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Jacquelyn Palermino

Dos 711 Research Methodology

Compare and Contrast Article Analysis: Part 1

After reviewing trade journals versus peer-reviewed scholarly journals, I noticed there are
many differences that distinguish one from the other. Trade journals or trade magazines have a
bright and welcoming appeal that target a broad audience of a particular trade or industry. They
feature articles pertaining to the latest trends and developments, display job opportunities, and
advertise products or services available. Trade articles use an informal style of writing which is
written by contract writers or by the staff of the magazine.1,2 In contrast, scholarly journals use a
formal style of writing directed towards professionals and researchers of a certain field and can
be used as research or for academic use. Scholarly journals communicate facts and information
relating to original research and help gain professional knowledge. A scholarly article has a
structured format and contains references and statistical methods from other journals. Scholarly
articles generally consist of background information on a topic, the reason for performing the
study, the design of the study and methodology, results gathered from the study, and a
conclusion or analysis of the results.1

For the first analysis, I chose to examine the trade journal article “Tumor
Autocontouring-Efficiently Maximizing Dose and Minimizing Damage to Healthy Tissue”. This
article is written by freelance writer Mark Klincewicz and published on the Radiology Today
website.3 In this article, the author explains the process of autocontouring for tumor volumes and
critical structures, what tools may be used to complete this process, and the benefits it has in
treatment planning. Contouring of the tumor and surrounding tissues play a significant role in the
field of radiation oncology. To minimize dosage to normal cells, it is important to precisely
identify and contour target volumes and adjacent surrounding structures. The author explains that
in most cases, digital images from a CT or MRI are used to help locate the tumor. Once the
tumor is defined, a doctor or specialist contours the target volume and determines what field
shape to treat and what areas to avoid. This process can be very time consuming because each
structure must be manually contoured on the planning scan, slice by slice. In the article,
Klincewicz explains that the advancement of autocontouring helps to alleviate these problems.
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Autocontouring, or computer-aided contouring, uses algorithms to create a more standardized


method of contouring that manually draws a precise contour by the means of automatic
segmentation. Autosegmentation is a tool that searches for differences in contrast and in the
shape of structures. It uses a library of different CT images that has been previously gathered
from other people with the same structures contoured. When a patient’s anatomy is of similar
structure, the autosegmentation tool will create a contour that best fits the current patient’s
anatomy. Once the contours are completed by the computer, the doctor will have to review the
scan and possibly modify the autocontoured structures. Klincewicz states that autocontouring is
an effective tool and achieves accuracy levels with errors of less than 1 mm. With achieving this
accuracy and the ability to be able to contour more structures at a faster rate, this tool can be very
beneficial in the medical field.2

As a medical dosimetry student, I found this article interesting and helpful. I feel that this
topic will be used during my clinical practicums and future career. When I first found this article,
it caught my attention because we are learning how to contour certain structures within our
classes. After reading the article, I wasn’t sure if my institution had a similar program for
autocontouring. During my clinicals, I originally created all the contours manually, which takes
up a large amount of time. Today, I helped plan a case that I was able to use the autocontouring
tool in our planning software. This allowed for my clinical preceptor and I to tell the computer
what structures to place and then go back after to review and make any minor adjustments. I
found it very helpful and faster than doing each contour by hand.

This article was informative and easy to understand. It has some strengths but mostly
weaknesses. Although, the author did a good job at explaining the need to have precise
knowledge of the location of a tumor and the adjacent structures, I feel that the article focused
more on the promotion for an autocontouring program. In the article, a product manager from
BrainLab4, a software supply company, describes how their software planning tools called
SmartBrush and SmartShaper, along with the use of automatic fusion can help a physician get a
clearer idea of the exact location of the tumor. The article also includes supporting statements
from product managers from Varian Medical Systems and Accuracy Incorporated.5,6 These
statements support the use and benefits of an autocontouring program and how the goals of
contouring can be met with the use of their equipment. This article lacks scientific data proving
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the accuracy of autocontouring. There are also no references cited or data shown to prove where
the author gathered his information from, making it difficult to consider the article as a credible
source.

Overall, the trade journal article was interesting to read and helped to understand how
autocontouring is created. With the use of a patient database, physicians and dosimetrists can
reduce the time it takes to contour each structure. It can also help to differentiate between tissues
of different densities as well as noise in a CT scan. This advancement in technology can help
define tumor volumes in minimal time with improved accuracy. As a medical dosimetry student,
I feel it is important be aware of this technique and to make sure each contour is correctly drawn.
The focus of our job is to make sure the target volume receives the prescribed amount of
radiation while minimizing dosage to the surrounding normal structures.
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References

1. Hunzeker, A. Reading and Writing in Radiation Therapy & Medical Dosimetry.


[SoftChalk]. La Crosse, WI: UW-L Medical Dosimetry Program; 2018.
2. Trade magazine. Wikipedia Web site. https://en.wikipedia.org/wiki/Trade_magazine.
Accessed January 26,2018.
3. Klincewicz, M. (2009, June 1). Tumor autocontouring-Efficiently maximizing dose and
minimizing damage to healthy tissue. Radiology Today. 10(11):22. Retrieved from
http://www.radiologytoday.net/archive/rt060109p22.shtml. Accessed January 26, 2018.
4. Brain Lab. Brain Lab Web site. https://www.brainlab.com/en/. Accessed January 27,
2018.
5. Varian medical systems. Varian Web site. https://www.varian.com/. Accessed January
27, 2018.
6. Accuray Incorporated. Accuray Web site. http://www.accuray.com/. Accessed January
27, 2018.
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Compare and Contrast Article Analysis: Part 2

For the second part of my analysis, I chose to review the Journal of the American Society
of Radiologic Technologists, Radiation Therapist edition. This journal consists of peer-reviewed
articles, columns, and directed reading articles for continuing education on topics related to
radiation oncology. The articles are written by professionals in the field of oncology and use
references from other journals to support its research. An article that I found interesting is the
peer-reviewed research article “Is Advanced Practice Needed Within Medical Dosimetry?” by
Collins et al. This article explains the reasoning for the potential need of additional staff in
medical dosimetry because of an estimated shortage of qualified dosimetrists, changes in the
technology and methods used to treat patients, and the potential need for increased cancer
services. The layout of this article is very structured and includes graphs and tables to help
present the data that was collected. The authors also describe the purpose, methods, results,
discussions, and conclusion of the study performed to determine the potential need for additional
staff who specialize in medical dosimetry.

The literature review of this article delivers pertinent information for this study. The
future predictions discussed in the article were gathered from previous research involving the
topic of advanced practice. The authors of this article describe how the creation of advance
practice began and what three factors may lead to the need for advance practice. These factors
consist of an escalation in service use, deficiencies in the number of medical and technical staff,
and longer patient wait times. Collins et al explains in the article that there will be a projected
shortage of medical dosimetrists by the year 2020. This shortage is anticipated due to a limited
number of dosimetry education programs and the changes in the exam eligibility requirements.
The authors also express that there is an estimated increase of nearly 48% in the need for cancer
services from the year 2005 to 2020. These findings led to the development of this study to
determine if there is a strong need for additional staffing in the field of radiation oncology.1

To gather information within the medical dosimetry community, a survey was developed
through Survey Monkey and a link was emailed to 5486 members of the AAMD. The survey
remained available for approximately three weeks and a total of 763 completed surveys were
received. The authors of this study used demographic data to review the responses of the
participants. The study considered the participants sex, education level, years of employment,
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method of dosimetry training, and their role at their facility. It also reviewed the participants by
their current work setting, the average patient load per day, status of the facility, and staffing
levels. The results of the study varied depending on what question was asked. Some of the
questions asked included “Do you believe having advanced practice in dosimetry will advance
the profession?”, Do you believe there is a need for advanced practice dosimetry within the
dosimetry profession?”, and “Should further education be required for advanced practice
dosimetry?”.1 Of the total 763 respondents, slightly more than 75% said having advanced
practice in dosimetry would advance the profession. When respondents were asked if they felt
there is a need for advanced practice in medical dosimetry, nearly 54% said no and 46% said yes.
Of the individuals who felt there is a need for advanced practice, 64 % said a contouring
specialist and 46% said a quality assurance specialist should be the role of an advanced practice
dosimetrist. The study showed 68% of the respondents felt further education is needed for
advanced practice dosimetry and more than 75% felt that by having advance practice roles, it
would advance their profession. Respondents having a high school diploma, associate degree, or
bachelor’s degree, mostly opposed the need for advance practice, whereas respondents with
master’s and doctoral degrees favored the need. Respondents who are within their first three
years of their dosimetry career felt the need for advance practice. Individuals who work in
administration or other jobs such as educators or working managers, supported the need for
advanced practice, while most staff dosimetrists do not. The study showed respondents who
work in facilities treating fewer than 20 patients per day or more than 75 patients per day
supported the need for advance practice. The respondents who felt their departments are
overstaffed or had no staffing concerns did not support the need for advanced practice, whereas
the respondents who felt their department is understaffed strongly supported the need.1

From the results of the study, the authors found from cross-tabulation analysis of the data
sets that underlying aspects of the issue emerged. Evidence showed that education, institution
mission, and academics affected the responses to specific questions. The authors explained that
the results could be associated to medical dosimetrists’ knowledge and understanding of the
health care system. For the past 40 years, the health care system has operated as a market-based
economy. Now, new approaches and economic models, such as bundled health care payments
and prospective payment systems, are changing the way the health care delivery system is
operated. Dosimetrists working in larger institutions may already be working under the new
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market models, which may lead to the support for advance specialization in medical dosimetry.
From the study, the authors concluded that the results from almost every demographic category,
for supporting or not supporting advanced practice specialization, were within 5-10% of each
other. Most of the dosimetry community saw no need for advanced practice specialization at this
time. In regard to the projected shortage of dosimetrist in future, an increase in the support of
advanced specialization may occur.

Overall, I feel this article was interesting as it pertains to my future as a medical


dosimetrist. The information provided within this article was easy to follow. The article used
references from other journals to support its research. The use of graphs and tables to display the
authors findings made the data easy to understand. Collins et al did a good job of portraying their
evidence and their reasoning for the potential need for advanced practice specialization in the
future. I feel the information provided in this research article is more dependent on what type of
facility the medical dosimetrist works in. It would be interesting to further break down the data
to see what the participants’ responses would be if questions were focused on topics within the
same working environment.
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References

1. Collins KS, McKinnies RC, Adams R. Is advanced practice needed within medical
dosimetry? Radiation Therapist. 2016;25(2):137-145.

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