Med Student's Differentials Dx

Diagnostic error is common. The usual accepted rate is between 5% to 15% before the report July 2010 in PEDIATRICS that revealed 45% rate in 1362 pediatricians surveyed.

There are many reasons leading to a wrong diagnosis. One is failure to ask one or two critical questions because of the natural limitation of our brain to 7 to 9 items at a time. Another reason is lack of time because of many patients scheduled and emergencies.

Suppose you are seeing a nine year old boy with chronic abdominal pain. The differential diagnoses of this has at least 30 diseases or conditions. To rule in or out most of the diseases in the list, I have 17 scripted questions in my EMR. I have trained my assistants how to ask these questions which are mostly answered by YES or No.

Med Student’s Differential Diagnosis is a tool that show the different serious and less serious causes of each of the common symptoms in Pediatrics followed by the best questions to ask.

Each question is followed by a menu of the most likely possible diagnosis if answered YES.

When all of the questions are asked and answered, the most likely diagnosis will be formed in the mind of the physician.

With this differential diagnosis app, the chance of making a wrong diagnosis is reduced.

Kidney Kard

The Kidney Kard is a comprehensive collection of the tools needed to interpret acid-base, renal, and electrolyte problems especially in patients with chronic or acute renal failure.
Medical students, residents, fellows in nephrology or urology, and physicians taking care of patients with kidney problems will find the Kidney Kard useful with a flick or click of their fingers.

If the stethoscope is for the cardiologist, otoscope for the ENT specialist, and ophthalmologist for the eye doctor, Apple’s Kidney Kard app is for the modern nephrologist.

Parents Diagnostic Aid (PDA)

Parent’s Diagnostic Aid, a new tool to help your child
A doctor’s office with a wall to wall mothers and children can be hazardous to your child’s health. Why? It is probably one of the leading cause of medical and diagnostic errors.

About 45% of 1362 USA pediatricians, in a survey reported at the July 2010 issue of PEDIATRICS, a popular reading journal of pediatricians, made a wrong diagnosis that harmed children.
There are many reasons why a diagnosis could be wrong. One of them is a crowded waiting room. When there are many parents and children in a
waiting room, some of the medical office staff can become easily stressed, hurried, and cut corners. Such environment is fertile for medical mistakes to happen.

A physician should see a patient for 15 to 20 minutes. This means that in one day 21 to 28 children can be seen in a usual un-hurried situation. However, when there are more than 28 children scheduled, the average time spent with each sick child is reduced to less than the “ideal” time.

This will expose physicians to stress and adequate time spent with your child is cut short. Occasionally this can cause diagnostic errors. For example an eight year old boy has a chronic abdominal pain sees a doctor. To diagnose this condition, at least 17 questions should be asked in Apple App PDA (Parents Diagnostic Aid) system. However, because the time is now shorter, a physician might not be able to ask all of the critical questions and potentially miss the diagnosis during the visit.

In a child who has Abdominal Migraine, when seen by a physician who is in a hurry because of over-booking, she or he might forget to ask three important questions to make this diagnosis like: Is there any one in the family with recurrent headache? Is there nose bleeding? Or is there car or sea-sickness?

When I was in practice, I often miss the diagnosis of Abdominal Migraine before EMR.

However, with an Electronic Medical Records with 17 questions embedded in it, I was able to make the right diagnosis of children with Abdominal migraine even though I was overbooked.

Unfortunately, only 30% of physicians in the USA have computers in their examining rooms. In this current environment, medical mistakes including diagnostic errors are common happenings.

To help this situation, we created an Apple app called Parents Diagnostic Aid (PDA). In this app is a list of scripted questions for the most common problems in children like fever, chronic cough, wheezing, headache, etc. that I used in my pediatric practice at Bangor, Maine. Ideally, I think all physicians should ask all questions that should include serious conditions in their thinking radar. If these questions are not asked, a serious illness can be easily missed resulting to injury or even death.

Suppose your child has a prolonged fever. Before you visit a doctor, you can first read and answer the 12 questions under “Fever” then bring it the doctor.

With the PDA it will save the physician time in getting the clinical history and at the same time reduce the chance of missing a critical question that might lead to the right diagnosis. All of the important questions are easily available in this new Apple app.

When all of the questions about Fever is answered and “i” is tapped, a parent will have an idea of the most likely diagnosis of their child before the office visit. A parent can then ask an intelligent question during the visit. By so doing, they can be part of the medical team in the treatment of their love one.

Armed with Parent’s Diagnostic Aid now you can have a basic idea on the possible illness reducing the chance of medical errors which is happening in thousands of children being seen by a physician every day.

Medical Apps Developer’s Team

What's New In Version 2.0

We have a better navigation with new icons.

Important Physical examinations of each symptoms in an easy format to read.

Critical tests for each symptoms follow the Physical Examination.

General summary of treatment.

A reliable source of further information and treatment mentioned in the
description.

Smart Baby Program

This App will teach parents how to demonstrate the concepts of counting, adding, subtraction, fraction, and early reading. This is based on research studies that the environment which is the family is the most critical factor in making our children happier and smarter. And if these activities are done with fun, as early as possible, the outcome is a happy and smart child both at home and at the school. These methods has been used in a pediatric office at Bangor, Maine successfully.

Early Education Works, Study Showed

In a study by Frances Campbell of University of North Carolina, it was shown that early childhood education is an important factor on the success of poor children. “Learning begins in infancy. Education should too,” Campbell stated.

In 1972, Dr. Ramsey, at the Frank Porter Graham Child Development Center enrolled 111 infants from low-income families (98% from black families) and randomly assigned 57 of the babies to high quality child care center. Among those who received the early high quality program, 40% were still in school; but only 20% for those who did not receive the care.

The study showed that 35% of those who receive the early care were still attending or had graduated from a 4-year college course compared to only 14% from those who did not.

Those who were also under the early quality care center had higher scores on both reading and math tests and about 65% of them were employed compared with the 50% of those who did not go under the early quality care.

The early quality child care program called the Abecedarian Project was different from the traditional day care program. Babies were enrolled as early as 6 months old, attended every day for the whole year round and the methods focused on the social, emotional, and cognitive activities.

This study by Dr. Ramsey clearly showed why children should have an early education from infancy.