Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
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Question: “I’d love to be in the bush, but I get more cases here,” said veterinary rehabilitation specialist Nicci Wright. Wright founded the hospital two years ago with veterinarian Dr. Karin Lourens and since then has treated about 4,000 animals. With the expansion of Pretoria and Johannesburg, South Africa’s capital city and its economic center, the animals indigenous to the region are being squeezed out by the rapid urbanization. The wildlife hospital mainly treats small mammals and raptors that are injured. There are about 160 animals on the small premises now, including half a dozen leopard tortoises, a toothless 12-foot python and an otter that was taken far from her natural habitat when someone tried to domesticate her as a pet. A Johannesburg resident arrives at the hospital, carrying a gray lourie in a cage made for much smaller domesticated bird. He found the large bird in the garden, attacked by his dogs, unable to fly after its tail and wing feathers were plucked out. Like in any hospital, nurse Alicia Abbott opens a file and transfers the new patient to a more comfortable setting so its treatment may begin. Most of the cages in the hospital are covered with towels to block the electric light from disturbing the animals. Along with physical injuries, many of them also suffer from trauma. Some species, like the endangered pangolin, show visible signs of post-traumatic stress disorder when they hear a male human voice or smell cigarettes smoke, a reminder of the poachers who hunt them, said Wright. “Everything is terrifying for them,” she said. In a wooden crate on the hospital floor, a juvenile pangolin begins to stir, scratching against the box. It is feeding time and a volunteer will walk him on a nearby hill where the pangolin, which is a scaly anteater, animal to search for ants. Pangolins are one of the world’s most heavily trafficked mammals because of demand for their scales in Asia. Another pangolin was recently sedated and checked by a sonogram scan to find that she was pregnant. Along with five staffers, the hospital relies on volunteers like Lauren Beckley, who lives nearby. Beckley cares for young primates like baboons and vervet monkeys, who cling to her after their own mothers have been shot or run over by humans. Other wildlife at the hospital include two newly born bush babies which are small nocturnal primates. One had been attacked by a cat and the other had fallen out of its nest. Once the animals are ready to return to the bush, Wright and her team work with nature reserves around the country to slowly introduce the animals into a new, safer, habitat.

Answer: Johannesburg wildlife clinic saves animals hurt in city.


Question: The story reports not only the cost of the blood test ($60), but the cost to detect one case (including follow-up), which the researchers calculated to be $28,600. This is excellent context. The story would have been better if it had noted that the people included in this study were at unusually high risk for developing this cancer. The 34 cases found after screening 20,000 people is almost 200 times the typical annual rate in the US and other countries (less than 1 per 100,000 people per year). The ultimate measure of cost is cost-effectiveness (cost per life-year saved) which requires survival data. These analyses can also be adjusted for quality of life. While most of this story is careful to note that this test has yet to show clinical effectiveness, that caution is trampled by the claim that this blood test “boosted patients’ chances of survival,” something that this type of study cannot determine. The claim that this test is more accurate than existing methods is also premature, since the study did not directly compare the blood test to existing methods. Finding more early-stage cancers is a necessary but hardly sufficient step in the pathway of demonstrating benefit for a new screening test. Clinical trials are needed to address issues of false positives, over diagnosis, over treatment, and survival. The story reports that developers of this blood test still need to show low rates of false positive or negative results. A low false negative rate means there are fewer missed cases of serious disease. The trade-off, though, is a higher false positive rate. All positive tests will need to be evaluated with a gold standard diagnostic test and the safety, acceptability, and costs of that gold standard test will profoundly affect the uptake of the new screening test. While the story reports that this study was a “proof-of-concept” experiment, it then says the test boosted survival, something that can only be known after directly comparing the new test to existing methods. Making treatment “dramatically more effective” can be proven only with randomized trials. All screening tests that can detect cancers at an earlier stage will be associated with an apparent increase in survival time, but as explained in more detail below, this does not necessarily mean that patients with screen-detected cancers actually live longer than they would have otherwise. Efficacy can be established only with an RCT. The story could have done a better job pointing out the many limitations in the work. For example, there was no follow-up testing for people who had negative blood test results. Even though the researchers surveyed participants a year after the testing, they didn’t produce any data on how many of the people with negative blood tests actually had cancer. What’s more, the researchers compared the survival rates of their patients to a different group of cancer patients from another study, which raises questions about how comparable the groups really are. There was also no discussion of the possibility that at least some of the tumors discovered through this screening might not have developed into dangerous cancers. The story does not address lead-time bias (that longer survival might be at least partly due to finding the tumor earlier in its natural course, rather than to just the effect of treatment). The researchers noted that the effect of lead time bias can only really be known through a randomized, controlled trial. We will rate the story satisfactory on this criterion because it is careful to note that this test is not ready for clinical use and that the study results apply to only one type of cancer. However, the story would have been better if it had pointed out just how rare this cancer is, less than one case per 100,000 people in the US per year. That is about 3,000 cases in the US per year — out of about 1.7 million cancers diagnosed annually. And the comment that the cancer “is prevalent” in southern China and Southeast Asia may be misleading. While it may occur more often in the region, rates are still on the order of 10 to 20 per 100,000 which is hardly widespread. The story squeaks by on this criterion because it includes a quote from an editorial in the journal that was written by an independent source. It would have been more useful to readers to include more comment and context from someone without financial ties to this study. The story is upfront about the financial interests of the researchers themselves and the company that owns the rights to their work, noting the keen interest in bringing this test to market. Although the story reports that “that nasopharyngeal carcinoma typically goes undetected until later on, when patients report symptoms such as recurring nosebleeds,” it does not tell readers anything about how often these cancers are found at an early stage. Readers are not given a sense of how patients typically fare with existing methods of diagnosis. The story clearly reports that the test is still experimental and that developers have yet to show that it could be practical and effective in clinical practice. The story highlights the desire for a new blood test that could be clinically useful. The story doesn’t appear to rely on a news release. It includes quotes from a telephone interview with an executive at the company developing this test.

Answer: Silicon Valley Startup Grail Sees Hope for Cancer Blood Test


Question: The final recommendations, issued by the U.S. Preventive Services Task Force and published in the Annals of Internal Medicine, apply to people aged 55 to 80 whose smoking has put them at high risk of cancer. That includes former heavy smokers who have quit within the past 15 years. Heavy smokers are considered to be those who smoked a pack a day for 30 years, or two packs a day for 15 years. According to a comprehensive review of medical evidence since 2004, the panel found the benefits of screening high-risk individuals with low-dose computed tomography, or CT scans, outweigh the potential harms of overdiagnosis and increased exposure to radiation, which also contribute to cancer risk. The panel, which is comprised of independent experts and advises U.S. policymakers, gave the screening a “B” recommendation, meaning it is at least moderately certain that the benefits of the scans outweigh the harms. Under the Affordable Care Act, insurers are required to cover preventive services with a grade of “B” or higher. The guidelines are intended to help prevent some of the 160,000 annual lung cancer deaths in the United States, which exceed the total number of deaths from breast, prostate and colon cancer combined. Smoking is the biggest risk factor for developing lung cancer, resulting in about 85 percent of lung cancers in the United States. The guidelines largely fall in line with recommendations from most major groups of cancer experts, including the American Cancer Society and the American Society of Clinical Oncology. When the initial recommendations were published in July, some doctors expressed concern that the guidelines could lead to overdiagnosis and overtreatment of cancers, in much the same way that widespread screening programs for breast and prostate cancers have done.

Answer:
Some current, former smokers should get annual lung scans: US panel.