Tablet devices, such as Apple’s iPad, are becoming widely supported by medical centers and increasingly adopted by orthopedic surgeons. With the release of Apple’s newest generation iPad, we suspect that many orthopedic surgeons either own an iPad or have at least considered purchasing one. These devices have many uses, such as patient education, radiology review and electronic medical record entry. The expanded screen size also makes it ideal for reading.
In this month’s column, we will review iPad apps designed for reading articles and orthopedic journals. We will also introduce a few peer-reviewed journals that have made the leap to app-based digital format.
The portable document format (PDF) has become a standard format for medical literature, and many PDF tools are available for the iPad. GoodReader ($4.99) and iAnnotate ($9.99) are two leading PDF reader apps that the orthopedic surgeon should find useful.
iAnnotate is a full-function PDF annotation, reader and file organization app with an intuitive user interface and tool set. The app is organized to allow for file transfers to the iPad, viewing your library and reading documents. Files can be transferred directly via Dropbox, using iTunes, or directly from the web or WiFi connection. In our testing, all formats worked well for both small and large file libraries.
The library feature organizes all files into their respective folders with different organizational and sorting options (title, date, etc.). An impressive and robust feature is the search. This tool searches all documents within a library by full text or titles. The primary feature of the app, however, is the PDF reader. Conveniently, this app allows for up to six files to be simultaneously open for quick browsing. A left-sided toolbar includes search and scroll functions, while the right side includes annotation tools such as highlight, underline, comment and other useful navigation elements. This app is loaded with features, and you may not use all of them. One of our favorite features is the ability to directly “flatten” a document, including all annotations, and email or print it directly from the device. Overall, iAnnotate is a full-featured PDF reader and organizer that we highly recommend.
GoodReader is another popular PDF reader. It is available for the iPhone as well and shares similar features to iAnnotate. The user interface is organized differently. However, it still includes an equally functional file library with the ability to download files directly from the web and integrate with mail servers, Dropbox, SugarSync and more. This app also includes a search feature, but limits the search to article names, not full text.
The download organizer allows for more flexibility when selecting where to place downloaded items, which may be important to some users. The reading pane is similar to other apps. It includes tab-organized files with navigation and reading tools along the bottom, and annotation tools along the right side. As with other apps, you can flatten and email a copy. Aside from stylistic variation, the most significant missing function in GoodReader compared to iAnnotate is lack of full-text search. If this feature is important to you, then you may want to consider iAnnotate.
In addition to making PDF versions of their articles available to readers, publishers have been shifting toward complete digital app versions of existing journals. An early adopter has been Wolters Kluwer, which has now released early versions of Spine and Plastic and Reconstructive Surgery journals for the iPad. Both journals are currently free, but will require paid subscriptions in the future. In addition, the Journal of Trauma is also set to be released in upcoming months. Some advantages of a digital journal app are that the table of contents has been linked to each article, the entire journal is presented with advertisements and editorials, and there is a specific navigation platform. With regard to navigation, swiping right/left will advance/return to the next article in sequence, while swiping up/down will scroll within an article. Unlike the PDF readers previously mentioned, there is no annotation functionality. We think that a trend toward digital journals is a step in the right direction for medical publishers.
Other publishers have also started releasing journals and review books for iPad. Acta Orthopaedica, a Scandinavian orthopedic journal, has a free app that includes the ability to download any article from their archives since 1930 at no cost. While the app lacks an integrated search function, the ability to view and download full-text literature is a wonderful feature. All articles are downloaded in PDF format and must be read within the Acta app (no ability to export to iAnnotate or GoodReader). Another app, Hospital Physician Orthopaedic Surgery Board Review Manual, is marketed as a review journal for orthopedic surgeons. Currently free, the app includes six issues for “Volume 8,” and focuses on one topic each month that contains about five to 10 pages of text. This may be a source of intermittent information for orthopedic surgeons, especially if topics continue to expand.
In this issue, we have highlighted some ways that apps can aid orthopedic surgeons in keeping abreast of the literature. We will address patient education and teaching apps for orthopedic surgeons in next month’s column.
For more information:
- Matthew DiPaola, MD, is an assistant professor and shoulder and elbow specialist in the Department of Orthopedics at Wright State University in Dayton, Ohio. He is a writer for iMedical Apps and co-founder of Touch Consult, a developer of team-based medical software to improve signout. He can be reached at firstname.lastname@example.org.
- Orrin Franko, MD, is a PGY3 orthopedic resident at University of California San Diego. He has an interest in promoting mobile technology within orthopedic surgery and founded the website www.TopOrthoApps.com to help surgeons and trainees find the most relevant orthopedic apps for their mobile devices. He can be reached at email@example.com.
- Disclosures: DiPaola and Franko have no relevant financial disclosures.