Vous êtes sur la page 1sur 7

1

Stephanie Olson
Research Methods in Medical Dosimetry I
March 22, 2015
Article Comparison: Trade Publication Article vs. Peer Reviewed Article
Part I: Trade Publication Article
Trade publications are informally written articles which appeal to broad audiences.
These types of articles are typically written by paid staff or contract writers who collect
information from professionals in the field for which the article subject pertains. Subject
material often pertains to current events or services relating to an area of interest.1 The trade
article I chose to examine was titled Tumor Auto ContouringEfficiently Maximizing Dose and
Minimizing Damage to Healthy Tissue which was written by Mark Klincewicz and featured in
Radiology Today. The article discusses the benefits to using auto contouring software in the
treatment planning process. I will examine this article for the interest it may have among
medical dosimetrists, the accuracy for which I feel the information presents itself, and the
strengths and weaknesses of the article.
The article discusses how manual contouring of patient volumes can be both tedious;
time consuming and subjective from professional to professional.2 What one person may feel to
be the edge of a patient organ may not be the same to another. This can create over or under
contouring of tissues thus causing over or under dosing of a particular structure. The article goes
on to state that not only can auto contouring be a time saver, it will improve accuracy and also
allow for more structures to be contoured because it is not as strenuous as drawing structures
manually. One way auto contouring can be applied is through the use of database comparison
where many different site-specific contour samples are stored in an archive to be used later for
patient contouring. An auto segmentation tool finds the best match for a patients anatomy from
the archive and then applies those contours to that specific patient. Ultimately, the goal of auto
contouring is to quickly and accurately contour structures and then maximize the dose to the
tumor while minimizing the dose to normal tissue.2
This article could be of interest in not only the medical dosimetry profession but in
radiation oncology as a whole. Auto contouring could be useful to medical dosimetrist, radiation
oncologists and radiation oncology residents as well as physicists within a radiation oncology

2
department. Not only would auto contouring be a time saver, we as dosimetrists could perform
contouring of structures which can be more complex such as structures in the head and neck or
abdominal regions. At our institution, the radiation oncology residents complete most of the
contouring but there are times when we are given dose constraints for an organ at risk for which
they have not completed the contour for. Instead of delaying the treatment planning process
having to wait for these contours to be completed, we could use the auto contouring tools to
complete them ourselves.
Much strength was presented throughout this article. Not only did the author present
many advantages for the use of an auto contouring tool in radiation oncology, examples of
manufactures using this technology were given such as Brain Lab, Varian Medical Systems and
Accuray Incorporated. The companies mentioned are commonly used in radiation oncology
centers across the world. However, the article did not address the disadvantages to the use of
auto contouring such as professionals becoming dependent on these tools. I feel as professionals
use the auto contouring more and more, they could rely on them too much and not review the
contours thoroughly which could result in over or under contouring of a structure. The article
could have benefited by having some data to back up the claims as to how accurate auto
contouring can be but being that this is a trade publication, it is written with a journalistic
approach and not a scientific approach.
The article presented a broad summary as to how auto contouring could play a role in the
radiation oncology field with the main points being a reduction in time spent performing manual
contouring and an increase in the accuracy of contours by reducing the subjectivity among
professionals. The information provided in the article could be beneficial to medical dosimetrists
and other professionals in radiation oncology by presenting the advantages to using auto
contouring tools but did not discuss the disadvantages to using such tools nor did the author back
up accuracy claims with any supporting data. Overall, I feel this article presented well-informed
material from dependable sources which could be beneficial in the medical dosimetry profession.

3
References
1.

Lenards N, Weege M. Radiation Therapy and Medical Dosimetry Reading.


[PowerPoint]. La Crosse, WI: UW-L Medical Dosimetry Program.

2.

Klincewicz M. Tumor Auto ContouringEfficiently Maximizing Dose and Minimizing


Damage to Healthy Tissue. Radiology Today. 2009;10(11):22. Retrieved from
http://www.radiologytoday.net/archive/rt060109p22.shtml.

4
Part II: Peer Review Article
In comparison to a trade publication, a peer review publication is a formally written
article which appeals to a narrow audience of professionals or researchers. These articles utilize
journal references and statistical data to answer a hypothesis or to debate a professional issue.
Articles of this type must be reviewed by peers prior to publication.1 The peer review article I
chose to examine was Bullying Behavior Among Radiation Therapists and Its Effects on
Personal Health written by Jordan Johnson and Megan Trad and featured in the journal Radiation
Therapist. The hypothesis as well as the introduction, methods, results, and conclusion
subsections will be reviewed and my overall impression of the article will be discussed.
The goal of the research study presented in this article was to identify how common
workplace bullying occurred in the radiation therapy profession, what types of bullying
behaviors are occurring and how these are being handled by administration and what effects
these bullying behaviors have on the personnel being bullied.3 Until this article, no studies were
found relating to radiation therapy and workplace bullying. However, several studies
investigating workplace bullying in health care related fields, most commonly in nursing, were
documented in the literature review of this article. From these studies pertaining to health care
related workplace bullying, it was hypothesized that bullying behaviors were also occurring in
radiation therapy.3
A quantitatively designed study was created to evaluate workplace bullying and its effects
on those who were bullied on the job. Participants were all registered radiation therapists
through the American Registry of Radiologic Technologists. Researchers of the study contacted
radiation therapy departments to collect data from a diverse group of participants ranging from
different practice settings and geographic locations. Contact was made with either the chief
therapist or radiation oncology managers to gain support for participation in the study. Once
agreement to participate was given to researchers, an email with instructions and a survey link
was administered to the initial contact person. From there, the email was then forwarded to the
radiation therapists within the facility. The use of Survey Monkey was used to administer the
survey and obtain results. The survey consisted of 78 yes/no or Likert-type questions which
included questions from four categories: bullying prevalence and demographics, workplace
environment, effects on personal health and effects on job performance.3

5
Researchers displayed the data collected in four tables titled from each of the four
categories listed above. Each table represented the question from the survey, the possible
answers for the given question, the number of participants as well as the percentage of
participants who chose the particular answer. The hypothesis of this study was confirmed
through the data collected. Of the 308 participants surveyed, 194 stated workplace bullying was
present in either their current or previous place of employment. Results showed the highest
percentage of workplace bullying occurred between therapist to therapist followed by supervisor
to therapist and finally therapist to supervisor. Approximately 71% of those who answered yes to
bullying being present in their workplace also said they themselves were victims of bullying.
Participants were also asked how the bullying behavior affected their personal health. Ninetythree percent said being bullied either somewhat or greatly affected their stress level while others
reported having trouble sleeping due to thinking about work issues or had increasingly higher
blood pressure because of their work environment. Other participants reported having anxiety,
depression, gastrointestinal issues, loss of appetite and chest pain.3
The study provided a correlation between bullying and the negative health effects among
those who were bullied. However, researchers in the study indicated that further investigation
could be done to determine how many, if any, acts of bullying have been reported and in the
cases which were reported, what type of intervention took place. Another area which could also
help to support this study would be to investigate acts of bullying and staff turnover. In certain
geographic areas, radiation therapists may not have jobs readily available and in turn have to stay
at their current place of employment and unfortunately just deal with the bullying if no
intervention takes place. From the data collected, researchers also noted that bullying in the
workplace could ultimately affect patient safety and the quality of care patients receive.3
One of the biggest concerns in radiation therapy is the safety and quality of care when
delivering radiation treatments to patients. This article only began to touch on a topic which is
highlighted almost daily in our schools across the nation but of which you rarely hear about in
the workplace. Bullying can cause harmful health effects and thus create undesirable work place
environments which can ultimately affect the care patients receive. The researchers in this study
created a great base for future studies on the topic of workplace bullying. The background and
research design were easy to follow and the data collected supported their hypothesis.
Researchers acknowledged the need for further research relating to the reported acts of bullying

6
and what types of intervention took place in those instances. From previously studied acts of
bullying in health care related workplaces, particularly in the field of nursing, researchers were
able to develop a well-defined study using relevant information from those sources. Overall, I
was impressed with this article not only because it brings to light a topic which many find hard to
discuss but also because the data collected certainly show that bullying is present in the radiation
therapy workplace. This article made it clear that future education and training should be
provided in the radiation therapy profession to help deal with bullying behavior. Ultimately
patient safety and quality of care may be affected if not addressed.

7
References
1.

Lenards N, Weege M. Radiation Therapy and Medical Dosimetry Reading.


[PowerPoint]. La Crosse, WI: UW-L Medical Dosimetry Program.

2.

Lozano, RG. Characterizing a Culture of Training and Safety: A Qualitative Case Study
in Radiation Oncology. Radiation Therapist. 2013;22(2):139-152.

3.

Johnson J, Trad M. Bullying Behavior Among Radiation Therapists and Its Effects on
Personal Health. Radiation Therapist. 2014;23(1):11.