E is wrong because of the word 'circumstances'. As I understand it, 'circumstances' refers to the facts of the situation: that there is no test to distinguish between the two diseases, that there is no treatment for disease X but there is one for disease Y, etc.
It doesn't refer to an assumption about what disease the patient might have, so saying that circumstances must change to fit the strategy (which is to assume Y) is wrong as it's not what the author is concluding.
Comments
E is wrong because of the word 'circumstances'. As I understand it, 'circumstances' refers to the facts of the situation: that there is no test to distinguish between the two diseases, that there is no treatment for disease X but there is one for disease Y, etc.
It doesn't refer to an assumption about what disease the patient might have, so saying that circumstances must change to fit the strategy (which is to assume Y) is wrong as it's not what the author is concluding.
that makes sense. thank you @"declan.pollard" !