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A health report notes that of the patients operated on for a certain fracture, 9 in every hundred failed to recover at the district hospital against 3 in every hundred at the taluk clinic, and concludes that the taluk clinic does this operation better than the district hospital does. Which of the following, if true, most weakens the report's conclusion?

Competition practiceLogical / Critical
  • AThe district hospital performs about six times as many of these operations in a year as the taluk clinic does
  • BThe two institutions use plates and screws of the same make
  • CThe surgeons at both institutions were trained at the same medical college
  • DSuch fractures are graded from one to four by severity; the clinic sends on every case above grade two and keeps the rest, and within each of the four grades the district hospital's patients recover in a larger share of cases than the clinic's

Step-by-Step Solution

The report has set two overall figures against each other as though the two institutions were treating the same kind of case, and they are not: the clinic keeps the easy grades and passes the hard ones to the hospital, so the hospital's total is heavy with cases that would go badly anywhere. Grade by grade the hospital does better than the clinic, which reverses the conclusion outright. Six times as many operations bears on how much practice each has, and could as easily be read in the hospital's favour. The same plates and the same college make the two more alike, which if anything supports the report by removing rival explanations rather than damaging it.
Answer: D) Such fractures are graded from one to four by severity; the clinic sends on every case above grade two and keeps the rest, and within each of the four grades the district hospital's patients recover in a larger share of cases than the clinic's

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