1

Patrick Melby
DOS 711
03/02/16
Compare and Contrast: Trade publication vs. Peer reviewed publication
Part 1: Trade Publication
Trade publications are meant to give out information to a broad audience. The
information is intended to be informative about current events and technology while keeping the
articles entertaining.1 Many times they take into account the different statements and personal
opinions of professionals across the field. The trade publication that I chose to review came
from Radiology Today, and it is written by medical free lance writer, Beth Orenstein and is called
Proton Therapy and Cost.2 Throughout this paper I will summarize the article, explain why it
appealed to me and also analyze its strengths and weakness.
In this article, the writer portrays the perceptions of medical professionals about the cost
of proton therapy. She first refers to a study that directly compares the cost of protons ($32,428)
compared to intensity-modulated radiation therapy (IMRT) ($18,575) for prostate cancer.2 After
stating this fact, the author then collects different statement from medical professionals on who
share their professional opinions about the cost of protons. The statements that she collects are
from physicians who don't believe that the costs differential is as great as it seems. One
statement, suggested that because protons cause less side effects, they will need less care which
lowers the patients cost. Another physician stated how 10 treatment of an accelerated partial
breast irradiation would actually cost less than using 6 weeks of IMRT for whole breast
irradiation.2 These physician are trying to prove to the insurance companies that these treatments
are cost effective, so that insurance will reimburse patients for these treatments. Additional
statements were added saying that as more proton centers are constructed, and as more types of
treatment become approved for proton therapies, they expect the prices to drop.
This article was very interesting, since protons therapy is relatively new in terms of
radiation oncology. It shows signs of being able to produce better or similar results while
reducing the side effect to the patient. Better patient results are of great interest of to me, so this
is why this article appealed to me. If proton therapies become more accepted by the insurance
companies, it could start to become a more common way of treatment.
It is difficult to determine the degree of accuracy involved in this study. Although a few
studies were mentioned, there are no references list for the reader to look into and further
examine the study. Otherwise, much of the data that was displayed was from quotes by different

medical professionals without any real hard evidence following their statements. Because of this
it is fairly difficult to research and to see if this article had true facts behind it.
As mentioned earlier, trade publications are meant to be for a broad audience while keep
the content informal.1 Because of these main goals, the proof and evidence throughout these
articles may be withdrawn. After studying this article about the cost of proton therapy, I believe
that the authors main goal was to briefly try to gain peoples interest in the subject, so they could
look further into the topic and study the real research out there themselves.

1. Lenards N, Weege M. Radiation Reading & Writing in Radiation Therapy & Medical
Dosimetry. [Powerpoint]. La Crosse, WI: UW-L Medical Dosimetry Program; 2016
2. Orenstein B. Proton therapy and cost. Radiology Today. February 2015;(16)2:22.
http://www.radiologytoday.net/archive/rt0215p22.shtml. Accessed February 29, 2016.

Part 2: Peer Reviewed Article

Peer reviewed articles are different from trade articles because they are formal and to be
used for research and procedures. These publications are meant to professional audience and be
specific, showing the scientific proof.1 The research is based off of other studies that are cited,
rather than personal statements or opinions. The peer reviewed article that I decided to analyze
related to my trade publication. It is Proton therapy of cancer: Potential clinical advantages and
cost-effectiveness published in the Acta Oncologica.2 It is also about the cost and effectiveness
of proton therapy. During this paper I plan on evaluating each of the sections within this article
and describe my thought about how accurate and reliable the research was.
Throughout the introduction of this article the author describes how it is important to
make economic evaluation of new technologies to know if it is worth spending the money to
research. This information is important for researchers to consider, to know if their research is
worth the money. This relates to proton therapy by evaluating if the medical benefits outweigh
the increase in cost.2 The difficulty here was that there was very little data about different proton
therapies out there at that time of this study. The goal of the article was to evaluate if the medical
benefit of proton therapy justified its higher costs. Throughout this study 4 different types of
cancers are examined that could be beneficial to use protons therapy. These cancers include leftsided breast cancer, to try decreasing the dose going to the heart; prostate cancer, to decrease the
dose to the rectum; certain head and neck cancers, to decrease the side-effects associated with
conventional therapy; and childhood medulloblastoma, to decrease the amount of brain tissue
exposed to radiation reducing the chances of secondary cancers.

The data for this study was collected mostly by analyzing other studies and trying to
relate them together into a greater picture. For example, one study was used that stated that the
prostate could get a larger dose using protons to further decrease chances of recurrence. This
could be possible because the proton therapy would give less side effects to the patient. Other
studies were used to explain the benefit of using protons in comparison of photons for the
remaining 3 cancers as well. The following studies used involved evaluating the cost and
effectiveness of the treatments. The cost of both proton and photon therapies were compared.
For effectiveness, quality adjusted life years (QALY) were used. This measurement was used
because the assumption was that the proton therapies may not increase life expectancy, but it
would increase quality because of the decreased side-effects.2
The results of this paper showed that considerations should be made towards investing in
a proton center. Their assessment of the cost vs. QALY showed that the benefits to the patients
quality of life would outweigh the costs. These results were stated with a great amount of
uncertainty. Throughout the discussion, the author reiterates all of the different assumptions that
were used throughout this study. He shows instances in which the data that they used to
calculate their conclusion could be flawed. For instance, this studied used a 30yr lifespan for the
proton center as part of the cost analysis.2 They continued to say that with increased technology
there is no guarantee that protons won't be phased out by a newer technology, causing their 30yr
lifespan to be decreased. They also talk about how the 3 other sites other than the prostate were
assumed to potentially be more effective than protons. Because of the small amount of data
available, it was not possible for this assumption to be clinically proved.
My overall thoughts about this article is that they explained there reasons behind the
study very well, but there were too many uncertainties that were involved. I believe that it is
important to try and evaluate the total cost-effectiveness, but with the small amount of data
available, I found the study to be very unsure because the large amount of assumptions. The
author discusses the "large uncertainties around many variables"2 in the discussion. That being
said, the author did a great job of thoroughly searching the research available and trying to piece
together this puzzle. Multiple sources were used to support individual statements. The author
did great at backing up his findings with valid research and creating the best results from the
limited data. But with all the uncertainties, I believe that the author may have shown knowingly
that increased data on proton therapies should be pursued to be able to better analyze the true
effectiveness of protons.

1. Lenards N, Weege M. Radiation Reading & Writing in Radiation Therapy & Medical
Dosimetry. [Powerpoint]. La Crosse, WI: UW-L Medical Dosimetry Program; 2016
2. Lundkvist J, Ekman M, Ericsson S, Jnsson B, Glimelius B. Proton therapy of cancer:
Potential clinical advantages and cost-effectiveness. Acta Oncologica. 2005;44(8):850-861.
doi:10.1080/02841860500341157.