparin, should we maybe use bivalirudin instead? Should I start high-dose atorvastatin right now? I just tried searching for "integrillin," "bival," and "atorvastatin" and the data was right there immediately. Comparing magnitude of benefit of ticagrelor over plavix over aspirin alone? Took like 45 seconds flipping through 3 trials with this app. These were all questions I actually settled in the past week which is why I decided to dust off the old SDN login to thank the guys who made this app and to recommend it to everyone else out there who takes care of patients with ACS.

 

[BlackNDecker]

I'm not trying to be a d!ck but maybe this is only useful for people that have poor internet search skills.

Using your Bivalirudin analogy:

This dude has high-risk NSTEMI but can't make it into the cath lab today, are you sure you want to start integrillin? Instead of heparin, should we maybe use bivalirudin instead?

I found 4 trials summarized in less than 5 seconds:
http://en.wikipedia.org/wiki/Bivalirudin

You could argue that Wikipedia is openly edited and susceptible to errors...but an iPhone app is also susceptible to errors.

 

[jmeyers52]

I certainly wont disagree that there are some topics/studies that are fairly straight forward to find via a quick internet search. This is probably especially true with relatively newer trials like ACUITY and HORIZONS. I think for some of the older landmark trials though, this is much less true. Additionally, our hope was to provide a resource that was more portable and easier to access on the go when a computer wasnt available or was less practical. We've also tried to give some thoughtful context in the summaries of the trials with the historical timeline of the therapy and how it fits in with other similar therapies and trials (GP IIb/IIIa inhibitors, oral antiplatelets, etc).

Undoubtedly, there will be some people that find their current approach of googling a trial and trying to find a summary or quickly skimming the full text satisfies their needs. We hope, however, that a number of people will find an app like this and the quickly accessible and distilled information to be a useful addition to their mobile medical app arsenal. With the addition of the free version (still pending approval by Apple) people will be able to try the app on a more limited basis and see if the content is something they find useful.

 

[littlelebowski]

I'm not trying to be a d!ck but maybe this is only useful for people that have poor internet search skills.

Using your Bivalirudin analogy:


I found 4 trials summarized in less than 5 seconds:
http://en.wikipedia.org/wiki/Bivalirudin

You could argue that Wikipedia is openly edited and susceptible to errors...but an iPhone app is also susceptible to errors.

I would contend that having perspective with trials is far more important than simply the ability to find article abstracts on google.

For example your Wiki search turned up ACUITY, which if you look at the 4 sentence Wiki summary it looks great. ACUITY, however, was a very flawed study. It was designed to eval patients undergoing PCI (where GP IIb/IIIa's are most efficacious) yet 11% of patients underwent CABG, and 33% had no intervention, so only 56% of patients actually had PCI. They also included patients who received LMWH and UFH in the bival groups which may help associate a benefit to bival.

ISAR-REACT 4 (which Wiki makes no mention of) was specifically designed to address the criticisms of ACUITY, and offers much stronger evidence for Bivalrudin.

You may be able to quickly find trials on google, but not having perspective on why some are landmark trials, and knowing the weaknesses of others can be detrimental.

You should check out ACS Trials, its FREE, and I think you will be surprised with the quality of the content.