• Hayley Goldbach, Aileen Y Chang, Andrea Kyer, Dineo Ketshogileng, Lynne Taylor, Amit Chandra, Matthew Dacso, Shiang-Ju Kung, Taatske Rijken, Paul Fontelo, Ryan Littman-Quinn, Anne K Seymour, and Carrie L Kovarik.
• Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
• J Am Med Inform Assoc. 2014 Jan 1; 21 (1): 37-42.

ObjectiveMany mobile phone resources have been developed to increase access to health education in the developing world, yet few studies have compared these resources or quantified their performance in a resource-limited setting. This study aims to compare the performance of resident physicians in answering clinical scenarios using PubMed abstracts accessed via the PubMed for Handhelds (PubMed4Hh) website versus medical/drug reference applications (Medical Apps) accessed via software on the mobile phone.MethodsA two-arm comparative study with crossover design was conducted. Subjects, who were resident physicians at the University of Botswana, completed eight scenarios, each with multi-part questions. The primary outcome was a grade for each question. The primary independent variable was the intervention arm and other independent variables included residency and question.ResultsWithin each question type there were significant differences in 'percentage correct' between Medical Apps and PubMed4Hh for three of the six types of questions: drug-related, diagnosis/definitions, and treatment/management. Within each of these question types, Medical Apps had a higher percentage of fully correct responses than PubMed4Hh (63% vs 13%, 33% vs 12%, and 41% vs 13%, respectively). PubMed4Hh performed better for epidemiologic questions.ConclusionsWhile mobile access to primary literature remains important and serves an information niche, mobile applications with condensed content may be more appropriate for point-of-care information needs. Further research is required to examine the specific information needs of clinicians in resource-limited settings and to evaluate the appropriateness of current resources in bridging location- and context-specific information gaps.

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