PrepTest 141, Section 4, Question 6
Clinician: Patients with immune system disorders are usually(63 more words not shown)
Which one of the following(13 more words not shown)
- AHow large is(11 more words not shown)
- BWhy are immune(12 more words not shown)
- CIs the new(12 more words not shown)
- DHow long has(11 more words not shown)
- ETo what extent(15 more words not shown)
Reading the argument
A third drug might help the bones. What if it interferes with the treatment the patient needs in the first place?
Keep the three jobs separate. The first drug treats the immune system disorder but raises the risk of bone loss. The second helps preserve existing bone. The new, third drug helps grow new bone cells. That sounds useful, but its benefit on its own doesn't settle whether adding it to this combination makes sense.
For instance, the new drug might undermine the immune-system treatment. Or it could have serious side effects that outweigh the extra bone growth. The existence of a side effect doesn't automatically make a treatment a bad choice—the first drug may have important benefits despite its risks. It does mean we need to understand the tradeoffs before recommending another drug.
What we’re looking for
This question asks what would help us evaluate the recommendation. We aren't committed to supporting or opposing it. A useful question could lead us either way, depending on its answer. I'd want to know whether the proposed combination actually delivers the benefit the clinician expects.
Working the answers
- A
The size of the first drug class doesn't tell us whether adding the new drug is helpful. There could be one immune-system treatment in that class or many; either way, we still need to assess the proposed combination.
- B
This concerns the decision to use the immune-system treatment in the first place. It might have benefits worth its bone-loss risk. But knowing why patients receive that treatment doesn't establish whether they should now add the bone-growth drug.
- C
Relative price alone doesn't resolve this recommendation. A more expensive drug might still be worth adding, and a cheaper one might be ineffective. Also, this isn't a proposal to replace the bone-preserving drug with the new one; patients would take both. We need more than which of the two costs more.
- D
How long the bone-preserving drug has been used doesn't tell us how well the new combination works. The recommendation concerns adding the third drug, not deciding how established the second one is.
- ECorrect
This checks an interaction in the other direction from my first concern: perhaps the existing drugs prevent the new drug from working. If the new drug retains its effectiveness in the combination, the promised bone-growth benefit has support. If it loses that effectiveness, the clinician's reason for adding it largely disappears. Those different answers would change our assessment of the recommendation.
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