The flowchart indicates the steps in the process of comprehensive gene

Question

https://gmatclub.com/forum/download/file.php?id=81703 The flowchart indicates the steps in the process of comprehensive genetic tumor testing that doctors hope will provide cancer sufferers with personalized treatment. Arrows indicate the next step needed in the process. On the basis of the information provided, select from each drop-down menu the option that creates the most accurate statement. An arrow extending from Box 5 to Box GRAPH_1_PLACEHOLDER would address the fact that tumor cells can mutate over time. An arrow extending from Box 5 to Box GRAPH_2_PLACEHOLDER would address the fact that knowledge about the effects of particular drugs on particular genetic mutations and their protein products is constantly changing. ID: 700175 GMAT-Club-Forum-ug1fmyfq.png

egmat · Accepted Answer

Here is a  detailed video solution  for this interesting question. 
See how this question can be solved in the test environment using " Owning the Dataset " approach.

https://www.youtube.com/watch?v=aEHlAO0K8DU

Let us know if you have any questions.

KarishmaB · Answer

Say a doctor performed the following steps for a patient. 1. Extract genetic info from tumour 2. Identify mutations 3. Catalog mutations and identify trouble spots 4. Determine suitable drugs and give to patient 5. Assess patient health Now after step 5, he gets to know that: I. Tumor cells can mutate over time. What should he do? He should extract genetic info again from tumour after some time to check whether they have mutated. So he will need to go to step 1 again. An arrow extending from Box 5 to Box 1 would address the fact that tumor cells can mutate over time. ANSWER II. Knowledge about the effects of particular drugs on particular genetic mutations and their protein products is constantly changing. How given drugs impact different mutations keeps changing. So after step 5, the doc should check repeatedly whether there is any update on how drugs affect different mutations. If this info has changed, then he may need to change the drugs he is administering. Hence he should go back to step 4 and again determine suitable drugs to give as per latest info and then give those. An arrow extending from Box 5 to Box 4 would address the fact that knowledge about the effects of particular drugs on particular genetic mutations and their protein products is constantly changing. ANSWER GMAT-Club-Forum-o2b91zru.png

chetan2u · Answer

The five steps are
1. Extract genetic information
2. Decipher this information to find mutations
3. Analyse and pinpoint trouble spots
4. Administer drugs
5. Assess health

The statements now are

An arrow extending from Box 5 to Box ? would address the fact that tumor cells can mutate over time.
 To check whether tumour cells can mutate, one has to extract the genetic information again. So, go back to step 1.

An arrow extending from Box 5 to Box would address the fact that knowledge about the effects of particular drugs on particular genetic mutations and their protein products is constantly changing.
 Now, we are addressing the issue of drugs, so we have to go back to the box from where we talk about drugs and its administration to the person. So go back to step 5.

mollyweasley · Answer

Could someone please explain why the first drop down is not Box 2? It was mostly a language issue IMO, where I deciphered that the tumor can and has already mutated. But please confirm!

chetan2u · Answer

Box 2 talks of 'deciphering genetic blueprint identifying blueprints', but one can do that  only when a person after healthy person is assesd for any tumor and then the genetic information is extracted from tumour cells.  
The  colored portion  can happen only at step 1.

Dbrunik · Answer

Very low quality question. 2 should work.

Posted from my mobile device

bb · Answer

This is a low quality question? What does quality mean to you?

Dbrunik · Answer

99% of GMAT questions are great. This one simply does not make the cut.

In real-world scenarios (yes, I know the GMAT is not real-world, bear with me), doctors would likely loop back to step 1 and proceed to step 2 sequentially, as mutations are dynamic, and re-extracting genetic information would be the first action. However, the language around "address" and what it really implies seems overly rigid or ambiguous, especially if you're thinking from a broader or more realistic perspective.

I understand that it is trying to test your understanding of flowcharts, but the prompt (nor the solution) is not quite clear enough to indicate that step 2 (for box 1) is not sufficient.

It does make sense, in retrospect, that step 2 is where the actual deciphering of the genetic information occurs, because it is based on data gathered in step 1. Thus, you cannot "address" the mutation without first revisiting step 1 to gather updated genetic information.

However , the official answer says, "Returning to step 2 would not be appropriate because step 2 involves deciphering the genetic blueprint of cells extracted prior to the mutation, and any step after that is based on information gathered in step 2." Okay, so what is this actually saying? Step 2 is the one that would help you arrive at any meaningful conclusion, but in order to get there, you have to go through step 1. This is wordplay with the word "address."  Further, for box 2 in which the answer "4" is correct, you could make the same argument that you might as well just go back to box 1 again. At this point, the official solution is almost comical. This is the primary reason why this is a poor question.
 
How does one, having undergone chemo and the reassessment of health (step 4 and 5), best assess if the tumor can mutate? Isn't it sort of implicit, in this question, that we would go through step 1 in order to ultimately get to step 2? Furthermore, you could even make the argument that going back to step 1 wouldn't do anything to address the fact that tumor cells can mutate, under the set of possible outcomes, because "if a tumor is present," and the answer to that question is "no," then you've done nothing to address the fact that cells can mutate over time because: 1. Consciously, although you started with one specific goal, you've now done something completely different, and 2. Again, there is nothing about choosing step 1 that implicitly leads you to step 2, which is where you would arrive at a legitimate and/or material conclusion to the original question.

I mean, just imagine—you go to your doctor’s office, cleared of cancer, with the concern that tumor cells can mutate over time. The doctor goes to step 1, and there is no tumor detectable ("no" to the first question), yet there is still a mutation occurring (undetected). I get that with these questions, it's not testing scientific knowledge, but if it’s totally at odds with what an oncologist might say would be sufficient to address the concern, it can't really be that great of a measure of graphics interpretation ability, or flowcharts.

Dbrunik · Answer

Sorry i just realize i didnt even directly answer your original question. in truth i couldnt answer that so i had to google it. "A high-quality GMAT question should be clear, concise, and test critical reasoning or problem-solving skills. It should focus on evaluating key abilities such as quantitative reasoning, logical thinking, and data analysis, while avoiding ambiguity. The question should be challenging yet solvable within a reasonable timeframe, with answer choices that require thoughtful consideration to eliminate incorrect options. It should reflect real-world application and align with GMAT exam standards."

I guess my other post is just explaining why this question doesnt best fall into this description. ha

Dbrunik · Answer

hi, can you please explain why, given then we have to go back to the start for box 1 and answer "1" instead of "2", why are we not also going back to step "1" instead of "4" for box 2 (the second question)?

Dbrunik · Answer

hi, can you please explain why, given then we have to go back to the start for box 1 and answer "1" instead of "2", why are we not also going back to step "1" instead of "4" for box 2 (the second question)?

MalachiKeti · Answer

Hi  Bunuel   KarishmaB  pls explain why for first Q the cells we have already collected they wouldn't mutate as well and just going to step 2 would be sufficient?

bb · Answer

Hi. Not a medical expert here and I feel some knowledge of medical field may be helpful (though on the GMAT it can equally be harmful). 
I don't think you collect cells and they live on their own somewhere. I don't think it is possible. I think they collect cells, map them (extra DNA/genetic signatures/etc) and discard the rest, so they "read" the cells and thus the cells you collected are sort of a one-time thing. So any time you need additional readings, you need to collect the cells. That is my understanding.

bb · Answer

I got tripped up by the second question as well - I did not read it carefully enough:

An arrow extending from Box 5 to Box     ____     would address the fact that knowledge about the effects of particular drugs on particular genetic mutations and their protein products is constantly changing.

Here I made the mistake of carrying over the information from the first question. I got it wrong because I assumed that we will need to pull the material again from the Tumor. However, this question is not talking about mutations taking place in the tumor. There are 2 things that are changing: 1) Tutor and 2) Knowledge about how to treat the tumors. So question #2 is only concerned with the Knowledge that is changing. So if we are only concerned with the knowledge changing (I realized it after I re-read it), then we only need to go back to Step 4 to consult the database.

Hope this helps.

bb · Answer

Got it. We have an unwritten rule that we had to remind people from time to time - that is Official Questions are never low quality (there are very rare mistakes that are the results of typos in the questions) but outside of 1 case with a typo, Official questions are always high quality - they are sovereign, so GMAC dictates what are the questions and all questions they release are high quality. They are the standard. We cannot call the standard low quality because that makes no logical sense. This is a hard Official Question. If you disagree with it, you can say it is hard, hard to understand, makes no sense, and a lot of other things, but it is not low quality.

kanikaa9 · Answer

I agree with you here  Dbrunik  . Sorry  bb

Part 1 of this question is indeed poor quality. How would one prove the fact that tumour is mutable or not? After assessing it, right? And option 3 clearly says we have to 'pin-point' trouble spots hence not all tumours are a trouble. So even I don't think 1 is really the appropriate answer here. The flowchart can be tweaked a bit.

bb · Answer

I don’t mind at all. Please feel free to disagree with me, I even welcome it, it’s a good part of the normal discourse 👍

harshvardhanindia · Answer

IK whats troubling me and many others in this question , the answer assumes that the tumor has mutated after the sample has taken (while the doctors are on step 2/3/4/5) and that sample had a different genetic markup from the tumor now present in the body , so specialized targeted therapy doesnt work, BUT the thing is simply extracting genetic information will not give us any insight upon whether there have been any changes hence i didnt opt for 1 BUT now if i choose 2(which i did) i m essentially using the same previous sample and hence again will get the same result , so it has to be 1&2 , but one is more important.

if i draw an alternate scenario- imagine a keg of beer still brewing and you take out a sample and run a test on the level of alcohol present (step1), then the results of the tests are sent for analysis to see under what category the beer sample you took out will be acc to the the amount of active yeast in the beer and the strength of the alcohol (step 2). now in step 3 you note down your reading in the master book while highlighting key metrics like amount of active yeast and strength of the beer and in step 4 you will give out a specific agent that kills the the amount of active yeast based on the amount of yeast in the keg ie for upto 25% you give compoundA and for further you give compound B (A ONLY WORKS TILL 25% CONC AND SAME WITH B ) so that it doesn't ferment further. and then in step 5 you label the beer keg as Category 1 beer or category 2 beer. The question asks what will you do if you wanna see if the amount of yeast in the beer has changed over time. for that we can compare our previous sample with the current sample and maybe till the time we gave the compound the amount of active yeast kept on increasing and the conc of yeast increased more than 25% making compound a ineffective hence we mis-categorized the beer ,so we would need to draw a new sample to verify what the question wants and do 1 again to verify that the amount of yeast conc has change , while if i choose 2 there infact wont be any change.

I am a NOT AN EXPERT BUT NONE OF THE EXPLAINATIONS WERE MAKING SENSE TO ME so i sat with it for 30 mins and this is the explanation that helped me justify 1vs 2 in the first question.

egmat · Answer

Here's a detailed solution:

Understanding the Flowchart Structure

Notice how the current flowchart flows in one direction: Box 1 → Box 2 → Box 3 → Box 4 → Box 5. Each step builds on the previous one, ending with patient health assessment. But the questions are asking about feedback loops - arrows going  backward  from Box 5 to earlier steps.

Question 1: Tumor Mutations Over Time

Let's think about this logically. If tumor cells mutate over time, what does that mean for the process?

The key insight here is that  new mutations = new genetic information . When you're assessing patient health (Box 5) and detect that the tumor has changed, you need fresh genetic data to understand these new mutations.

Looking at the boxes:
- Box 1: Extract genetic information from tumor and healthy cells
- Box 2: Analyze existing genetic data 
- Box 3: Compare with databases
- Box 4: Select treatment based on current data

To capture  new  mutations, you must go back to the source - Box 1 - to extract fresh genetic information. You can't just re-analyze old data.

Answer for Question 1: Box 1

Question 2: Changing Drug Knowledge

This scenario is different. Here, the tumor hasn't necessarily changed, but our  knowledge  about which drugs work best for specific mutations has improved.

Think about it: if researchers discover that Drug X works better than Drug Y for a particular genetic profile, which step needs updating?

- The genetic data is still valid (Boxes 1-3)
- Only the  treatment selection  needs to change based on new knowledge

Box 4 is where "the most appropriate cocktail of drugs" gets determined and delivered. That's exactly the step that applies updated drug knowledge.

Answer for Question 2: Box 4

The logic here is beautiful: biological changes (mutations) require going back to data collection, while knowledge changes require going back to decision-making.

You can discover the systematic framework that works for all flowchart analysis problems  here on Neuron . You can also find detailed explanations for many other similar official questions  here  with practice quizzes and detailed analytics into your weaknesses.

The flowchart indicates the steps in the process of comprehensive gene

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The flowchart indicates the steps in the process of comprehensive gene

Prep Toolkit

615 to 715 in 15 Days (Ria's Strategies)

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My Rewards