Chapter 42 — Quiz
Twenty-four items. Mixed multiple choice and short answer. Answer key at the end — cover it.
1. In the §42.1 funnel, the persuasion is concentrated at the top and the money at the bottom.
Which step generates the most revenue over time?
- (a) Attention
- (b) Interest
- (c) The low-friction consultation
- (d) The recurring subscription
2. Which statement best captures the chapter's structural claim about the funnel?
- (a) Every step in the funnel is unlawful
- (b) Each step is individually legal and defensible; the assembly is a sales channel with a physician
in it
- (c) Remote prescribing should be prohibited
- (d) Prescribers in these systems are generally dishonest
3. Complete the sentence in your own words: In commerce, friction is __; in clinical care,
some friction is ____.
4. Which of the following does disclosure of a financial relationship actually accomplish?
- (a) It removes the creator's financial incentive
- (b) It corrects the selection effect in what content gets made
- (c) It informs the audience that a material connection exists
- (d) It transfers the audience's trust to a neutral party
5. A creator tries a product, finds it disappointing, and makes no content about it at all. Name
the phenomenon this produces in the aggregate information environment, and state in one sentence why
no disclosure requirement can flag it.
6. An affiliate arrangement paying a recurring revenue share aligns the creator's interest
most strongly with which audience behavior?
- (a) Curiosity
- (b) Registration
- (c) Purchase
- (d) Persistence — continuing to pay
7. True or false, with a one-sentence justification: A paid-partnership tag on a video is
evidence that the claims in the video are unreliable.
8. Why can an engagement-optimized recommendation system not rank health content by evidential
quality?
- (a) Because platforms have chosen not to invest in it
- (b) Because evidential quality is a property of the relationship between a claim and a body of
literature, and is not a feature of the file
- (c) Because regulators prohibit it
- (d) Because users would object
9. Name the three properties that engagement optimization selects for in health content, and state
how Chapter 5's evidence hierarchy ranks them.
10. On the five-rung compression ladder in §42.4, which element is typically cut first as a claim
moves from paper to comment?
- (a) The name of the drug
- (b) The direction of the effect
- (c) The qualifiers — subgroup, comparator, population, duration
- (d) The claim that a study exists
11. Why is a transformation narrative difficult to characterize as deceptive?
12. According to §42.5, the effect of keyword-based moderation and demonetization on health
content is to exert selection pressure toward:
- (a) Greater precision, since creators must be careful
- (b) Imprecision, since penalized nouns are replaced by vaguer language
- (c) Longer formats
- (d) More frequent citation of primary literature
13. In §42.7, why does the manufacturer of an approved drug face the strictest constraints on
efficacy claims of any entity in the table?
14. Which entity in the §42.7 table is legally selling attention rather than a medicine?
- (a) The compounding pharmacy
- (b) The supplement seller
- (c) The individual creator
- (d) The telehealth service
15. True or false, with a one-sentence mechanism: The absence of an approval made advertising for
compounded preparations less constrained, not more.
16. A "structure/function claim" belongs to which regulatory regime?
- (a) Approved prescription drugs
- (b) Compounded preparations
- (c) Supplements
- (d) Medical devices
17. Put the six steps of §42.8's template in order: supply appears · opening closes · demand
spike · demand must be manufactured · legal opening · shortage.
18. In the dossier exercise, which of the following is described as the strongest structural signal
of credibility available?
- (a) A claim made by someone with a large audience
- (b) A claim made by a credentialed clinician
- (c) A result published against the interest of whoever produced it
- (d) A claim repeated by many independent creators
19. Define the genetic fallacy, and explain why §42.9 warns that it is the characteristic error of
someone who has just learned to read business models.
20. Which question in the five-question read is designed to identify retention content —
material aimed at people who are already paying?
- (a) Question 1
- (b) Question 2
- (c) Question 3
- (d) Question 5
21. You ask Question 5 — what would this person have said if the evidence were bad? — and
conclude that no content would exist at all. What have you identified, and what have you not
established?
22. The chapter rates the claim "a standard affiliate disclosure eliminates the biasing effect of
the sponsor relationship on viewers' treatment decisions." Give the rating and the one-sentence
reason.
23. The claim "direct-to-consumer telehealth prescribing increases the proportion of people
receiving appropriate treatment" is rated ⚠️ rather than ✅. Name the two endpoints that get
conflated, and state what evidence would move the rating.
24. §42.9 ends with a calibration test: run the five-question read on content you already agree
with. Which of the six rating-system rules does this test enforce, and what failure mode does it
prevent?
Answer key
**1.** (d) The recurring subscription. Lifetime value accrues monthly; the persuasion at the top may
generate very little revenue per viewer.
**2.** (b). The chapter's claim is structural, not accusatory — every individual step withstands
scrutiny, and the assembly is still a sales channel.
**3.** *In commerce, friction is a defect (measured as loss and engineered away); in clinical care,
some friction is the safety system* — the scheduled visit, the slow history, the pharmacist's second
look, the follow-up that catches a side effect. A conversion metric cannot distinguish the two,
because it has no term for a harm that a delay prevented.
**4.** (c). Disclosure informs. It does not alter the incentive, undo the selection effect, or
dissolve trust built on unrelated content.
**5.** A **selection effect** — the visible distribution of opinion is not the distribution of
opinion, only the distribution of opinions worth publishing. No disclosure can flag it because the
distortion lives in content that does not exist; every individual video can be disclosed, sincere,
and accurate while the aggregate picture is wrong.
**6.** (d) Persistence. Revenue share pays for as long as the subscription survives, which aligns the
creator with retention rather than merely with conversion.
**7.** **False.** A tag is evidence of a financial relationship, which predicts *which claims get made
and which go unmade* — not the accuracy of any particular claim. Sponsored content routinely contains
accurate claims; unsponsored content routinely contains inaccurate ones. Treating the tag as a
refutation is the genetic fallacy (item 19).
**8.** (b). It is an architectural fact, not a matter of will: watch time, completion, shares, and
transcript text are computable; the relationship between a claim and a literature is not in the file.
**9.** **Confidence, novelty, and personal narrative.** Chapter 5's hierarchy ranks all three lowest —
confidence disconnected from support, novelty preferred over replication, and anecdote in place of
controlled comparison. Over this feature set the optimization target and the epistemic target are
close to inverted.
**10.** (c) The qualifiers. Each cut shortens the sentence, raises confidence, and improves
performance, and no cut requires anyone to lie.
**11.** Because it never states a causal claim. It supplies a protagonist, a before, an after, and a
duration; the viewer assembles the causation. Nobody said the compound caused the change — the
sequence said it, and a sequence is not a sentence.
**12.** (b) Imprecision. A precise claim requires the precise noun; when the noun is penalized, what
circulates is a vaguer claim about a vaguer object, which is less checkable and less linkable to the
literature.
**13.** Because promotional speech is part of the regulated activity attaching to the approval. The
manufacturer is legally selling a regulated product, so its claims are tethered to the approved
label, must carry risk information with fair balance, and may not promote unapproved uses. Note the
irony the section draws out: the strictest rules apply to the entity holding the most evidence.
**14.** (c) The individual creator. That is precisely why drug-promotion law does not reach them and
general advertising and endorsement law does.
**15.** **True.** Promotional rules attach to an approval. A preparation with no approval has no label
for claims to be tethered to, so it falls back to general advertising law, which is far less specific
about efficacy claims for medicines.
**16.** (c) Supplements — a separate statutory regime permitting structure/function claims without
pre-market approval, prohibiting disease claims, and requiring a disclaimer.
**17.** Demand spike → shortage → legal opening → supply appears → demand must be manufactured →
opening closes.
**18.** (c). Evidence produced against the producer's own interest is the most structurally credible
category available, because every incentive was pushing the other way and it appeared anyway.
**19.** The genetic fallacy is rejecting a claim because of its source rather than its content. It is
the characteristic error of the newly business-model-literate because the tool is genuinely powerful
at predicting *which* claims appear, and it is tempting to promote it into a verdict on whether a
given claim is true — which it cannot deliver.
**20.** (c) Question 3, which asks at which step of the funnel the content sits. Retention content is
the least-noticed category: it looks like encouragement, education, or community, and its commercial
function is to prevent cancellation.
**21.** You have identified a **selection effect**, not a liar. You have not established that the
claim in front of you is false, that the creator is insincere, or that the product does not work. You
have established something about the process that generated the content you can see.
**22.** ❌ Hype outpaces evidence. Disclosure changes what the audience knows without changing what
the producer is paid to say, does nothing about content that was never made, and in experimental work
on advice-giving has sometimes increased rather than decreased compliance with conflicted advice.
**23.** The conflated endpoints are **"receives a prescription"** and **"receives appropriate,
guideline-concordant treatment."** Studies establishing increased treatment volume rarely establish
appropriateness. The rating would move on comparative studies using appropriateness and outcome
endpoints, with prescriber compensation structure and commercial integration recorded as variables so
the access effect and the volume effect can be estimated separately.
**24.** Rule 4 — *never downgrade with distaste* — here applied to sources rather than molecules. It
prevents the failure mode in which the business-model read becomes a rationalization engine:
interrogating the funding of claims you dislike while accepting congenial claims unexamined. The test
should cost you something roughly as often as it confirms you.