Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
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Question: Paragraph: Although the release doesn’t give actual costs of warfarin versus some of the newer drugs, or factor in the cost of the usual monthly blood testing required of those taking the drug, it does note the cost of the gene testing used for the study, and that the $200 price tag is now less than a month’s prescription of one of the newer anti-coagulants on the market. The release gives results in both actual numbers of patients and the percentage of reduction of adverse events in those given the genetic test and a comparison group. Although it does so in general terms, the release covers the essentials: the risk of using blood thinners like warfarin and the risks of not using them. The release offers a good description of the design of the study. It was randomized and enrolled more than 1,600 older patients at high risk of blood clots following surgeries. The release explains that one group received warfarin dosing based on standard factors (age, height and weight) and the second group was dosed using these clinical factors plus their genetic variants. The release also offers a detailed breakdown on how many fewer side effects occurred among patients had genetic testing completed compared to those who didn’t. No mongering here. Nicely done and quite complete. Although the release briefly mentions the availability of a “newer anticoagulant,” it should have included a sentence or two about these newer injectable drugs and their overall risks and benefits in comparison to warfarin. It would also have been helpful to tell readers whether the genetic testing that appears to play a role in safer warfarin dosing would have clinical relevance for informing the use of the new blood thinners as well. The fact is that genetic testing is irrelevant for the newer anti-coagulants because they operate in a completely different manner. But all the blood thinners — old and new — carry the same risk of bleeding. The problem with warfarin is the variability in blood levels which requires frequent monitoring, hence the genetic tests to guide dosing. The careful reader will get it: testing for these genetic variants is still an experimental practice for the most part, and further testing of how the mutations affect warfarin is needed. But the release could have been more explicit in saying that no one is yet recommending genetic testing for millions of warfarin users. While the genetic tests are “available” in the sense that anyone can order them for the most part, they are not routinely used clinically and probably wouldn’t be covered by insurance so in that sense they are not widely available to most people. The release describes how the genetic test used in the new study differs from previous similar studies. Overall the language is careful and contextual. The headline should have been toned back a bit to note that this is early research and more study is needed before concluding that “Genetic testing helps set safe dose of common blood thinner,” as the headline now states. Claim: Genetic testing helps set safe dose of common blood thinner

Answer: This news release describes results of a study designed to learn whether testing for the presence of three gene variants could make dosing with the blood thinner warfarin safer for patients given the drug to prevent blood clots after joint replacement surgery. The study found a modest reduction in the risk of bleeding or clots (from over- or under-dosing) in those whose regimens were developed in part by genetic testing for the variants, compared to those whose doses were calculated without the genetic testing. The release does an overall good job in describing the study, its purpose and design; and in quantifying the results. It could have been even stronger if it had included more information about newer alternatives to warfarin that are growing in use and an explicit statement that no one is yet recommending routine genetic testing for the variants based on this study. And although the headline somewhat over promises clinical benefit at this point in time, thoughtful readers will come away with a decent understanding of the context of the research and its potential impact. Some estimates put the number of Americans regularly taking the clot-preventing blood thinner warfarin and several newer anticoagulants at more than six million. Warfarin (sold under the brand name Coumadin) requires frequent blood testing to address risks of overdoses (and potentially lethal bleeding) and under-dosing (ineffective prevention of strokes and other blood clots). Because warfarin is cheap, and its effects are reversible with vitamin K, research designed to make it easier and safer for patients to take is likely to be highly newsworthy for them and their caregivers.


Question: Paragraph: We’ll rule this not applicable because, in general, most people have ballpark knowledge of how much chocolate costs. The story did not mention that dark chocolate is typically more expensive than milk chocolate — especially for the premium brands with very high concentrations of cocoa solids. A brief explanation would have been helpful. The story went the extra mile here, providing the absolute rates of stroke seen in the groups consuming the lowest and highest quantities of chocolate. “Among those with the highest weekly chocolate intake — more than 45 grams — there were 2.5 strokes per 1,000 women per year. That figure was 7.8 per 1,000 among women who ate the least (less than 8.9 grams per week).” These statistics weren’t provided in the study text, suggesting that the writer made the calculations based on data contained in one of the study tables. We applaud the extra effort made to provide meaningful statistics to readers! Close call here, but the story goes a step further than WebMD when discussing the possible adverse effects of consuming too much chocolate. In addition to warning that chocolate has a lot of fat, sugar and calories, it explicitly notes that eating too much of it “could be counterproductive.” WebMD offers no comparable warning and suggests that eating more chocolate than was consumed in this study would result in similar health benefits. This story was much more cautious in its depiction of the findings than the competing WebMD coverage. Most important, it was careful to explain high up that the study found only a correlation between chocolate intake and lower stroke risk. As one of the study authors explains: “Given the observational design of the study, findings from this study cannot prove that it’s chocolate that lowers the risk of stroke.” We also appreciate the story’s more nuanced language regarding which constituents of chocolate might be responsible for possible benefits. Whereas WebMD states unequivocally that flavonoids and antioxidants “deserve the credit” for these benefits, Reuters says more judiciously that  flavonoids “may be responsible for chocolate’s apparent effects on health.” [Emphasis ours.] “Whether that theoretical benefit translates into real-life benefits remains to be proven by rigorous studies, however,” Reuters appropriately adds. There was no disease-mongering. This was the only major shortcoming — no independent perspective. An expert in epidemiology might have pointed out, for example, that the data on chocolate consumption were collected from subject self-reports, and therefore should be viewed cautiously. The availability of chocolate is not in question. The story appropriately notes that there is a stronger statistical association with dark chocolate as opposed to milk chocolate. The story notes that previous research has linked higher levels of chocolate consumption with improved heart health. The story includes comments attributed to a direct email from one of the study authors, so we can confirm our overall impression that this story wasn’t based on a press release. Claim: Chocolate lovers have fewer strokes, study finds

Answer: Starting with the headline, this story is careful to explain that the study observed fewer strokes in those who ate more chocolate; it doesn’t suggest that the chocolate prevented strokes. It also features excellent use of statistics, a more explicit description of potential harms, and mentions alternative approaches to prevention. The only major shortcoming was a lack of an independent perspective on the findings. Some journalists may balk at our insistence that stories about observational studies include appropriate discussion of the limitations of the evidence. In only 378 words, this story provides another example that this can be done – and it doesn’t require the length of a full medical journal article to do so.


Question: Paragraph: The Southeast Asian island nation, which is under partial lockdown to try to curb a recent surge in infections, also reported its ninth death from the disease. A large number of the new cases are linked to outbreaks in migrant workers’ dormitories. Singapore has quarantined thousands of workers in dormitories after they were connected to several cases of the COVID-19 respiratory disease. To date, a total of 586 people have fully recovered from the infection, the health ministry said. Claim: Singapore confirms 386 more cases of coronavirus in biggest daily jump.

Answer:
Singapore’s health ministry confirmed 386 more cases of coronavirus infection on Monday in the city-state’s biggest daily jump, taking its total to 2,918.