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Nick Hopkins
DOS 711 – Research Methods I
Compare & Contrast Articles

Article Analysis Part 1: Trade Magazine

There are many ways that we can get our information these days and as health
professionals it is important to understand some of the differences between sources. In this
analysis I will examine two different articles, one from a trade magazine and one from a
professional peer reviewed journal. These two sources can have differences in their intended
audience, types of content, methods of gathering content, writing style, types of authors, and
references.1 In reviewing a trade magazine, I will address the strengths and weaknesses of the
article, the question of accuracy, and how the information presented pertains to myself and others
in the field of medical dosimetry. For this purpose I have chosen an article by Jennifer Couzin-
Frankel2 from a recent issue of Science magazine entitled “Autoimmune diseases surface after
cancer treatment”.
This article reports on the appearance of autoimmune diseases as a side effect of the new
class of immunotherapy drugs known as checkpoint inhibitors. Couzin-Frankel2 recounts the
perspectives of several speakers from an annual meeting of the Society for Immunotherapy of
Cancer. It predominantly addresses new cases of type 1 diabetes in these patients but also
mentions other diseases such as lymphocytic myocarditis, thyroid disease, and colitis as possible
side effects. These new cancer drugs are thought to unleash the immune system on cancer cells
but the author indicates a causal relationship in unleashing it on healthy tissue as well. There
seems to be little data on what characteristics might be shared between the patients that develop
these side effects, but many of the people mentioned are working to create studies or gain access
to the such data. The author also describes interest in uncovering how this potential research
might shed light on patients with autoimmune diseases not associated with checkpoint inhibitors.
While I find this article to be personally interesting, I do not believe it directly impacts
my current training as a medical dosimetrist. It is tangentially relevant however and allows for a
greater understanding of our patients and the considerations of an oncologist. It could provide
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clarity to information that we see in a medical record in a similar fashion to how knowing about
certain surgeries can better prepare us to understand what we may see on patient imaging.
I think this article presents the case for more research on checkpoint inhibitor induced
type 1 diabetes fairly well. There are plenty of people quoted and reports on members in that
community calling for action or mobilizing themselves to generate more information on the
topic. One area that it seems to fall short is presenting anything more than anecdotal evidence to
support the underlying claim that the immunotherapy treatments caused the autoimmune
diseases. Only select patient cases are presented and no evidence to the contrary seems to be
examined. In that it is not presenting rigorous scientific evidence, I believe it to be accurate, but I
also feel that it could be misleading to the casual reader that might take as fact some of the
assertions or speculations of the author and other quoted sources.
References:
1. Lenards N, Weege M. Reading and Writing in Radiation Therapy & Medical Dosimetry.
[SoftChalk]. La Crosse, WI: UW-L Medical Dosimetry Program; 2016.
2. Couzin-Frankel J. Autoimmune diseases surface after cancer treatment: Side effects of new
immunotherapy drugs draw scrutiny. Science. 2017;358(6365):852.
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Article Analysis Part 2: Peer Reviewed Research Article

Peer reviewed journals offer articles that adhere to a strict format and standard for quality
of content.1 Publication is seen as being more prestigious as it requires the review of one’s peers
for approval to print. For my analysis of a peer reviewed article I have chosen “Is advanced
practice needed within medical dosimetry?” by Collins et al2 from the magazine Radiation
Therapist. Despite the abstract and introduction sections not being explicitly labeled, they
appeared in the customary locations and fulfilled their purposes of summarizing the article and
providing background information.1 The remaining methods, results, discussion, conclusion, and
reference sections are clearly marked with headers and contain the requisite information.
The authors present historical examples in which an increase in service use, a decrease in
medical or technical staff, and an increase in patient wait times have led to the creation and
utilization of advanced practice specialization.2 They then posit that with projected increases in
need for radiation oncology services as well as projected shortages in qualified medical
dosimetrists, there may be a need for advanced practice within that field. These projections are
clearly cited by reputable sources. The example of physician shortages that lead to the creation of
physician assistants and nurse practitioners as well as the more recent example of registered
radiology assistants helps to relate the proposed need to the medical dosimetry profession.
To collect data and test their theory an online survey was developed and reviewed by an
institutional review board.2 It contained their initial research question, “Is there a need for
advanced practice within the dosimetry profession?”, along with related questions and fields for
providing demographic information. It was then sent through email to 5486 members of the
American Association of Medical Dosimetrists (AAMD). After approximately three weeks a
second email was sent in an attempt to increase the response rate. In total 763 surveys were
completed, a 13.9% response rate that is typical for surveys sent to medical dosimetrists.2
The results of their survey showed that respondents were divided with respect to their
research question, 54% responding no and 46% responding yes.2 They also collected data on
what functions respondents thought advanced practice dosimetrists should perform. Multiple
responses were allowed to be selected and from the 369 people who responded the top three were
“specialized treatment planning” with 94% selecting, “contouring specialist” with 64% selecting,
and “quality assurance specialist” with 47% selecting.
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A cross-tabulation analysis of the data provided some additional insights into the factors
affecting respondents’ position with respect to the research question. Collins et al2 inferred that
the respondents underlying knowledge of current dynamics in the U.S. health care system and
radiation oncology could play a role in how they responded. They proposed that larger medical
centers usually have more staff and practice some specialization whereas smaller clinics often
require dosimetrists to be generalists. Collins et al2 report that 86% of respondents indicate they
are not being asked to specialize which, as they remark, may explain why the majority of the
dosimetry community doesn’t see a need for specialization. Despite this, respondents that
indicated high patient volumes and being understaffed had a larger favorable stance to advanced
practice in medical dosimetry. This fits well with past examples of advanced practice creation
provided in the introduction. The researchers also indicate that with these results the need for
additional research is clear.
This type of research was aiming to get the opinions of the medical dosimetry community
that was surveyed in an attempt to draw conclusions about changes in the professional practice.
The methods for this type of data collection were appropriate and the analysis performed was
thorough and rigorous. A variety of sources ranging from 2002 to 2016 were referenced by the
authors and include journals, reports, advisory panels, and national databases.2 I think the authors
clearly understand the limitations of their data as a snapshot of an ever changing professional
landscape.
References:
1. Lenards N, Weege M. Reading and Writing in Radiation Therapy & Medical Dosimetry.
[SoftChalk]. La Crosse, WI: UW-L Medical Dosimetry Program; 2016.
2. Collins K, McKinnies R, Adams R. Is Advanced Practice Needed Within Medical
Dosimetry?. Radiation Therapist. 2016;25(2):137-145.