Twenty institutionalized epileptic patients participated in a study of a new anticonvulsant drug, valproate. Ten of the patients (chosen at random) were started on daily valproate, and the remaining 10 received an identical placebo pill. During an 8-week observation period, the numbers of major and minor epileptic seizures were counted for each patient. After this, all patients were "crossed over" to the other treatment, and seizure counts were made during a second 8-week observation period. The numbers of minor seizures are given in the accompanying table.17 Test for efficacy of valproate using the sign test at α = 0.05. Use a directional alternative.

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Placebo ValproatePatient pcriod Placebo Valproate penod number number 4 10