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  1.    #1  
    Hey All,

    I submitted my MedCalc: Pediatric Dosing to the app catalog a while ago and it has recently had a good number of downloads. However, I only have two reviews, both of which have been horrible. One gave me 0 stars commenting that this app is "bata" and why is it part of the actual catalog.

    The other one is a bit more substantial. They commented on the app itself and offered suggestions for improvement.

    They asked me to include an IV Percentage calculation. I'm not quiet sure what that means. Can anyone here (maybe specifically in Pediatrics?) tell me what an IV Percentage would entail, so that I can include it in the app?

    I've tried looking around on Google and asking a few people to no avail.

    Anyone out there know what they're talking about? and/or how to calculate it?

    If you have any questions, just type MedCalc in the app catalog and look at the reviews.
  2. #2  
    It's too bad reviewers can't be contacted to determine specifics like this....
    My device history:

    - Jim J.

    (On Sprint for many years)
  3. #3  
    (Pediatrician x 30 years.)
    The term "I.V. percentage calculation" is vague and imprecise. The amount of fluid to be administered by I.V., and the rate given is determined by several things:
    1. Maintenance needs (fluid required for normal body functions).
    2. Replacement of ongoing losses (eg: diarrhea, etc)
    3. Correction of already existing dehydration.

    I think that the person suggesting "I.V. percent" is referring to #3 above. If so, then (if you are not familiar with that calculation) it would be a good idea to get some help with that. FYI - I created a pediatric calculator program that runs in Palm OS for my personal use, so I have done this before. I'd be willing to try to help you (although I am very busy at the moment). I'll keep an eye on this thread. -Jim
  4. #4  
    Maybe put something in the app description like "please contact me at this e-mail before you place a negative review. Give me a chance to improve." I am sorry you had bad reviews, dont give up your app. I am a physician and provide care to newborns as well and dont know what an IV percentage is. So dont give up.
    One app idea is dosage of all emergency medications based on weight. Lets says atropine, you put in weight 1 kg, and concentration like 0.4 mg/ml and out spits the app how much mg and mls to give.
    I can find a website for you, which tells you all emergency drugs and there weight dosings.
    If this helped you hit thanks.
  5. #5  
    SirataXero,
    I just downloaded your MedCalc and played with it. Unless I am missing something, it appears to calculate only dosing of medication. I don't see an area that allows any calculation of IV rates/amounts. That's fine. If you did want to add that, it is a whole lot more complicated than "one-time" medication orders. A calculator like that would be quite useful to a pediatrician (and worth paying for).
    To get an idea of how we think when ordering IV fluids, have a look at this: MedCalc: Pediatric Fluids and Electrolyte Therapy.
    I would definitely pay money for a WebOS app like that!
    Another idea for a pediatric calculator (one incorporated into my own PalmOS application) is the calculation we do when trying to increase the caloric intake of an infant who is failing to gain sufficient weight. We may ask the Mom to mix the formula with less water (or add calorically dense liquids to the formula) in an effort to increase weight gain. Again, this is somewhat complicated (less complicated than IV calculations) but still fraught with the possibility of harming the child if your calculations are off.
    -Jim
  6. #6  
    Hi SirataXero and everyone else,

    Don't worry too much at all about those reviews. They are bound to occur and I have received similar complaints for apps that actually attempt to make daily life easier but it definitely can be a tough crowd to please.

    I am the developer of DOSE for webOS, a medical dosage calculator for webOS. I believe the calculations you are discussing are already available in the app DOSE.

    You can check out the official catalog entry here:

    DOSE

    Let me know, and if you want more added you can certainly post to the thread I started on precentral here:

    Precentral Dose Thread

    Take care,

    Rich
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    #7  
    I just Neeto'd myself the link to your app to try. (When I searched in AppCatalog, no luck for some reason.)

    I think I had seen it a month or so ago, and meant to try it out, but must have spaced it. Will try both it and Dose.

    As to your question, I think it would be IV hydration rates, which jimfuchs above details. (I'm a family physician)

    I am just getting ready to try WebOS programming myself, because I am tired of having to start up the Classic emulator for my pregnant moms list. Hope that people will give me constructive feedback, too!
    Last edited by BBooDoc; 09/26/2010 at 09:18 PM.
  8. #8  
    Hi BBooDoc,

    You can just search the catalog for "J@ckpot" and you will find all of our official production apps.

    Rich
  9. BBooDad's Avatar
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    #9  
    thanks -just back from a delivery. I'll look into them.
  10. #10  
    Rich,
    Does your DOSE application provide IV rates based on % of dehydration for children and infants? If so, I'll buy. I have never seen one (other than the one I programmed for myself for PalmOS). What I mean, is something like this: MedCalc.......(a MedCalc different than SirataXero's). Any IV rate calculator I have ever seen for handhelds and phones has only calculated rates for patients above 20 KG. And I have also not seen one that includes correction of deficit based on % dehydration. Below 20 kg, the formula becomes algebraic rather than simply arithmetic (you probably know this).
  11. #11  
    Oops, wrong URL - duh...
    Here it is: MedCalc.
    -Jim
  12.    #12  
    Wow Guys,

    Thank you SO much for all the responses here! I honestly wasn't expecting this much feedback. I really appreciate it.

    j@ckpotideas, kkhanmd, BBooDoc and jjeffcoat, thank you all for the kind and encouraging words. I won't let these reviews stop me, but they sure are discouraging.

    I'll try to eek out some time from my real job to improve the apps I put out as time goes on, but I figure I can throw out some free apps and people can appreciate them just for what they do, not for making their beds in the morning, keeping the coffee warm, and reading them the morning papers...
    *sigh* k i'm done.

    I see the Online MedCalc IV calculator you included, jimfuchs (thanks for that).

    That's the website I used for the current Pediatric Dosing app that I've put out. I was thinking that eventually I could turn all of those modules into one full fledged app. That would take some time, though. Until then, I can work on just turning the one you linked into an app and throwing it into the catalog...
  13. #13  
    SerataXero,
    I think it would be difficult to create a calculator by looking at that MedCalc website without actually knowing the algebraic formulas that determine the coding. So here is a website that discusses how these calculations are made:
    Clinical Practice Guidelines from Royal Children's Hospital of Melbourne
    If you want a beta tester (or is there such thing as alpha testing) I'd be glad to help.
    -Jim
  14. #14  
    Hi jimfuchs,

    Dose does not currently provide that ability. However, It would not be very hard to implement. How common a calculation is this in practice? What would be the most important calculations needed in a dosage calculator.
  15. #15  
    Rich - These are the most common calculations a typical pediatrician would do, in order of frequency (most to least frequent):
    • Medication dosing (often done in your head).
    • Conversion from English to metric (kg/lbs, cm/inches) and vice versa.
    • Body Mass Index and percentile, based on age.
    • Percentage of weight loss in a 2-7 day old newborn (today's weight compared to birth weight)
    • IV volumes, rates, and electrolyte concentration - based on maintenance needs, prior loss (dehydration), weight; if less than 48 hours old, age in hours; and if premature, gestational age in weeks.
    • Formula intake needed by infant to provide sufficient weight gain.
    • Same as above, but with variation of infant's caloric needs, frequency of feeds, and caloric density of formula.
    • "Recipe" for addition of less water to formula to increase caloric density (for both powdered or concentrate formula).
    • "Recipe" for addition of powdered formula (or human milk fortifier) to pumped breast milk to increase the caloric density.
    • Body Surface Area (calculated from height and weight)


    This is essentially a list of what I created in my "PedCalc" program that runs in PalmOS, that I run on my Pre via the Classic emulator (which is a pain, due to it's slowness to load). I'd pay $20 (more?) for this in WebOS. I created the application using PDA Toolbox, which enables non-programmers to create things like this.

    As you can see, pediatrics is a pretty calculation intense area of medicine (so is the adult ICU and emergency room). And a pediatric ICU, ICU nursery, or emergency room...well, you can imagine. The above calculations are not uncommon for pediatricians like me....general primary care types who still take care of our patients in the hospital and newborn nursery, as well as the office. We are a dying breed, being replaced by hospitalists, and out-patient doctors, PAs and NPs....but that is a different thread. Hope this helps. -Jim
  16. #16  
    Jim,

    Thanks alot for that detailed post. I am going to look into this immediately. You are an asset to the medical community and it is disconcerting to see how the general primary care physicians are being re-organized / replaced with the hospitalists, out-patient doctors, PAs and NPs. I sure hope the quality of our country's pediatrics do not suffer too much. I may contact you again with some questions, if you are open to them. Please keep up the good work! Thanks again,

    Sincerely,

    Rich
  17. #17  
    Sure - You can PM me if you like. And if there are any hospitalists out there, I mean you no criticism. I just think that we doctors should utilize you like seasoning (or hamburger helper), rather than having you cook the entire dinner (unless the patient is very sick, of course). -Jim
  18. #18  
    Thanks Jim,

    I may take you up on it! I also mean no harm, criticism, or offense to anyone in the medical profession. You are all essential for the well being of our world.

    - Rich
  19.    #19  
    Quote Originally Posted by jimfuchs View Post
    SerataXero,
    I think it would be difficult to create a calculator by looking at that MedCalc website without actually knowing the algebraic formulas that determine the coding. So here is a website that discusses how these calculations are made:
    Clinical Practice Guidelines from Royal Children's Hospital of Melbourne
    If you want a beta tester (or is there such thing as alpha testing) I'd be glad to help.
    -Jim
    Hey jimfuchs,

    I don't actually make a calculator looking at the website, I take the calculations specifically done by the website itself and incorporate them into an app. That is what I plan on doing. I'll see if I have the time to look at the source of the website and turn it into an app. Hopefully j@ckpotideas has enough time on his (their?) hands to take this on. I would love to, but it would probably take some time for me.

    Also, Thank you very much Jim for all your input.

    Good Luck!
  20. #20  
    Yes, we are planning on incorporating additional functionality. We have many, many, apps currently in the official app catalog, many in progress, and many plans for updates. We will certainly try our best to cram as much functionality as we can into the app, as well always make it a point to do.

    - Rich
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