SAT Reading & Writing · Cross-Text Connections
**Text 1** Early observational studies that tracked postmenopausal women over time found that those who chose to take hormone replacement…
**Text 1**
Early observational studies that tracked postmenopausal women over time found that those who chose to take hormone replacement therapy had lower rates of coronary heart disease than women who did not take it, leading many physicians to recommend the therapy for heart disease prevention.
**Text 2**
The Women's Health Initiative, a large randomized controlled trial in which women were randomly assigned to receive hormone therapy or a placebo, found increased cardiovascular risks for some hormone regimens, contradicting the earlier observational findings.
Which choice best explains why the two studies might have reached different conclusions, based on information in the texts?
Early observational studies that tracked postmenopausal women over time found that those who chose to take hormone replacement therapy had lower rates of coronary heart disease than women who did not take it, leading many physicians to recommend the therapy for heart disease prevention.
**Text 2**
The Women's Health Initiative, a large randomized controlled trial in which women were randomly assigned to receive hormone therapy or a placebo, found increased cardiovascular risks for some hormone regimens, contradicting the earlier observational findings.
Which choice best explains why the two studies might have reached different conclusions, based on information in the texts?
Answer and explanation
Answer: D: Women who chose to take hormone therapy in the observational studies may have differed systematically from women who did not, in ways related to their heart disease risk, a source of bias that…
The key structural difference between the two study types, named directly in Text 2's method ("randomly assigned"), is exactly what explains the discrepancy: observational studies can't rule out that healthier or more health-conscious women were simply more likely to choose the therapy in the first place, a bias random assignment eliminates. A misstates trial size, which isn't described in either text and runs contrary to how large, well-known randomized trials in this area were actually conducted. C reverses the actual chronology described in the passage. B invents a claim about declining effectiveness that neither text supports.
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