Reading Comprehension

PT147 · S3 · P3 · Q15 Theoretical vs. Clinical Equipoise

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The following passage is based on an article published in 1987.

Topic

Clinical vs. Theoretical Equipoise

Framework

Old vs. New / Problem vs. Solution

Main Point

OLD/PROBLEM -- theoretical equipoise, which holds that physicians can't take place in a drug trial comparing two different treatments unless they are equally confident in both options.

NEW/SOLUTION -- clinical equipoise is a more attainable, but still sufficiently robust, standard that means as long as there's good-faith dissension within the medical community (i.e. the medical community is still agnostic about which is the better treatment), then physicians have no ethical qualms participating in the comparative drug trail.

Summary

P1 - Background of Old

Author explains physicians' ethical standard (prescribe best treatment) and application of that standard to the thorny issue of comparative drug trials. Introduces the concept of theoretical equipoise.

P2 - The Old way is a Problem

The author explains the ways in which theoretical equipoise sets too high a bar, one that would make it too hard to start a drug trial or to complete one, once early evidence starts trickling in.

P3 - The New Solution

The author outlines what clinical equipoise would be, a standard that would mean an individual physician can have a preferred treatment in a comparative drug trial as long as the broader medical community has not yet registered a consensus on a preferred treatment.

P4 - Implications of New/Solution

The author takes a victory lap explaining how clinical equipoise hits that Goldilocks spot of just ethical enough, just practical enough.

15.

The primary purpose of the second paragraph of the passage is to

  1. provide a view that contrasts

    Opposite

    This paragraph shows why theoretical equipoise sucks, which then becomes an argument in favor of clinical equipoise. This answer choice is saying P2 is anti-clinical equipoise, when in reality it's anti-theoretical equipoise.

    3% picked this

  2. explore the factors underlying physicians'

    Too Narrow

    In the middle of this paragraph they mention a couple factors that could underlie or influence a physician's preferred treatment, but this answer choice is missing "theoretical equipoise" entirely, which is both the headline and the takeaway of the 2nd paragraph: 1st sentence Unfortunately, theoretical equipoise may be too strict. Last sentence Consequently, if we adhere to theoretical equipoise, few trials will start and even fewer will finish.

    1% picked this

  3. undermine the moral principle that

    Out of Scope: undermine moral principle

    The moral principle that underlies all equipoise is that the physician should be prescribing the best available treatment. This answer choice is saying that the purpose of the 2nd paragraph was for the author to argue that "we shouldn't always prescribe the best available treatment". That's not what the author is arguing in the 2nd paragraph (using clinical equipoise, which the author ultimately argues for, may occasionally result in giving a patient a less-than-best treatment, but that's not something the author wants and it's definitely not the focus of the 2nd paragraph). The 2nd paragraph is trying to undermine the practical viability of adhering to theoretical equipoise.

    3% picked this

  4. Correct

    state the main difficulty with

    Why this is right

    This looks like a decent match for our Passage Map prediction: 2nd paragraph was where the author introduced the Problem. The main difficulty of adhering to the standards of theoretical equipoise is that the evidence for two treatments is almost never judged to be exactly balanced, and in the rare times that it is, as soon as a trial starts to accumulate data the balance will be tipped towards one treatment. The problem is crystallized in the final conclusory sentence: if the standard of theoretical equipoise is adhered to, we'll be able to start very few clinical trials and we'll be able to finish almost none of them.

    Skill tested: Paragraph Purpose · how this choice captures the passage's function is the move to repeat next time.

    83% picked this

  5. illustrate the conflicts inherent in

    Wrong Emphasis: general equipoise

    The first paragraph was getting us acquainted with the general notion of equipoise. The second paragraph is where we specifically start talking about theoretical equipoise, and the problem with adhering to such a strict standard.

    10% picked this

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