Veronica Laird

Compare & Contrast Part 1- Trade magazine

After looking at a trade magazine compared to a professional journal, I have noticed
many differences in the writing style and the setup of the different publications. For my trade
journal article I have chosen to use the January 2017 edition of Radiology Today. At first glance,
the magazine has many bright pictures and ads throughout the journal. Trade journals are for a
broad audience and are informal compared to a professional journal.1 The articles cover
a broad subject within radiology and discuss certain products that are on the market. I chose to
critique the article More Bubbles, Less Trouble by Kathy Hardy. I decided upon this article
because it is on the cover page of the magazine, its catchy title, and the ultrasound imaging that
is displayed in the article.
More Bubbles, Less Trouble is about contrast-enhanced ultrasound (CEUS) and the new
FDA approval of Lumason.2 Lumason is a contrast agent developed by Bracco Diagnostics. It is
the first FDA approved contrast agent for the use of focal liver lesions in adult and pediatric
patients. It helps to improve sensitivity and specificity of ultrasounds for the differentiation of
malignant and benign lesions. Hardy explains some of the benefits of using Lumason, and also
goes into a few of the problems that are involved such as operator-dependency, positioning, and
reimbursement. The article also reviews the technology involved in these procedures. Lumason
can be used with any ultrasound unit, as long as it has a contrast package. The Aplio 300 and 500
Platinum ultrasound systems from Toshiba America are specifically introduced as great options
for using CEUS. At the end of the article, one of the interviewees Stephanie Wilson, MD
states the use of contrast-enhanced ultrasound for liver in the United States is lower than we
would like, by sharing the positive results of contrast-enhanced ultrasound, we show everyone
that its not such a formidable procedure to take on in practice.
I found the subject of CEUS interesting, but I dont think that it is very helpful to
practicing medical dosimetrists. This would not be something that is used to help enhance
treatment planning in radiation oncology. I felt throughout this article hardcore facts were left
out. I did not feel that any of the claims had evidence to back it up. The first thing that I looked
up after reading this article was the author to see if she has any radiology or medical background.
Upon researching Kathy Hardy, I found that she is a free lance writer who writes about various
subjects with no medical professional background.3 Throughout the article Hardy interviewed
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various different medical professionals. The first two people that were mentioned were Edward
Grant, MD, and Stephanie Wilson, MD. Grant is the treasurer and Wilson is the co-president of
the International Contrast Ultrasound Society (ICUS).4 Upon further investigation, a silver level
sponsor for the ICUS is Bracco Diagnostics, the developer of the Lumason. The second
interviewee was Maria Luigia Storto, MD. She is the head of medical affairs related to X-ray and
ultrasound for Bracco Diagnostics.2 Lastly, Hardy interviews Paula Ucio, who is the senior
manager for market development with Toshibas business unit. I find that all of the people that
have been interviewed for this paper represent a very biased point of view, which makes me
further question the validity of the article. The article argues that contrast-enhanced ultrasound
is a reliable, evidenced-based tool for determining the features of a mass in the liver, however, I
have a hard time seeing the evidence to support that statement.
Although I feel that the article is very biased I do believe that it has some strengths. It is
very well written, and easy to understand for people who are not in the medical field. It has a
catchy title that helps to draw readers in. I also like that Hardy went through some of the
problems that were involved with using Lumason. As stated above, weaknesses include the lack
of evidence based research, and biased opinions. At one point Wilson states "with contrast, we
have 90% to 100% accuracy, in regard to whether or not the mass is benign or
malignant."2 There is no reference or research to back up this claim. Hardy also fails to go into
the accuracy of CT and MRI in comparison.
Overall I felt that this article was used to get Lumason on the market with practitioners. I
do think that it could be a useful tool given the right investigation and research. Upon more
investigating into Lumason, I did find clinical trials that are currently in process with pediatrics,
however, at this time it is only for echocardiography.5 I do hope that clinical trials
for Lumason and liver imaging do open up. I also hope it becomes a great tool for detecting
cancer in the future.
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References
1. Lenards N, Weege M. Reading & Writing in Radiation Therapy & Medical
Dosimetry.[SoftChalk]. La Crosse, WI: UW-L Medical Dosimetry Program; 2016.
2. Hardy, K. More Bubbles, Less Trouble. Radiology Today. 2017; 18(1): 12-15. Retrieved
from http://www.radiologytoday.net/digitaleditions.shtml. Accessed January 30, 2017.
3. Linkedin. https://www.linkedin.com/in/kathyknaubhardy. Acessed January 31, 2017
4. International Contrast Ultrasound Society. ICUS Board. http://www.icus-
society.org/about-icus/icus-board. Accessed January 31, 2017
5. Evaluation of Safety and Efficacy of Lumason in Pediatric Echocardiography. Evaluation
of Safety and Efficacy of Lumason in Pediatric Echocardiography - Full Text View -
ClinicalTrials.gov.https://clinicaltrials.gov/ct2/show/NCT02282163?term=lumason&rank
=3. Accessed February 1, 2017.
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Compare & Contrast Part 2- Professional Journal

For my peer reviewed article, I chose to use the fall 2016 edition of Radiation Therapist.
When skimming through this journal there are a few ads, but mostly it has evidenced
based articles. The articles that are presented are peer review publications, directed reading for
continuing education credits, and columns. Each of the articles is written by medical
professionals in the field of radiation oncology. After looking through the peer reviewed research
articles, I chose to review the article entitled Is Advanced Practice Needed Within Medical
Dosimetry by Kevis S Collins, PhD, R.T.(R)(T), CMD, Richard C McKinnies,
MSEd,R.T.(R)(T ) , CMD, and Robert Adams, EdD, R.T.(R)(T), CMD, FASRT. I felt that this
was a great article because it directly pertains to me and my field of study.
Is Advanced Practice Needed Within Medical Dosimetry first briefly discusses the
purpose, methods, results, discussion, and conclusion of the research performed. The article then
went more into depth in each of these subjects. The research question was to pose questions
regarding the perceived need for advanced practice specialization in medical dosimetry to meet
the needs of this dynamic field of health care.1 The background of this question was posed
because of the constant change in the field of radiation oncology and the expected shortage of
medical dosimetrist by 2020. Collins, McKinnies, and Adams went into how historically there
was a shortage of physicians in the 1960s. This shortage helped to develop the fields of physician
assistants and nurse practitioners as physician extenders. With the addition of physician
assistants and nurse practitioners there was an increased access to care and better patient
outcomes. The authors go over the three primary factors that advanced practice is driven by: an
escalation in service use, deficiencies in the number of medical and technical staff, and extended
patient wait times. Another example used for advanced practice specialization is
the development of registered radiologist assistants. With the advancement in radiation
oncology, the limited number of dosimetry education programs, and changes in the exam
eligibility requirements, there is projected to be a shortage of medical dosimetrist. It
is also estimated that an increase of nearly 48% in the need for cancer services from 2005 to
2020 will occur. With all of these factors, the study gathered information about advanced
practice in the medical dosimetry community.
A survey was conducted through Survey Monkey with a link that was emailed to 5486
members of the AAMD.1 The survey went on for three weeks, and a total of 763 surveys were
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completed. The results went through demographics of the respondents. The demographics
they looked at was the individuals sex, education level, years employed, method of dosimetry
training, role at facility, current work setting, average patient load, status of facility, and staffing
levels. One of the questions asked was is there a need for advanced practice within the
dosimetry profession? The survey showed that 56% said no and 46% said yes. Of the people
who answered yes, 64% said contouring specialist is needed, and 46% believed a quality
assurance specialist is needed. Of those respondents 68% indicated further education should be
required. 86% of the participants are not currently being asked to work in specific specialized
areas of dosimetry. They were also asked if having an advanced practice dosimetry category
would advance the profession, and 75% agreed with that statement. For respondents
with the highest education of high school, associate, or bachelor degrees most frequently oppose
the need for advanced practice. Those with a masters or doctoral degrees were in favor.
Respondents in the first 3 years of their career feel the need for advanced practice. Most of
the individuals who work in administration or jobs classified as other support the need, while
most staff dosimetrists do not. In clinics that have a higher patient load felt more need for
advanced practice than those that treat fewer than 20 patients a day. Lastly, individuals
who felt that they were understaffed strongly supported the need for advanced practice, while
those who felt sufficiently staffed did not.
In the discussion analysis the authors discovered that the data revealed underlying aspects
of the issue because of the cross-tabulation analysis of the data sets.1 It became evident that
education, institution mission, and academics affected responses. The analysis reviews how in
the past 40 years the U.S. health care delivery system has operated in a market-based economy,
and this is how most medical dosimetrists have worked. The market is now changing into new
approaches such as bundling health care payments. Dosimetrists that work in larger institutions
already work under some of these market models, which might be why they support advanced
specialization. Dosimetrists working in larger healthcare systems usually are more specialized as
compared to a smaller practice which has more broad and generalized working skills.
The authors concluded that in almost every category the results to support or not support
advanced practice in medical dosimetry were within 5-10% of each other, however, the majority
feel that there is no need for advanced practice.1 They believe that if the projected shortage of
medical dosimetrists occurs, then the support for it might grow. The authors believe that
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potential roles of advanced practice could open in the future, which would change the roles of
medical dosimetrists. They also conclude that more research is needed, and to gather information
from other radiation oncology professionals.
I was very interested in this article being a soon to be graduate in medical dosimetry.
This information directly pertains to my future. The authors did a very good job of analyzing all
of the information given to them and coming up with unbiased evidence based conclusion. The
use of graphs and the statistical evidence was very well displayed and easy to interpret. This
article has all of the research that the trade journal was lacking. I am interested to see if the
authors follow up with another survey in the future, and if they extend it to other professionals in
the field.

References
1. Collins KS, McKinnies RC, Adams R. Is Advanced Practice Needed Within Medical
Dosimetry? Radiation Therapist. 2016;25(2):137-145.