Prescribing under pressure using a mobile app: a study

Todd Vandenbark

iPad and notebookIn a recently published article in the journal Resuscitation, 28 doctors and seven medical students in the pediatric department of a British hospital “were asked to prescribe both a dopamine infusion and an adrenaline infusion for a hypotensive child. For one calculation they used the BNFC as their reference source and for the other they used the ‘PICU Calculator’ on the iPhone.” Participants prescribed the right dosages 100% of the time using the mobile app, while those using the British National Formulary for Children prescribed correctly only 28.6% of the time. The mobile app was more than three times faster for obtaining the answer, saving an average of over five minutes per participant. And each participant was markedly more confident in their prescribing with the app than with the BNFC.

As pointed out in the iMedicalApps blog, this study has several important shortcomings:

  • Small sample size
  • It does not take into account “more advanced fusion pumps which can simplify parts of the process.”
  • One of the study’s primary authors is a contributor to the app’s development, though without financial investment.

From this author’s perspective, there are two important implications to this study. First, follow-up is needed, taking into account the typical equipment and stress present in the situation. Second, it appears we now trust computers and their programmers more than the writers of printed medical texts. Yet the only oversight of such devices comes from the medical professionals involved in their development. Is the current system sufficient to protect patients from technical problems and market-related pressures? If a book is dropped, its text does not change. Does dropping and repeated use of mobile devices affect the functioning of the software contained within? If it does, can that put a patient at risk?

What do you think? Tell us!