MD Consult (beta) and First Consult (version 1.0.1)

Abstract

First Consult is a decision support tool for quick answers at the point of care. First Consult only requires a data connection for the initial content download and updates. First Consult is very similar to DynaMed, another evidence-based, point-of-care, clinical decision support tool.

MD Consult (beta) and First Consult (version 1.0.1) [mobile access]. Elsevier, 3251 Riverport Lane, Maryland Heights, MO 63043; 800.401.9962 (within US and Canada); mdc.customerservice® elsevier.com.

This past year saw the introduction of mobile interfaces;, for Elsevier's MD Consult and First Consult. There are fundamental differences between the two. MD Consult is a mobile-optimized site, while First Consult is a mobile application (commonly called an app). Being a mobile-compatible site, MD Consult requires a wireless or data connection for access,- while the First Consult app stores the content on the device and can be accessed from anywhere.

MD Consult and First Consult are both available as institutional and individual subscriptions. For institutions, MD Consult can be purchased as a stand-alone product, with First Consult as an addon companion product. First Consult cannot be purchased separately. For individuals, MD Consult can be purchased for the desktop with mobile access. First Consult can be purchased only as a mobile product. With institutional subscriptions, one's clients must first create a personal account from a desktop or laptop computer within one's institutional Internet protocol (IP) range. This personal account is used to log onto mobile MD Consult and First Consult. Information on institutional or individual subscriptions is available at www.info.mdconsult.com and www.info.firstconsult.com.

MD Consult is available on the iPhone, iPod Touch, iPad, or Blackberry and smart phone platforms such as Android, Symbian, and Palm Treo. First Consult is only available for iPhone, iPod Touch, and iPad. This review is based on the iPhone version. To access MD Consult mobile, log in at rn.MDConsult.com or mobile .MDConsult.com. An MD Consult icon can be added to one's device. For First Consult, a free download is available via the App Store on the device or by downloading from itunes.apple.com and syncing to one's device.

The purpose and content of the 2 mobile products closely reflect their web counterparts. MD Consult is intended to be an in-depth compendium of medical content with full-text access to almost 50 electronic books, 50 electronic journals, and 30 Clinics of North America. It searches MEDLINE from 2000 to the present and over 1,000 practice guidelines. First Consult is a decision support tool for quick answers at the point of care. It has more than 700 evidence-based medical topic monographs that are continually updated. The displays for MD Consult and First Consult differ from each other, but both are well laid out and easy to navigate, search, and view.

At the top of each MD Consult screen, the logo links to a page to browse common medical topics, and the "i" icon offers detailed help on configuring, navigating, and searching. On the medical topics page, users can jump to the letter in the alphabet using the sidebar. For each topic, users can drill down to relevant sections, which include Overview, Signs & Symptoms, Etiology, Diagnosis, Treatment & Management, Prognosis, Screening & Prevention, Epidemiology, and Practice Guidelines. Each section has links to full-text book chapters, journal articles, Clinics clinical reviews, and /or practice guidelines. A Refine Your Search section offers specific subtopics.

Along with browsing of a list of topics, there is a box to free text search the books, articles, Clinics, and guidelines. It also supports field searching within journals and Clinics. Fields include Abstract, Article Title, Author Affiliation, Chemical Compound Name, Language, Major Medical Subject Headings (MeSH), MeSH, National Library of Medicine (NLM) Citation ID, Publication Date, and Publication Title. The search box also offers an auto-correct feature, which is not necessarily helpful. Above the search box are two others for navigating outside MD Consult, one to enter a uniform resource locator (URL) and the other, a Google search box. These multiple boxes can be confusing initially.

Search results are sorted by books, Clinics, journals, and guidelines with the number of results indicated for each. Books, Clinics, and most guidelines are in full text, but journal results may be citations only or may include the full-text article. There is not a way to limit to full-text only.

The detailed content in MD Consult is useful for practitioners to stay abreast of recent medical developments. The companion product, First Consult, provides summarized, evidence-based answers to clinical questions at the point of care. It covers screening, prevention, diagnosis, and treatment for the majority of medical conditions responsible for office visits and inpatient admissions. The content is stored on one's iPhone, iPod Touch, or iPad, so it is available anywhere, anytime. First Consult only requires a data connection for the initial content download and updates. Updates can be handled automatically or manually. The content is continuously updated.

Mobile First Consult has Medical Topics monographs only and neither the Differential Diagnoses nor Procedures sections found in the web version. Each monograph is broken down into easy-to-navigate pages under Background, Diagnosis, Treatment, Outcomes, and Prevention. A Summary is given at the beginning, and evidence-based references are included under Resources at the end. The monographs are written as easy-toscan, succinct, bulleted points that follow a standardized format.

First Consult offers an alphabetical index of topics with letters along one side for faster navigation. There is a search box at the top of the screen and icons for Topics, Recent Updates, and Account along the bottom. Searching First Consult is more limited: It only searches the "official" name of the topic and related synonyms. It does not suggest alternative terms, which may necessitate scanning the entire index.

In terms of content, MD Consult is similar to UpToDate, which is also available in a mobile-optimized format requiring a wireless connection for access. Both provide detailed, in-depth narratives on a large number of diseases and conditions. But MD Consult, with content from multiple sources, has more overlap and duplication, making it slower to use than UpToDate. First Consult is very similar to DynaMed, another evidence-based, point-of-care, clinical decision support tool. DynaMed is more affordable; however, the web version does not offer any additional content, unlike First Consult.

Users should not have any difficulty setting up mobile access to either MD Consult or First Consult. Indeed, it may be too simple: In the personal account registration process for institutional subscribers, there is nothing to prevent clients not affiliated with your organization from setting up an account if they have access to computers within your IP range. Elsevier does not impose limits on how many clients may set up personal accounts on a subscription.

As Internet-enabled mobile devices enhance their content levels and improve their navigation and ease of use, they are rapidly becoming ubiquitous, with users turning to their handheld devices instead of their desktops for critical information. MD Consult and First Consult have developed mobile platforms that are well designed to meet the needs of medical practitioners. Given that there is no additional cost for this access, libraries would be well advised to heavily promote its availability to their users.