Dr. John Bedolla is the assistant director of research education and assistant professor of emergency medicine at the Dell Medical School at the University of Texas at Austin. He is also editor-in-chief of ED CLEAR, an evidence-based medical risk reduction program. Dr. Joe Habboushe is MDCalc’s co-founder and CEO. Earlier this year, the two sat down and talked about MDCalc’s content development process and future plans.
Dr. John Bedolla (JB): Hello, I’m Dr. John Bedolla. I am assistant professor of medicine and I’m also the director of risk management for a large EM group. One of the reasons I like MDCalc is that it gives you actionable information that you can use in clinical practice, and it seems to be very well vetted and have a really robust process for adding [calcs]. I’m talking with Dr. Joe Habboushe today and getting some insight into MDCalc. So Joe, how is that you add content to MDCalc?
Dr. Joe Habboushe (JH): Excellent question. MDCalc is eleven years old, it was started by my partner, Graham Walker, when he was a med student, and he just put a few scores on a website. I joined him a few years later and we’ve developed a process since then. Number one is that we pick scores that are well-validated and well-accepted, but after a few years, our users asked us to start developing the content around the scores that would help them use it better.
So, we do that in two ways. We talk to two different types of experts: number one is the creator of the score themselves, so Phil Wells for the Wells Criteria, Graham Teasdale for the GCS Score, Ian Stiell for the Ottawa and Canadian scores). They can write a section for how you can use the score best, but we also have another expert, who is unbiased, to give an evidence-based synopsis of the score, when to apply it, when not to apply it, [and] after you get the score, what to do next. All things that will help the user—the physician—apply this score best, so that they can help the patient best.
JB: And what’s new on the horizon?
JH: There’s so many new things in this past year and this coming year for us. Three years ago we had 80 scores on MDCalc, now we have over 250 [Editor’s note: we have 325+ calculators to date], and this coming year we will likely add a few hundred more. This is going to cross most fields of medicine. We are actually used now by over 50% of US physicians each and every month. So, we are the most broadly used [physician-owned] medical reference in the US.
Besides adding new calculators, we’ve actually developed, of course, the iPhone app and we’ve about to launch an Android app [Editor’s note: our Android app was launched in April 2017]. This year we are starting to work on much better and [more] seamless EHR integrations.
JB: You also seem to have a novel process where you don’t just look up the [calc], you look up the chief complaint?
JH: We have a new functionality in our new website, which we just launched last month [January 2017]. Our users were asking us, “how do we learn about new scores that we don’t yet know about?”. That’s a good question. How do we learn about these scores? You either learn about it in residency or through a colleague. So, we’ve developed this new type of searching functionality where you can present the clinical scenario into MDCalc and learn about the scores.
For example, if a patient comes in and you’re worried about PE, you can click PE + Diagnosis and you’ll see the Wells Score, Geneva Score, PERC Rule, and explanations on how they’re different. After you diagnose PE, you can click on PE + Prognosis and then you’ll see a whole new set of scores to help you prognosticate the PE and help you figure out how to best treat it. Do they need to go in the ICU? What kind of medications? Those are scores like the PESI score and a few others.
JB: Excellent, thank you very much!
Thanks to Dr. Bedolla and ED CLEAR for producing this video interview.