Comparison between Low Dose X-ray and Conventional X-Ray Techniques - Article Example

? Research Critique of “The Use of Low Dosage X-Ray (Lodox/Statscan) in Major Trauma: Comparison between Low Dose X-ray and Conventional X-Ray Techniques" Name: Institution: Abstract The introduction of the report gives an overview of the problem area, and the importance of addressing it, showing a need for the shift to Lodox imaging, as it improves patient outcomes. In support of the study, the report mentions the differences in resuscitation time among the different contexts, which results in improved patient outcomes. The introduction addresses the problem area satisfactorily. In the area of dosage, the authors clearly show the reduction in exposure when imaging is done under the Lodox context. The authors also account for the reduction in time of exposure, identifying the need to shift to the new context of imaging – considering the various advantages it offers. However, the authors should have given more information on the importance of the dosage reduction. Under the ethics part, the authors mention the certification and the consent sought before carrying out the study, showing the authenticity of the inquiry. The methodology section discusses the settings for the study fully, but fails to offer information on study sample and the selection method used, satisfactorily, which raises questions over the authenticity of the inferences. At the results section through to the conclusion, the authors fully support their hypothesis, but are limited in that they did not address the shortcomings of the study. This therefore, shows the need for more research in the area, to fill the information gaps left. Introduction The introduction of the report gives an overview, over the importance of the problem area; the need for low dosage X-ray exposure, which could reduce the deaths resulting from the lengthy procedures undertaken during a conventional X-Ray exposure session. The report introduces the need for resuscitation – which is administered according to the guidelines of the ATLS (Advanced Trauma Life Support) (Boffard et al., 2006). The report goes ahead to introduce the therapies administered during the procedure, including the radiology of the chest, pelvis, and the cervical spine. According to the authors, these procedures can be time consuming, which results in adverse outcomes from the patients under care. Further, these procedures may not produce any helpful information in many cases (Boffard et al., 2006). The report goes ahead to account that the use of low dosage X-ray exposure can reduce the time needed for the procedure, so as to reduce the time required for resuscitation. However, they point out that there is a need to compare the images captured in both cases, in terms of their quality (Driscoll & Vincent, 1992, pp. 111-114). The authors, further, define the Lodox/Statscan system of X-ray imaging – and its initial use as a device for detecting smuggled diamonds. The machine produces a complete body skeletal system and imaging of soft tissues. One advantage with the imaging is that the images can be digitally enhanced and enlarged for clarity – when being analyzed by medical personnel. However, the authors have not given information on whether the change of exposure system is necessary for all patients, and whether it is usefully, only to certain groups of patients. The problem of study is brief, but fully introduced the problem of study at the introduction area, which is the adverse outcomes resulting from delays during resuscitation (Gestring et al., 2002). Dosage At the area discussing dosage, the authors clearly show a reduction in the exposure to radiation between the two types of imaging. They show the difference in radiation dosage between the conventional X-ray procedures as compared to the low-dosage procedure. The explanation on the dosage clearly supports the thesis of the report, as it shows a considerable reduction in radiation exposure. For example, they account that the Lodox procedure has a radiation skin penetration of average 36.3 mrem and range 17.8-66.8 mrem as compared to that from the conventional dosage of 591 mrem at a range of 20-2280 mrem. Through the evidence given, the authors clearly demonstrate the reduction in radiation dosage, which supports its advantages over the conventional procedure. The information given in this area is brief but satisfactory to support the study (Boffard et al., 2006). However, the authors should have been clearer over the significance of the reduction in dosage, on how it determines the reduction in the time for resuscitation and the significance of Lodox in reducing the adverse effects of the procedure (Boffard et al., 2006, p. 1176). Ethics The researchers adhered to ethical values, as documented at the ethics section. The report states their adherence to GCP (Good Clinical Practice) norms, as guided by the Milpark hospital and the host University’s commission. The report also accounts that the patients gave their consent. The ethical accounts demonstrate the crucial nature of the study, as evidenced from the consultations made – prior to the study (Boffard et al., 2006, p. 1177). Methodology The writers begin the methodology part, by explaining the context of the study center in a very elaborate manner, which was the Milpark Hospital, in South Africa. They describe the Hospitals adherence to the standards laid down by the ACSCT (American College of Surgeons Committee on Trauma) for the hospitals level 1 trauma center. This information is produced as evidence to demonstrate that the hospital was a proper study area for the inquiry. The information is elaborate enough, to the extent that they explained the outlay of the hospital, for example explaining the admission procedure for trauma patients. The authors discussed the admission towards the resuscitation stage, explaining the different machinery used during the study, and the comparative account of the different procedures as administered at the center. For instance, they account that after the routine AP scan is administered, patients were transferred to the resuscitation area – where the X-rays were administered using a gantry-mounted Philips system. The report is very explicit over the methodology used during the study, the procedures observed, for example the ATLS principles, and the exposure areas used for the different procedures. These substantial discussions of the step by step procedure throughout the study demonstrate evidence in support of the course of study (Boffard et al., 2006, p. 1177; Chen et al., 2010). An account of the comparison done between the images captured through the different contexts is discussed. For example, the account explains that the time taken for the conventional diagnostics radiology was recorded. Also, the time spent on additional imaging, for example that for extremity views was recorded after measurement. The section offers information over the number of subjects for the study, evidence being the exposure of 50 of the 100 patients to conventional X-ray. These accounts of the discussion offer evidence in support of the thesis of the researchers, as the information creates the basis for the comparison of the images captured from the different procedures. The explanations account for the basis on which the authors develop a comparative study of the quality of the images from the different contexts. The discussions are satisfactorily in support of the study, and form a core part of the problem of study; exposing the effectiveness of Lodox as compared to the conventional model (Boffard et al., 2006, p. 1177). The authors go ahead to discuss the next step after the resuscitation was complete, where the surgeons recorded the findings. The same findings were compared with those captured from the Lodox procedure, in the following areas: showing element not shown in the Lodox imaging, but which are traceable in the images from the conventional imaging; pointing out any elements visible in the images from the Lodox context and not visible from the images taken through conventional imaging and any clinical choices or decisions done on the basis of the variations explained before. Through this account, the authors are completely in support of the thesis of the study, as they tried to expose the differences between the imaging results from the different contexts. The evidence, through the practice of study depicts the issue of inquiry and the progress towards drawing answers. The course of the evaluation is fully in support of the study, as it sought to express any weaknesses in the usage of Lodox among these patients. This part is considerably covered, and satisfactorily explicit in the progression of study (Boffard et al., 2006, p. 1177). The other group of 50 subjects was exposed to Lodox imaging, and the decisions made on the basis of the Lodox procedure. The procedure for showing the differences in the image qualities of the images from the different procedures was the same. Any details portrayed through the Lodox and not in the conventional X-ray images, any decisions altered due to the Lodox imaging. The inquiry method for the different focus groups was lucid, and adequate to reveal the distinction between the two groupings. However, as expected – the authors did not discuss the selection of the sample, as the report only mentioned the selection of 100 subjects for the study. For instance, the researchers would have used non-probability convenience sampling to select the subjects of the study, or a part of the study group. The researchers, also, did not expressly delegate one of the two groups as the control group and the other as the experimental group. The study had errors, in that it did not give information on factors that would have impacted the results from the study, for example the medical histories of the different patients or groups of patients. The researchers did not discuss the methods of sample selection, except the inclusion and exclusion criteria. An example in this case would be randomizing the experimental or the control group by random selection, rather than the uncontrolled admission of the patients into the study. The lack of a proper sample selection model also indicates that the results from the study may not be representative of the entire population of the patients administered to the different procedures. Further, no account was given, of the entire groups of patients represented by the study sample (Boffard et al., 2006, p. 1178). Based on the overt description of the processes used during the study, and the facts given to verify the study, the researchers did not take into account the different areas stated above, which may have influenced the findings of the study. They also did not mention other extraneous variables, which may have affected the findings from the study or the validity of the findings from the different groups. For example, patient history and other demographic characteristics of the subjects were likely to influence the findings of the study. The researchers did not discuss the analysis of the data from the study. The lack of a proper data analysis model may lead to biases in the derivations of the findings from the study, which could render the inferences inaccurate or erratic (Boffard et al., 2006, p. 1178; Beningfield et al., 2003). Results At the results section, the researchers start with a discussion of the demographics of the subjects – an area that was fully discussed at the methodology section. This subsection supports the thesis, as it lays emphasis on describing the duration taken by the study, the number of subjects contacted for the inquiry and those, who were eligible as informants for the inquiry. However, the area does not substantially address the significance of these variables in supporting the course of the problem. At this area, no evidence is provided to support the course of the study, which should have been the case (Boffard et al., 2006, p. 1178; Parry, Glaze & Archer, 1999). The demographics section clearly gives evidence of the characteristics of the subjects, which are in support of the thesis of the inquiry, guiding the development of the problem of study and which are offered as proof to sustain the study. This part is substantially addressed – to reflect that the subjects covered it effectively. The qualitative results from the study clearly describe the differences between the Lodox images and the conventional images, which are clearly in support of the issue of study. The quantitative analysis of the Lodox images also supports the problem under study, providing evidence to develop the subject and the problem area. The results section goes ahead to discuss the resuscitation periods consumed at the different contexts. This information is provided as evidence to support the study, and the course of addressing the problem area. At this section, the authors give enough evidence of the results, including the type of films used, which include ATLS films, and conventional films. The results from the imaging clearly support the thesis of study, as it shows a considerable reduction in resuscitation time and the satisfactory results captured through Lodox. For instance, they give evidence that at phase 2, the Lodox procedure clearly revealed the presence or the absence of bullets in a patient’s body. The reasons and the data given by the authors to support the results – clearly demonstrates the ability of the Lodox, as compared to the conventional procedure, as well as its advantages including the reduction of imaging duration. The results are clear enough, that they allow readers to understand the course of the study and the significance of the study. Drawing from the back-up for the thesis of the study by the inferences drawn, it is clear that the inquiry was useful and the issue to be addressed by the inquiry was significantly tackled (Boffard et al., 2006, p. 1178). The discussion of the results offers substantial explanation of the results captured through the study, demonstrating that the researcher’s study, fully supported the course of inquiry, and sustained the hypothesis of the study. The evidence given at the discussion area fully addresses any information gaps expected at this section, and demonstrates that the Lodox procedure is a plausible alternative, as it offers all necessary information and reduces the delays caused during the procedure. For example, they gave evidence of the contrast between the two procedures, where Lodox registered a scan time of 12.85 (AP and lateral) at a range of (10-15) contrasted to 21 minutes at a range of 15-25 for conventional imaging. Therefore, the discussion fully supports the thesis and addresses the problem of study (Boffard et al., 2006, p. 1179). The discussion section demonstrates how the study contributed to the growing information in the particular area of intervention, which reduces the time spent for the procedure substantially, resulting in better patient outcomes. However, there is one area that they did not address, which is that of exposing the weaknesses of the study. For example they would have noted the effects of patient history on the outcomes – which they did not address. Following the failure to address the weakness of the study, future studies will have to address any weaknesses evident in the study, so as to capture factual findings (Boffard et al., 2006, pp. 1180-81; Mervis et al., 2008). The conclusion that the authors developed from the study were appropriate for the inquiry conducted, showing that the confidence of patients in the Lodox procedure increased. The conclusions also demonstrate that the Lodox procedure resulted in a substantial reduction in the time taken during resuscitation, following the efficiency and the speed of the imaging process. This verified the problem of study, showing that the time taken for resuscitation could be significantly reduced, which improves the patient outcomes realized through the procedure. They also demonstrate a reduction in radiation exposure by 6% average – making the procedure very effective, especially for pediatric assessment. The unit also presents the advantage that it can be transported and used for mass casualty contexts. This is the case, as it can image large numbers with complete accuracy – for example to show metal fragments. Therefore, the study ends with the conclusions that support the thesis; provides evidence over the effectiveness of the procedure, as demonstrated using the evidence at the results section. The conclusion part also restates the thesis and the main findings, as well as the implications of the study, which demonstrates that the inquiry identifies information gaps, which can be filled through further research. The conclusion section binds the discussion of the report in an effectual manner (Boffard et al., 2006, p. 1181). References Beningfield, S., Potgieter, H., & Nicol, A. et al. (2003). Report on a new type of trauma full body digital X-ray machine. Emerg Radiol, 10, 23–29. Boffard, K. D., Goosen, J., Plani, F., Degiannis, E., & Potgieter, H. (2006). The use of low dosage X-ray (Lodox/Statscan) in major trauma: comparison between low dose X-ray and conventional x-ray techniques. J Trauma, 60 (6), 1175-81. Chen, R., Fu, C., Wu, S., Wang, Y., Chung, P., Huang, H., Huang, J. & Lu, C. (2010). Diagnostic accuracy, biohazard safety, and cost effectiveness-the Lodox/Statscan provides a beneficial alternative for the primary evaluation of patients with multiple injuries. J Trauma, 69 (4), 826-30. Driscoll, P.A., & Vincent, C. A. (1992). Variation in trauma resuscitation and its effect on patient outcome. Injury, 23, 111–114. Gestring, M., Gracias, V., Feliciano, M., Reilly, P., Shapiro, M., Johnson, J., Klein, W., Kauder, D. & Schwab, C., (2002). Evaluation of the lower spine after blunt trauma using abdominal computed topographic scanning supplemented with lateral scanograms. Trauma, 53 (1), 9-14. Mervis, S. E., Matsumoto, J., & Shanmuganathan, K. et al. (2008). Use of total body digital radiography (Statscan) for acute trauma imaging: preliminary experience in comparison with traditional computed radiography. Abstract. American Society of Emergency Radiology scientific Conference. Phoenix. Parry, R., Glaze., S., & Archer, B. (1999). The AAPM/RSNA Physics tutorial for residents. Typical patient radiation doses in diagnostic radiology. RadioGraphics, 19, 1289 –1302. Read More