Thursday, March 28, 2013

Bottom Line: Read (iTunes link) is an free, functional, and beautiful iOS app for browsing the medical literature, with its incredibly well-implemented institutional access putting it head and shoulders above many similar apps.
Disclaimer: I have no ties to QxMD. I'm just enthusiastic about this app.

Technology has enhanced our access to the medical literature like never before. I'm not that old, but even I can remember the days of painstakingly hunting through library catalogs to find references for some class paper. Now, I hardly have to lift a finger -- I have custom bookmarks set up to route Medical Subject Heading (MeSH) queries through our UNM Library's Proxy -- and I am inundated with full-text access to hundreds or even thousands of articles.

Clearly, the challenge of our generation will not be finding information, but filtering it.

Read, by QxMD (Twitter profile), makes this process not just easier, but more enjoyable. On initial setup, the user can select areas of clinical interest, after which they are presented with abstracts of various landmark articles from those specialties. You can also choose specific journals that are pertinent to your clinical interests. As I've alluded, Read also has built-in support for the "Libproxy" services of hundreds of universities, including the University of New Mexico. This means you can sign in with your UNM NetID (I recommend against using your HSC ID, just in case, since your UNM NetID works just fine) and Read will do all the rest of the work to get full-text access to papers through UNM. Obviously, this won't help you get articles from journals for which UNM does not own a subscription, but I've been really impressed at how well it works for the rest.

Once set up, the interface makes it look almost like a newspaper or magazine format -- far more visually appealing than many of the existing PubMed apps, in my opinion. Once you see an abstract or article title that piques your interest, give it a tap. A window pops up with the full text of the abstract (if available), and a small progress bar at the bottom of the screen notifies you that it is already downloading the full text of the article in PDF form (assuming either free or UNM access, of course). I honestly think that Read facilitates accessing the full text of an article even easier than using PubMed directly on my computer -- it's that good.

Main interface of Read by QxMD

Once the paper is downloaded (usually only a few seconds), you can open it in a full-screen browser. Recent updates have enabled in-app annotations like underlining, highlighting, notes, and freehand markup. There are unobtrusive on-screen buttons to let you thumbs up, thumbs down, star (to "favorite" for easy access later), or comment on a given paper. The comments are not just your personal notes, but instead are discussions in which you can interact with other users. While I haven't seen much utilization of this feature yet, this is one of the areas where I think QxMD has been particularly forward-thinking. The ability to add your thoughts, opinions, and criticisms of a paper, nearly seamlessly, collaborating with other great minds in your field… this holds incredible potential. Every major piece of medical literature could become its own world-wide journal club, where anyone from the layperson to the clinician to the postdoc would be free to ask or share thoughts on methodology or compare findings to other pieces of literature. It could become something truly amazing.

Viewing an article in Read by QxMD

Additionally, Read has the ability to share a paper to Facebook, Twitter, or by email. Perhaps my biggest gripe with Read is the omission of the familiar "Open in…" feature that myriad iOS apps use to send files between iOS apps. While Read's annotation feature are improving, I own other apps that specialize in PDF annotation, and other apps that specialize in storing and organizing my research library; I adore Read's interface for discovering and accessing literature, but I would like the option to export the PDF files to these other apps. The share by email feature does attached a copy of the PDF file to the email, so for now I've been using that to email the PDF to myself. Alternatively, you could use an IFTTT email trigger to import from email to Dropbox, or to send yourself a push notification with a download link via Pushover. Lots of options for workarounds.

A few last thoughts. As I've become more interested and involved in the tech community, one lesson I've learned is that there generally is "no such thing as a free lunch." While some apps you use may truly be both "free as in speech" and "free as in beer", most "free" apps have some built-in way to make money. They need to, or else the developers investing hundreds and thousands of hours into their development would go hungry. In-app advertising is a common way to do this, and honestly I'm usually relieved when a free app has advertising, because at least then I know how they're making money from me. Less visible alternatives to advertising are often privacy invasive, and there's even a risk that less ethical developers may be selling your personal information to shady interested parties. I strongly recommend that you frequently take time to ask yourself how any company providing a free service or software can afford to do so, and what their motivation might be if not financial gain.

I only bring this up because I was instantly suspicious when I noticed how well-made Read is, and yet it does not have in-app advertisements. Before I felt comfortable encouraging fellow UNMSOM students to use the app, I decided to contact QxMD directly to inquire about how they can afford to produce such a nice app without ads. I received a prompt, courteous, and thorough response from a Canadian physician (IM / nephrology), who outlined a number of potential ways they may choose to monetize Read in the future. He asked that I not share their plans, but I will say that they all seemed completely ethical and reasonable in my humble opinion, and his transparency put my concerns to rest. I really, really appreciated a sentiment he expressed in his email:
I'm a practicing Internist/Nephrologist, and I believe that my apps have already done more good than all the clinical work I'll do in my entire career (1 person trying hard X 35 years << 500,000 clinicians doing 1 thing better because of one of my apps).
In summary, I'll say that Read is probably my favorite iOS app for discovering new medical literature. I strongly recommend that any medical student with an iOS device give it a shot -- you have nothing to use. Its strongest point is the best implementation of institutional access that I've yet seen in any app -- iOS or otherwise -- and my biggest criticism is the inability to directly export PDF files to other iOS apps. Read gets the SMRT seal of approval.

1 comment:

  1. A truly excellent app; super clean interface and great usability. Besides being a great delivery system of new and relevant articles, I've also found that searching for old articles works very well. Just today I pasted the name of a 1994 article in the search box, and it brought up the correct article--with a live download link--on the first try. Love it.