Clinical guidelines have increasingly become an important part of clinical practice, influencing everyday clinical decisions at the bedside, rules of operation at hospitals and clinics, health spending, and more.
Clinical practice guidelines can be defined as "systematically developed statements to assist medical practitioners with decisions about appropriate health care for specific patients' circumstances."
These guidelines are intended to provide concise instructions on how to provide healthcare services, which diagnostic or screening tests to order, how long patients should stay in the hospital, and other details of clinical practice.
The most important benefit of clinical practice guidelines is their potential to improve both the quality of care and patient outcomes. Clinical practice guidelines are often assumed to be the epitome of evidence-based medicine.
For more than three decades, the American College of Cardiology (ACC) and the American Heart Association (AHA) have been developing joint clinical practice guidelines to provide recommendations on the care of patients with cardiovascular disease.
These guidelines have become important documents for guiding cardiology practice and establishing standards for quality of care.
In 2014, the American College of Cardiology (ACC) launched Guideline Clinical App to bring all ACC/AHA guideline content to Android and iOS smartphones and tablets for free.
However, the Guideline Clinical App doesn't just provide the full guideline text but also includes a collection of interactive tools such as calculators, scoring tools, and algorithms, which are provided to complement the guidelines.
For each clinical guideline, the app also includes an executive summary and key takeaway points.
The initial version of the ACC Guideline Clinical App included three practice guidelines, including Management of Heart Failure, Assessment of Cardiovascular Risk, and Treatment of Blood Cholesterol.
Over the years, the app developers added additional guidelines, so the current version of the app contains 20 clinical guidelines.
As mentioned previously, ACC Guideline Clinical App is primarily intended for clinicians treating patients with cardiovascular disease, whether in cardiology, primary care, or other specialties.
Upon opening, the app will initiate the installation process and then try to update the guidelines with the most recent ones. You'd need to enable the access to the Internet on your device to allow the app to successfully perform this task.
After the update is completed, the users are taken to the home screen featuring My Tools section for bookmarked content and 20 guideline sections (colorful icons with abbreviations), including Cholesterol (Chol), Cardiovascular Risk (CV Risk), Heart Failure (HF), Atrial Fibrillation (AF), Valvular Heart Disease (VHD), Lifestyle (Lstyle), Obesity, Non–ST-Elevation Acute Coronary Syndromes (NSTEMI), Perioperative Management for Noncardiac Surgery (Periop), Device-Based Therapy (DBT), Supraventricular Tachycardia (SVT), Dual Antiplatelet Therapy Update (DAPT), Percutaneous Coronary Intervention (PCI), ST-Elevated Myocardial Infarction (STEMI), Stable Ischemic Heart Disease (SIHD), Coronary Artery Bypass Graft (CABG), Peripheral Artery Disease (PAD), Syncope, High Blood Pressure (BP), and Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death (VA/SCD).
Besides recommendations, each guideline includes an executive summary with top 10 points, as well as a collection of interactive tools such as risk scores, dosing calculators, and protocol-based algorithms.
The Guideline Clinical App has included some of ACC's other apps such as ASCVD Risk Estimator, Statin Intolerance, and Anticoag Evaluator, which are available in particular guidelines, such as Cholesterol, Cardiovascular Risk, and Atrial Fibrillation. Other ACC apps, such as TreatHF app is also available as a tool in Heart Failure guideline section.
By default, the guidelines are shown in the grid view, but they can also be viewed in a list format by tapping the second icon from the left on the bottom navigation bar.
Tapping on an icon of a particular guideline opens a 'pop up' preview of all content and tools available for a particular guideline. All guideline sections are similarly arranged.
For example, Cholesterol section contains the Executive summary, 10 points, ASCVD risk estimator, statin therapy, ASCVD risk prevention, statin with ASCVD, statin without ASCVD, statin monitoring, and statin intolerance, as well as patient resources.
Valvular Heart Disease (besides executive summary and 10 points) contains risk assessment, AVR indications for AS and chronic AR, TAVR vs. SAVR, rheumatic MS interventions, MR and TR surgery indications, AS checklists, anticoag for prosthetic valves, suspected PVT, VHD clinician tool, and patient resources.
The executive summary and 10 points are presented in a form of text, often formatted in tables. The tools are available as either interactive calculators or static algorithms and flow diagrams (users can simply choose how they want to view them).
However, I found the navigation in the app very complicated and confusing. Particularly, using the navigation arrows in Executive Summary part.
For example, there are arrows at the top that apparently help you navigate to the previous and next sections within the current guideline, and there are also arrows on the bottom navigation bar that should work like back and forward browser buttons. Except they often don't do that.
Plus, the Back button, when it's responsive, will take you to the completely new destination, usually not the one you signed up for.
Jokes aside, the navigation in ACC Guideline Clinical App is poorly implemented and the occasional unresponsiveness is something that should be addressed in future updates.
All content, including guidelines and tools, be bookmarked and then accessed from either the My Tools section or the Star button on the bottom navigation bar. This is the best way to avoid clunky navigation by adding the resources you may use more frequently in one spot.
The app also allows users to make notes within the content sections and tools.
A search function that can be accessed from the home screen or the bottom navigation bar enables users to quickly find the term by index search or full-text search. Just start typing and the autocomplete will populate the list with the most accurate results.
Finally, there's the Info section, where users can get contact information to report issues to the ACC, provide feedback, and watch a demo video or view picture tutorial on how to use the app.
Overall, the ACC Guideline App appears to be an excellent resource with access to a plethora of features, tools, and useful information within the cardiovascular disease spectrum, making the ACC guidelines more accessible.
The responsiveness and navigation of the app should be improved by the next update.
Benefit: All clinicians caring for patients with cardiovascular disease will benefit from this app