There is a great deal of geographical variation in the frequency of many surgical procedures—up to tenfold variation per hundred thousand between different areas in the numbers of hysterectomies, prostatectomies, and tonsillectomies.
What is it Saying?
*That the number of surgeries vary a lot geaographically*
To support a conclusion that much of the variation is due to unnecessary surgical procedure, it would be most important to establish which of the following?
Question Stem...
*If we make the conclusion, that much of the variation is due to unnecessary surgical procedure. Then which of the following things will strenghten it*
(A) A local board of review to each hospital examines the records of every operation to determine whether the surgical procedure was necessary.
Tempting. But wait? If we establish this. Then can we say that the variation is because there is unneccesary operations? ...No this when considered true just establishes the board. the results of that could be any thing. We have to look for a statement that will say that the procedure variation is due to unneccesary procedures.
(B) The variation is unrelated to factors (other than the surgical procedures themselves) that influence the incidence of diseases for which surgery might be considered.
Simple. A Causes B. Strengthen It. C doesnt cause B...Other things are not responsible for it.
(C) There are several categories of surgical procedure (other than hysterectomies, prostatectomies, and tonsillectomies) that are often performed unnecessarily.
Okay So? We are concerned about the categories mentioned.
(D) For certain surgical procedures, it is difficult to determine after the operation whether the procedures were necessary or whether alternative treatment would have succeeded.
Ah? Weakens the arguement. We have to say that it was unneccesary, not to create doubt. Moreve, it says certain surgical procedures. this could be anything, just 1 or 2 of the above mentioned, or some others totatlly.
(E) With respect to how often they are performed unnecessarily, hysterectomies, prostatectomies, and tonsillectomies are representative of surgical procedures in general.
This again doesnt strengthen the conclusion that variation is due to unnecessary surgeries.