Research & Critical Analysis Assignment 1

A pharmaceutical representative for a new targeted therapy for head and neck cancer gave me this article (attached) to encourage me to use his drug. Currently, the standard of care for locally advanced head and neck cancer is to use combined chemotherapy and radiotherapy. There is some evidence (Level 2 - one large RCT) that this new agent (cetuximab), when combined with radiotherapy, is better than radiotherapy alone in treating locally advanced H&N cancer. Please read the attached publication (from a reputable peer reviewed journal with a high impact factor), and answer the following:

  1. What treatments are compared?
  2. What is the study design?
  3. What are the weaknesses of this design?
  4. What have the authors done to address the design weaknesses
  5. What are the conclusions?
  6. Are these reasonable conclusions to draw, when considering the design and the results?
  7. Cetuximab is much more expensive than chemotherapy. The pharma rep wants us to use it, saying "this paper proves that cetuximab is as good as chemotherapy". Based only on this article, What do you think about this assertion and the decision to use cetuximab instead of chemotherapy.
  8. What study design could best address the clinical question in (7)?
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