By Wendy Sarubbi | December 16, 2011 3:44 pm

Medical students, residents and doctors can now move beyond fumbling through pages of a notebook when searching for critical internal medicine information to pinpoint a diagnosis.

An app and book project by Dr. Mario Madruga, assistant professor of internal medicine at UCF College of Medicine, and director of internal medicine residency program and medical teaching service director at Orlando Health, and Francoise Marvel, a fourth-year medical student from the Florida State University College of Medicine, puts that information at the users’ fingertips. They co-authored “Madruga and Marvel’s Medical Black Book: Guide to Differential Diagnosis, Mnemonics and Clinical Pearls” and “Madruga and Marvel’s Medical Black Book App.”

“The app helps you access information quickly,” said Francoise, who currently is in a research clerkship at the National Institutes of Health in Bethesda, Maryland.

Francoise, who has a background in technology and once worked on an NIH program to train health care workers online, was doing her internal medicine rotation with Dr. Madruga when he offered her a chance to put the information he began collecting in 1993 in his medical black book as a resident and put it into a unified format.

“One week after she got the black book, Francoise had a first rough draft of the medical black book completed,” said the doctor, who also teaches at FSU’s medical school. After a year of work, the book was published and the app approved.

Open the app and under “Browse” are four categories: Differential Diagnosis, Mnemonics, Clinical Pearls and Case Studies. It also features bookmark and search functions.

For example, Francoise said, if you click on “Atrial Fibrillation” under “Clinical Pearls,” and “Mnemonics,” you will find major causes and evidence-based treatment guidelines. By considering all conditions that could account for a patient’s illness and how to effectively manage them, she said, there is a better chance that a critical factor will not be missed and a timely, accurate diagnosis is reached.

The “Case Studies” section presents case histories and prompts the user to arrive at a diagnosis.  “It encourages problem-solving and challenges people not to fall into complacent-thinking,” said Francoise.

UCF M-3 student Ruth Strakosha said the “Black Book” app made a difference during her internal medicine clerkship this year.

“It helped me to organize my thoughts and differentials.  It was very practical to have during rounds because it was so compact and clinically relevant,” Ruth said.

“I would end up reading through several topics during the few minutes of downtime between cases or morning report.  My favorite and most-used pearls were the differential for atrial fibrillation and the causes of thrombocytopenia.  I referred to these countless times during the clerkship.”

The app reflects the continuing technical revolution in medicine. “I think that with every passing day we have to incorporate information technology into our daily practice,” said Dr. Madruga. The black book and application is “quick, easy and to the point. These are everyday clinical concepts that need to be understood by trainees in order to become successful practicing physicians.”


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