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Article Comparison: Trade Publication Article vs. Peer Reviewed Article

Yasmin Ahmed
Part I: Trade Publication
In the radiology field there are many publications that are offered through trade
magazines. A trade magazine is generally informal in writing style and targets a wide audience.
Articles that are published in trade magazines are usually fairly short, entertaining, and easy to
read. Trade magazines usually focus on informing the community of new products, techniques,
and news relevant to the field of interest. The information used to construct the articles is
typically collected by writers employed by the magazine and through interviews/statements from
professionals in the respective field. Some examples of trade magazines are Radiology Today,
Advance for Imaging and Radiation Oncology, and RT Image.1 The trade magazine article that I
chose is by Beth W. Orenstein and is from Radiology Today. It is entitled Minimizing Errors in
Radiation Therapy. I will provide a summary of the article and analyze its overall effectiveness.
This article discusses the need for an anonymous reporting system in order to minimize
errors within the radiation oncology field. The article is centered on a series of articles printed in
The New York Times in 2010. The New York Times series brought to light two radiation therapy
errors that resulted in the death of both patients. The series prompted the American Society of
Therapeutic Radiation Oncology (ASTRO) to quickly address the issues in the articles by putting
together a six-part quality assurance plan in regards to safety in radiation oncology. The president
of ASTRO, Anthony Zietman, MD, discusses that the series of articles actually pushed
professionals in the field to try and do something about errors happening in radiation therapy. He
states that safety in oncology is important now more than ever, since there have been
advancements in the field. There are also several treatment types, such as brachytherapy and
proton therapy. Due to the rapid advancements in the field, many centers were understaffed and
clinicians were not properly trained. He also states that there is a need for a national reporting
database so that incidents and occurrences can be accurately tracked without penalizing
individuals. ASTROs plan also stresses the importance of educating the patient regarding safety
procedures followed at a center. ASTRO is currently working with members of Congress on
legislation and with the National Institute of Health to evaluate safety.2

I found this article to be very interesting, accurate, and informative. Patient safety after
all is the number one concern in a radiation therapy department. I think it would be useful to
have a national reporting system. This would create awareness amongst the entire radiation
oncology team on what errors have occurred and how to minimize them in the future. Having
such a database would be extremely helpful especially for new dosimetrists entering the field,
because they will know what things to pay extra attention to.
One strength of this article is that it is centered on the series of The New York Times
articles. I think having this as the basis for the article gave it a centered theme regarding safety.
Another positive is that opinions in the article were taken from the president of ASTRO, who is a
medical doctor and a respected professional in the field. The article also displays measures being
taken by respected organizations in the field, such as ASTRO and the American Association of
Physicists in Medicine. The article also does a good job of saying that safety reporting
procedures are still a work in progress and there is much more progress to be made.
There are also some weaknesses that I believe exist in this article as well. For one, the
article does not list any references at the end. Also, the actual difficulties that may arise when
implementing a national recording database were not discussed. There are many factors to be
considered when creating a national database, such as what questions should be asked or should
they be yes or no format only. Other issues such as how early after an incident occurs should
the event be recorded and what constitutes reporting. Another big problem that may arise while
clinicians report issues is whether or not consistency exists amongst different individuals. One
person may report a similar event very differently than another person. This would have to be
tested by conducting trials amongst professionals to see how they would each report the same
incidents.

References
1. Lenards N, Weege M. Radiation Therapy and Medical Dosimetry Reading. [Powerpoint].
La Crosse, WI: UW-L Medical Dosimetry Program; 2015.
2. Orenstein BW. Minimizing Errors in Radiation Therapy. Radiology Today (12)1:30.
Retrieved from http://www.radiologytoday.net/archive/rt0111p30.shtml. Published
January 2011. Accessed March 20, 2015.

Part II: Peer Reviewed Research Article

There are many publications that are offered through scholarly journals. A scholarly
journal is generally formal and scientific in writing style. The target audience for scholarly
journals is generally professionals and researchers, as well as those involved in academics.
Articles that are published in journals are usually of a specific interest, such as those pertaining
to a certain treatment technique or anatomical site. The articles usually focus on a single
hypothesis, and research and experiments are done in order to draw conclusions. The information
and data used to construct the articles is typically collected by professionals in the respective
field and researchers. Some examples of scholarly journals are Radiologic Technology, Scanner,
and Medical Dosimetry.1 The scholarly journal article that I chose is by Vlachaki MT, Teslow
TN, and Ahmad S and is from Medical Dosimetry. It is entitled Impact of Endorectal Balloon in
the Dosimetry of Prostate and Surrounding Tissues in Prostate Cancer Patients Treated with
IMRT. I will provide a summary of the article and analyze its overall effectiveness.
The use of the endorectal balloon and its dosimetric impact was assessed for 10 IMRT
treated prostate cancer patients. The study was performed with 3 different positions for the
balloon. The balloon was placed in the most superior and inferior positions in the rectum and
also without the balloon. Treatment plans were then performed with all 3 scenarios. When the
IMRT plan with the balloon in one position was compared to the IMRT plan without the balloon,
a change in the dosing was revealed. For the prostate, the mean and minimum doses decreased
for the plan without the balloon from 74.36 Gy to 72.84 Gy, and from 67.62 Gy to 50.96 Gy.
However, mean dose to the rectum increased for the plan without the balloon from 32.92 Gy to
34.25 Gy.2
Using a balloon may also cause issues since the balloon can be positioned slightly
different each time, causing structures to be altered. Proper positioning of the target is extremely
important for IMRT, as a slight change may cause either under or overdosing. Also, since balloon
failure may also occur, this can result in underdosing of the target.2
This article had all of the required components of a scholarly article, such as abstract,
introduction, methods and materials, etc. Also, a list of over 30 references was provided in the
end. The hypothesis and methods used were all clearly stated. The authors also noted however
that daily set up error was not taken into account in their study. I think this was very good to

mention because it is an important factor to be considered when analyzing the results as a reader.
The article was extremely thorough and all the processes used were explained in detail. The
introduction was also very clear and concise. The tables provided in the results section were easy
to follow and understand. One issue I had with the article however is that some things in the
abstract were unclear. The authors starting discussing balloon failure results, however this was
not mentioned in the original 3 positions that the authors stated. It seemed to have come out of
nowhere. Hence, I got a bit confused until I read the discussion at the end of the article to clear
up the confusion.
Overall, I found this article to be interesting because it made me wonder what factors are
considered when a facility decides whether or not to use a rectal balloon for IMRT prostate
treatments. Some factors that may be an issue is patient comfort, insurance approval, and pretreatment preparation time. Also, if a balloon were to fail during treatment delivery, it may cause
a deviation in dose. Another thing to be considered is balloon placement. Although on board
imaging may be done to verify the position, that does not guarantee that the balloon will not fail
or be placed slightly different each time. I think with the use of the balloon it has some benefits,
but I am not sure that those outweigh the uncertainties that also come with the use of the balloon.

References
1. Lenards N, Weege M. Radiation Therapy and Medical Dosimetry Reading. [Powerpoint].
La Crosse, WI: UW-L Medical Dosimetry Program; 2015.
2. Vlachaki MT, Teslow TN, and Ahmad S. Endorectal Balloon in the Dosimetry of Prostate

and Surrounding Tissues in Prostate Cancer Patients Treated with IMRT. Med Dosim.
2007;32(4):281-286. http://dx.doi.org/10.1016/j.meddos.2007.02.007