The following is an independent report on Dr. Dixon's completed and successful thesis for PhD. This analysis was undertaken by an overseas based Chair of Family Medicine.
Infection and haemorrhagic complications associated with skin cancer surgery
No other practitioner in Australia has focussed in such a scientific manner on the relevant issues of skin cancer treatment (and surgery is still the main stay of treatment for this disease) than the candidate.
Although, as he acknowledges repeatedly, the fact that his data is based on a single series of patients in his own practice, and that his practice is referral only, the types of lesions therefore are on the extreme side of required management, much of this data is applicable to the GP who carries out skin cancer surgery in his own practice.
The continuity of care and follow-up are unique demonstrations of a team approach and use of the opportunity to develop a large database that has been used to provide practical evidence of best practice.
The candidate has demonstrated critical insight in these reports using the reflective aspect of his practice and his willingness to test and share outcomes achieved. The experience of the candidate has focussed his research onto relevant issues in the surgical management of skin cancer and complications that all GPs and skin cancer doctors aspire to managing and preventing.
The development of large databases of patients in itself is of little value unless there is a plan to utilize the data. I have the impression that this was not data gathering for its own sake and then ad-hoc use of the data. There is evidence in the way the thesis is presented that the information was collected to answer the questions highlighted in the thesis title. He has used a number of methodologies to answer questions, including a randomised trial thus demonstrating a good grasp of different study designs to answer different questions.
The thesis has been tied together well albeit the timelines of the publications are not consecutive. However, it is understandable in the real world and does not detract from the work, rather makes the thesis more readable.
Perhaps a general literature review relevant to the topics might have been helpful in the first section of the thesis. Nevertheless I’m satisfied that the literature review in the proffered papers is adequate, relevant and current.
The candidate has published the proffered papers in a wide variety of peer reviewed journals - pure surgical, dermatological surgical, plastic surgery, dermatological, general medical journals and general practice journals. I believe this establishes the extent of the contribution to knowledge and relevance of the studies.
In addition he has provided evidence in the requested series from Australian Family Physician of the willingness to share what is highly relevant data and make it accessible to those in Australia and elsewhere who can use the information of the studies he has undertaken.