InfoRetriever 3.2 for Pocket PC.

Evidence-based medicine (EBM) is the practice of integrating individual clinical expertise with clinically relevant evidence derived from the medical literature. Because of time constraints combined with the volume of literature available and the complexity of medical database searching, clinicians are often unable to devote the amount of time necessary to pursue such evidence. Furthermore, although the medical literature contains evidence that can be used to improve patient care, only a small portion describes solid advances in the etiology, diagnosis, prevention, treatment, or prognosis of illness. Finding and understanding the most significant and valid studies is tough for busy clinicians and an impediment to the wide adoption of EBM. Evidence-based medicine databases, such as the Cochrane Library, filter the literature and provide systematic reviews on medical topics. There still remains, however, the problem of quickly getting this information to the bedside or other points of need. Handheld computers have shown great promise as vehicles for delivering medical information to the point of care, and InfoRetriever 3.2 for Pocket PC attempts to do so for the primary care physician who is especially interested in EBM content. InfoRetriever is a joint venture between Dowden Health Media, publisher of the Journal of Family Practice, and InfoPoems, Inc., whose officers include the editor and three other members of the Editorial Board of the Journal of Family Practice. This review concentrates on the Pocket PC version of the software. A Windows version and a Web-based version of InfoRetriever are also available, and a Palm OS version is under development. Currently, the developers strongly recommend that users run InfoRetriever on a Compaq iPAQ Pocket PC, because the iPAQ runs InfoRetriever twice as fast as any other Pocket PC and four times faster than earlier Windows CE devices. Installation of the InfoRetriever software—which is available as a free-trial, full-version download from the Website—is simple. The Website provides clear instructions and accompanying documentation on how to download, install, and later purchase and register the software. After ten uses, the free-trial version expires. To purchase InfoRetriever, users register at the Website and obtain a PIN number that “unlocks” the trial software and makes it fully operational; a second download is not necessary. Customer support staff responded to this reviewer's questions promptly and may be reached via email (support@medicalinforetriever.com) or a toll-free telephone number. InfoRetriever's features include prescribing information for more than 1,200 drugs, a selection of more than fifty-five clinical prediction rules, abstracts from the Cochrane Database of Systematic Reviews, and more than 1,000 brief synopses of selected clinically relevant articles from the primary care literature called MedicalInfoPoems. MedicalInfoPoems, or InfoPoems for short, are also available by subscription as a separate daily or monthly email update service. InfoPoems are synopses of the Patient Oriented Evidence that Matters (POEMs) published monthly by the Journal of Family Practice. Each month, the POEMs editorial team reviews more than ninety journals, identifies original research articles and systematic reviews that meet the criteria for a POEM, and writes reviews using criteria developed by McMaster University's Evidence-Based Medicine Working Group [1]. InfoRetriever also includes a diagnostic calculator where patient history, physical examination, and diagnostic test variables can be manipulated. Additionally, there are summaries of selected clinical practice guidelines available in the public domain, including related tables and algorithms as applicable. The developers have also indicated that Griffith's 5 Minute Clinical Consult is being incorporated into InfoRetriever. This reviewer considers the availability of the Cochrane database abstracts and InfoPoems on a handheld device to be a key feature of the InfoRetriever program. The full-length POEMs, available in the Windows version of InfoRetriever, are not available for the Pocket PC version. Having this information available for the handheld version would be a welcome addition. Determining from the InfoRetriever Website (medicalinforetriever.com) exactly how the three versions of InfoRetriever—Pocket PC, Windows, and Web—differ or are similar to each other is no easy matter. Information about related products and services could also be more clearly and logically presented. For example, the InfoPointer First-Alert system and MedicalInfoPoems refer to the same email update service. Nor is it clear what exactly is updated when subscribers receive software updates; according to the developers the clinical rules, drug information, diagnostic tests, and clinical practice guidelines are updated annually and, sometimes, more often. This reviewer wonders whether the lack of a clear description of the InfoRetriever versions and features may simply indicate a rapidly and dynamically evolving product. Despite the confusion the Website can create, InfoRetriever itself is a very useful product. Although InfoRetriever's search engine works quite well, there is room for improvement. The menu-driven process, which requires users to make selections through progressively more specific layers of subject matter before reaching a desired topic, can be a hindrance. For example, a search on diabetes mellitus requires users first to choose the type of data to be searched (e.g., reviews, diagnostic information, drug information, guidelines), then to select the relevant body system, and finally to choose the disease from yet a third menu. Adding a text-based search capability would make searching faster and easier. The search results screen is well designed and quickly understood. Cleverly designed icons indicating the type or origin of information for each item on the list of search results displays well on the Compaq iPAQ H3650's color screen. There are plenty of medical applications available for handheld computers, such as drug databases and calculators. What makes InfoRetriever unique is the EBM emphasis—specifically, the Cochrane database content and the InfoPoems. Used in conjunction with other tools currently available for handheld computers, InfoRetriever provides convenient accessibility to an important segment of the medical literature for busy bedside physicians with clinical questions.