NR 505 Week 3 Collaboration Cafe

NR 505 Week 3 Collaboration Cafe

Student Name

Chamberlain University

NR-505: Advanced Research Methods: Evidence-Based Practice

Prof. Name

Date

Week 3: Collaboration Café

Article Title

Are the studies on cancer risk from CT scans biased by indication? Elements of answer from a large-scale cohort study in France
British Journal of Cancer

Purpose

For this week’s assignment, the selected article closely aligns with the PICOT question regarding radiation exposure from CT scans in children and young adults. The purpose of this task is to critically appraise the research, assess its strengths and weaknesses, and discuss its relevance to clinical practice.

The PICOT question guiding this appraisal is: In children and young adults, does using a reduced radiation dose in computed tomography (CT) scans lower the lifetime risk of cancer compared to higher-dose exposure?

This French cohort study used a quantitative design to explore how CT radiation exposure during childhood and adolescence affects the likelihood of developing cancer. The researchers examined the connection between cumulative radiation exposure and cancer diagnoses while accounting for predisposing factors.

Research Design

The study employed a quantitative cohort design, emphasizing the collection and statistical analysis of numerical data. Quantitative research is effective for identifying relationships between variables in defined populations. In this study, the researchers analyzed whether CT scan exposure was correlated with increased cancer incidence among children. The use of a large sample size improved statistical reliability and enhanced the credibility of the findings.

Discussion of Sample

A non-probability sampling method was used to select participants. This allowed the researchers to include children who met specific inclusion criteria, such as age, timing of the first CT scan, and the absence of a prior cancer diagnosis.

Sample Characteristics

While the sampling approach was efficient and cost-effective, it introduced limitations in generalizability because the sample may not represent the entire pediatric population.

Description of Data Collection Methods

Data were collected across 21 French university hospitals and 23 pediatric radiology departments using multiple data sources to ensure accuracy and completeness.

Data Sources

The data included cumulative radiation doses, patient demographics, and the anatomical areas scanned. Follow-up continued from the first CT scan until December 2011, cancer diagnosis, death, or the 15th birthday—whichever occurred first.

Summary of Findings

The study evaluated whether childhood CT scan exposure increased cancer risk. During a four-year follow-up period, the following cancer cases were reported:

Approximately 32% of the children had cancer-predisposing factors. While potential links between CT exposure and cancer were observed, the authors cautioned that the short follow-up period limited definitive conclusions. They emphasized the need for longer follow-up studies to assess long-term cancer risks.

Strengths of the Study

Although not explicitly stated by the authors, several strengths were evident:

• Large sample size of more than 67,000 children, enhancing statistical power.

• Comprehensive data collection using hospital databases, imaging archives, and cancer registries ensured high data reliability.

• Focus on a high-risk population, as children are more sensitive to radiation effects, increasing the clinical importance of the results.

These strengths reinforced the validity and reliability of the study’s conclusions.

Limitations of the Study

The research had notable limitations, primarily the risk of indication bias. CT scans may have been performed on children already at higher risk of cancer, either for diagnostic purposes or to monitor known conditions. This made it difficult to distinguish between cancer caused by radiation exposure and that resulting from pre-existing health factors.

Additionally, the limited follow-up period restricted the ability to evaluate long-term cancer outcomes. The authors recommended future studies include longer observation periods and more detailed data on predisposing conditions (Journy et al., 2015).

Recommendations for Future Practice

The findings and related literature support several practice recommendations:

Implementing these recommendations can help ensure safer diagnostic practices for pediatric and adolescent patients.

References

Elfil, M., & Negida, A. (2017). Sampling methods in clinical research: An educational review. Journal of Advanced Practice Oncology, 5(1), 2107. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325924/

NR 505 Week 3 Collaboration Cafe

Journy, N., Rehel, J. L., Pointe, D. L., Lee, C., Brisse, H., Chateil, J. F., Caer-Lorho, S., Laurier, D., & Bernier, M. O. (2015). Are the studies on cancer risk from CT scans biased by indication? Elements of answer from a large-scale cohort study in France. British Journal of Cancer, 112(1), 185–193. https://www.nature.com/articles/bjc2014526