Read QxMD: Another Journal App for Your iPad

Recently I have been more atune to medical apps because I am in the process creating a libguide featuring medical apps.  From what I can tell, there are three main apps out there that try and provide full text access to institutional journals subscriptions via the iPad.  They are Browzine, Read, and Docphin.

Last week I reviewed Browzine, today I am going to review Read by QxMD.  Next week Alison Aldrich, will provide a guest post about Docphin.  (I usually try to use all of the products reviewed on my blog, but in this instance Docphin doesn’t work with the way my library provides off campus access and they don’t provide access to free journals.  So, I can’t try it. Alison has graciously agreed to try and write a guest post about it. -Thank you Alison!)  If possible, I will take the reviews and try and compare the three apps against each other.

Read is produced by QxMD which makes several medical apps. It is founded by “medical professionals” and is dedicated to “creating high quality, point of care tools for practicing health care professionals.”  They are partners with Cardio Exchange, Society for Vascular Surgery, Vascular Study Group of New England, American Academy of Family Physicians, and the Canadian Society of Nephrology.

It is also important to note their app is free and is available for the iPad as well as the iPhone (did not see an Android version). Their site promotes “seamless automatic one-tap access to full text PDFs available” for a lot of universities (full list scroll to bottom) including Johns Hopkins, Harvard, Washington University, and Yale. Despite advertising the institutions using Read, they do not include information on their website for librarians to add their institution. You have email them to add your institution, according to a tweet from QxMD .

After you download the app you are asked to create an account by adding information about your profession, specialty and institution.  I find asking for profession and specialty to be annoying but I realize this is for their usage stats. If your institution is not listed you can still use the app but you will get a warning that you will only be shown free papers (Take note because this will be confusing later on).

signin

Since my institution isn’t listed (it wasn’t listed for Browzine either, so we have a pretty equal comparison) I proceeded anyway without adding my it.

institution;

Next you are asked to select the specialties you would like to follow.  I chose Family Medicine because I know a few titles off the top of my head that are Open Access and would have free PDFs.

specialties

Once you select a specialty you are then asked to select journals to follow.  The first set of journals are ones within the specialty then you are presented with an A-Z list of all journals.  After selecting the journals you are also presented with a list of “collections” to follow. It appears they only have NEJM collections (which are subscription based and NOT free).

journals to pick

collections

If you are paying attention to my screen shots and with the fact that my institution is NOT subscribed you will notice that there are an awful lot of listings for non-open access titles.  For example: Almost all of NEJM’s stuff is available to only to paid subscribers. While Annals of Family Medicine  and the journal Family Medicine are free and have no embargo period on their most recent issues, that is not the case with the rest of the journals.  American Family Physician and Family Practice are not free and have an embargo on the current 12 months.

Personally I find this to be an area that has great potential to be very confusing to users.  If the first screen says “By not selecting an institution you will be shown only free papers,” then as normal average person (not somebody who understands nuances institutional subscriptions, free Open Access articles, and embargo periods, which most doctors don’t) I would expect that everything I see from the first screen forward would be free.  In other words since I told the app I don’t have an institution AND it told me I will only be shown free papers, then I would expect the app to be smart enough to only show free journals or papers.  Instead, I am able to see free papers and subscription papers side by side, only when I click on them do I realize whether they are available. (If it isn’t available I get message indicating I can’t download the PDF)

Now you might be saying, well this whole mess is pointless if your institution subscribed to Read. No it isn’t pointless. In fact, I think it gets even messier, because no institution subscribes to every journal.  There will be occasions where a user is logged in as your institution and selects a journal that your library doesn’t subscribe to (but is available on Read’s list).  The average user doesn’t know what the library subscribes to and will become frustrated when they tap to read the full text of an article and it can’t download the PDF.  Who do you think they will call when that happens? The following discussion plays in my head even now, “But it is listed on Read and your library is listed Read, so why isn’t it available?”

A listing of all possible journal titles that isn’t synced to a library’s holding list nor has the ability to only show free article for those not affiliated with an institution is confusing.  Doctors don’t know what articles are free and what aren’t without trying to first get the PDF.

 After you are done selecting the journals you are presented with a very helpful guide explaining your screen lay out.  This is necessary because there is a lot going on.
help

The display is set up similar to a Flipboard style of browsing, showing “Featured” articles by default.  There is no clear explanation as to what determines an article to be “Featured.”  As I mentioned I selected these specific journals:  Annals of Family Medicine, Family Medicine, American Family Physician and Family Practice.  However, the bottom right article is from the European Heart Journal which I didn’t pick.  (Sorry it is the journal is very faint, I couldn’t get it any darker.) I am not opposed to having featured articles, I like the idea because it allows people to become aware of articles outside of their normal journals.  But, I would like to know where they get featured articles from. Is it based on a rating system or something else? (My guess is it based on their algorithm they mention in a comment on iMedicalApps.)

flipboard 1

Tapping Journals at the top bar allows you to flip through the articles within your selected journals.  The Collections tab just allows you to view the NEJM Collections (which currently are the only collections available and are not free).  The outline icon (underlined in yellow on image below, next to the star) is the Topic Reviews button.  It allows you to browse through “1000’s of outstanding topic reviews” which are organized from broad to narrow subjects  Again it is important to note that not all of the articles listed as topic reviews are free.

subject

Tapping the star allows you to select articles as your favorites which you can tag with your own words or from a pre-selected list for easier retrieval. Below tagged an article Family Medicine, and while I was starting to type another word the auto suggest popped up.  The auto suggest while dynamic is a bit limited and I’m not sure where they are getting the rather long terms/descriptions.  It appears they are either journal article titles and/or topic review subjects.

tagging

IF you have a subscription, downloading the article is very easy, you just tap on the title and it tries to download the PDF.  You can email the PDF (if you have access), tweet it, share it on Facebook, add a comment, star it (which saves it as a favorite), or rate it with a thumbs up or down. If you can’t download the article you get the message “Paper could not be downloaded” and you are encouraged to either view the citation in PubMed or Add Proxy.  If you don’t have access to the full text you can still email the citation, tweet, Facebook it, comment, star it, or rate it.

no pdf

Finally users have the ability to directly search PubMed while within Read.  This would be useful if you read an article on a specific topic and you wanted to quickly search PubMed to see if there were other articles on the same topic.  However the search is so limited, it would just be better to use PubMed app you already have on your iPad or go to PubMed using your iPad browser.  I did a quick and dirty search on heart attack.  I have no idea what algorithems it uses when searching the text word heart attack but I get completely different results when searching PubMed directly. (I looked both within relevance and publish date, neither of which seemed to be close the the PubMed results.)  I searched using the MeSH term myocardial infarction and got similar puzzling results.

Finally, there is an issue regarding timeliness.  While Read displays the current issue for some journals, that is not the case with all journals.  For example the current issue for the Annals of Family Medicine (a free Open Access Journal) is January/February 2013, yet the most recent issue displayed on Read is the November 2012 issue. The same is the case for Family Medicine, and The Journal of Family Practice.  This is a problem within what I call the core journals as well. While BMJ, JAMA, JACC, and NEJM have the current issue available Lancet is two issues behind. Since many of the journals are current this could be an issue as to when their software hit the journal sites, perhaps it just needs tweaking with certain journals.  When many of the journals have the most current issue, it can be difficult to try and discover the ones that don’t. Kind of like find an needle in a haystack but the need moves, because the software does eventually get the most recent issue.

(I don’t remember noticing this within Browzine because their display was slightly different so I wasn’t as aware of the timeliness of the citation as I am within Read.  I will have to double check how timely Browzine is.) 

The good news is this app is free to users and free to libraries who want to make their journals available.  However, those libraries without straight forward proxy servers might have difficulty registering with Read. They would really need to contact QxMD to see if the two systems work together.  Doctors who like the idea of Flipboard for their medical journals will be happy with the display and function of Read. 

According to the comments made by Read on an iMedicalApps review, they feel their algorithmic curation of the literature is perhaps the greatest strength of Read. “Rather than simply relying on our users to tell us which journals they want to read, we use a combination of machine learning, semantic analysis, crowd-sourcing and proprietary algorithms to figure out which articles our users should likely be reviewing.”  I think it is  matter of personality as to whether doctors end up liking Read’s selections based on their algorithms or whether they prefer a different method of selecting/reading their articles.  However if Read’s algorithm determines what users should likely be reviewing then I have to wonder why their algorithms chose editorials, not articles, to display on the first Read page for JAMA. Are JAMA editorials more important that articles?

I think Read has a lot going on with it and a lot of potential but I am concerned about the fact that it only contains a few of the BioMed Central and PLoS titles which are Open Access and possible confusion regarding what is available full text and what isn’t.  In theory I know doctors shouldn’t care whether an article is full text, if it is relevant they should find a way to get it.  However, theory doesn’t always work in reality.  I have seen more doctors ignore relevant articles because they weren’t full text or they couldn’t figure out how to get the full text.  I have doctors who won’t click an order it button to order an article (FOR FREE) from our library because they don’t want to deal with it. I think there needs to be a better way for Read to work with institutions so that doctors clearly know what journals are available to them and what aren’t. Doctors assume that if they input their institution then what they see is what the institution gets, which is not always the case.

 

14 thoughts on “Read QxMD: Another Journal App for Your iPad”

  1. I absolutely love Read and have recommended it many of my friends and colleagues. I have almost reached the end of my pursuit of a Ph.D., and I promise you, I have really used Read in my research. It has saved me countless hours searching for articles since it does all the searching for me.

  2. I’m a midwife working for the NHS in the UK. I access journals either via NHS direct access if I’m on an NHS computer, or by Athens.

    I like Read and mostly find it very easy to use. My main issues are that I can’t integrate my Athens ID with it, as you’ve mentioned. And also that it doesn’t recognise midwifery as a specialty.

    I’ve chosen obs and gynae instead, but it’s not really the same, and several of the midwifery specific journals aren’t included, such as British Journal of Midwifery, which I think is a shame.

  3. Hi Joan,
    These apps are definitely targeted at doctors and researchers. They are not for the average patient because these apps do not contain journals that patients would normally read, such as Biochemica et Biophisca Acta, Hepatology, JAMA, etc. These apps allow doctors to get the table of contents to their favorite journals all in one spot and then click to get the full text of an article. Until the creation of these apps there was no ONE single spot where doctors or researchers could gather and read the table of contents. The reason was because each publisher had its own unique method for distributing tables of contents and for accessing full text journals through the institution.
    Our journal collection when from approximately 600 titles in print to now only 6 print titles. Our journals are now almost exclusively all online. Additionally, with the advent of online journals, open access, and database aggregated journals, are doctors and researchers have access to several thousand journals. That is a huge jump in number of journals available to our doctors and researchers. There are two ways to stay abreast of current topics and treatment information. 1. Is through a Medline topic search that is saved and provides monthly updates to the doctor. That is great for doctors who are interested in following a specific disease, injury, treatment, or drug. 2. The other method is to follow the table of contents in journals. Until these apps, there was no way to automate this effectively because of the publisher differences. Following the tables of contents of selected journals is a great way to keep informed about topics that are related to your area of interest but aren’t necessarily your expertise that you have created a subject search for.

    As I mentioned we now only have 6 journals in print. Almost all of our doctors and researchers want journals electronically and they want access to them via their computers and tablets. So the preference in print has waned significantly. In fact there are a few gold standard journals that we only get in print because their online pricing structure is crazy expensive. We are seriously considering cutting them because people aren’t even using them in print. They only want the PDF.

    Unless your electronic journal license agreements are specifically for one exact IP addresss (i.e. the only way to access JAMA is via one certain computer in the library, no other library in the hospital can access JAMA), then your ejournals can be access by tablets. I have NEVER seen a license agreement that specifically states the journal can only be accessed by desktop computers. They are for either a specific IP address (in the case of one computer only) or a range of IP addresses. As long as your desktop, laptop, cell phone, iPad, etc. is on that range it can is kosher to be accessible. In the case of Browzine, READ, Docphin and the other apps, you DO NOT pay for two subscriptions. The apps use your proxy server or off campus authentication system to provide access to those journals through your approved IP range. Now if you have a license that only allows access to one specific computer on a certain exact IP address then you need to upgrade your license to either a site license or concurrent user model (whatever the publisher lists). Again you wouldn’t have 2 subscriptions to a journal.

  4. I would say that we should ask a few clinicians how useful one or the other is. The average patient would be very confused by an app with white papers and research and I assume this app is for doctors correct?. I don’t know enough about research that docs read to make any comments on whether or not a majority would use an app or prefer an internet subscription for desktop/laptop. We surveyed our docs on how they like to receive communication from us (postal mail, phone or email) and the they said email. I also know our subscriptions here are only for desktop. Will we have to buy two subscriptions one for app and one for desktop to the various journal resources? Just curious about how docs consume journal articles. I prefer my white papers to be printed and read. Others like to read online on tablet. If I really want someone to read something I print for or email to them.

  5. I use WordPress. I could do more with it and really jazz it up and make it more interactive but the blog is done in my off time and with three kids my off time is limited. I squeeze the writing in whenever I can (lacrosse practice, bed time, riding as passenger in the car, etc.) so I just don’t have the amount of time I would like to really improve the core and structure of the site. I just do good to focus on the writing.

  6. Currently it seems like Drupal is the best blogging platform out there right now.

    (from what I’ve read) Is that what you’re using on your blog?

    my site – Molly

  7. Thanks, Krafty, for spending time finding and reviewing these things. I don’t use Apple mobile, so I can’t see “for myself” some of these tools. Perhaps either you or QxMD could tell me more about the “topic reviews.” Are these similar to Dynamed or UpToDate style monographs, and where do they come from? i.e. how do they compare to other point-of-care monographs now available for mobile (Dynamed, UpToDate, etc)

  8. Papers for Mac/iPhone/iPad by mekentosj.com also links to library proxy servers and downloads pdfs.

  9. Thanks Daniel, always nice to hear from the company.
    Regarding proxy issues…While proxy access is a common method for institutions (especially academic) to provide off campus access to the institutional network. However, many hospitals do not allow their libraries to provide proxy access to their resources, including journals. There is a large contingent of hospitals in the United States and the UK that use Athens to provide access to their resources. Other hospitals use their their catalog systems to authenticate and provide off campus access. This isn’t unique to small community hospitals. The Cleveland Clinic did not allow its library to have a proxy server to provide off campus access to library resources such as journals. So while providing proxy access is helpful and will reach most academic institutions, many doctors in hospitals not part of a university will have a difficult time access full text journals.

    As I mentioned, I respect the fact that you are trying to provide access to articles but as somebody who deals with a large amount of doctors on a daily basis and whose job is to find articles for them (among many other things I do). One of the biggest complaints we get from our doctors is they just want to know what journals we subscribe to and what is full text. We and other libraries have gone to great lengths to tag our journals. Doctors look for these tags or some indication that the journal is available through the library. I truly believe better clarification of what journals are subscribed journals and what aren’t will greatly enhance your product.

  10. Thanks for the thoughtful and detailed review of our app “Read by QxMD” (iOS install ==> http://qx.md/read).

    We built Read in order to enhance knowledge translation and ensure the most relevant and high impact articles get disseminated to clinicians, and hopeful adopted into practice.

    We love all the feedback we’re getting – we’re enhancing features continuously as a result.

    If your institution’s proxy access isn’t working, just drop a note to [email protected] and we’ll get this fixed as quickly as possible.

    For collections and journals, we’ll be adding significantly expanded options in the near future.

    While we recognize that some content remains blocked behind paywalls, we still believe in highlighting the best content possible. Our algorithms are still learning and seem to be getting “smarter” every week, in part based on our experience with a growing user base. Thankfully, more and more content is showing up in open access repositories such as PubMed Central. As well, there is a large amount of content that becomes freely accessible after an embargo period. Our system is setup to ensure that if the content is freely available to you, either through open access or institutional subscription, we’ll find it.

    Search is another area we’re really interested in. We’re quite proud that our search results differ from PubMed. The more we learn about a user (based on their app usage), the better we can customize search results that we think will interest them.

    We’ve been frustrated by not finding high yield results on the first page of PubMed. So far, the feedback we’ve received is that our featured page and search results help clinicians and scientists find important content they may have missed otherwise.

    Keep an eye on our progress – lots more to come over the comings weeks and months. Follow us @QxMD

    – Daniel Schwartz
    Medical Director and Co-Founder, QxMD

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