instruction:
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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Paragraph: The news release includes information about costs. We would have liked a little more context. The release states: “The costs associated with home infusion were also consistently lower than services provided in a health care facility, with savings ranging between $1,928 and $2,974 per course of treatment.” We need to know what percentage of savings that is per course of treatment. If the whole course costs $100,000, then saving $1,928 is a pretty small percentage. If the whole course is $10,000, than a savings of $1,928 looks more substantial. We found the news release skimmed over giving crucial numbers and metrics for benefits. Separate from the cost benefit to home infusion versus hospital or clinic infusion, the release should have given us some numbers for safety. Here is what the release stated (emphasis ours): “The research showed that patients receiving intravenous therapy at home had as good or better clinical outcomes as those patients who received the same therapy in a traditional health care setting. In addition, patients overwhelmingly preferred receiving their infusion therapies at home, reporting fewer disruptions in personal schedules and responsibilities. We need numbers to demonstrate how “as good” the clinical outcomes were. We need numbers to represent “overwhelmingly preferred.” By what percentage did what number of patients demonstrate preference? This is where the release could have taken some quantitative data from the study. The word “harms” does not appear in the news release. During intravenous infusions there are complications that may arise. The release does not mention harm, even to dismiss the probability as rare. The study being reported is a systematic literature review that only considered 13 prior studies. The release does not address the limitations of a literature review or give us the total number of patients represented by the 13 studies. Only 5 of the 13 studies used in the analysis addressed outcomes. One had no comparison group (“However, no adjustment for confounders was performed, and higher OPAT success rates were likely due to purposeful selection of younger, healthier patients for OPAT therapy,” according to the published study). In another study, “IPAT patients were selected from a time period during which OPAT was not available for any patients, minimizing selection bias by the matching fact.” In any case, less than half of the studies looked at outcome data and those that did involved different diseases from different time periods, some had control groups and some did not. We don’t think the evidence is strong enough to suggest outcomes were improved. The bias inherent in CVS employees culling the studies is also concerning. A better description of the review’s search and selection process may have helped allay any concerns about studies being cherry-picked. There is no disease mongering. The release is clear that the study was done by the CVS Health Research Institute. Since this is a news release from a profit-making company that operates directly to sell services under study, we hope the readers quickly understand there is an inherent conflict. This is the equivalent of a Coca Cola study about the benefits of drinking their product. The release explains the alternatives of clinic or hospital infusion compared to home infusion. Home infusion services are widely available. Their reimbursement is not widely available. The release says “clinical outcomes and quality of care have not previously been systematically evaluated.” The release doesn’t rely on any unreasonable or unjustified language. However, we do not think the news release proves the words used in the headline that say “Home Infusion Care Improves Patient Outcomes and Quality of Life While Reducing Overall Costs.” Based on a literature review, which does not randomize people into apples-to-apples comparison, you cannot claim to show better outcomes. The release does not offer any quantified benefits to support medical outcomes and doesn’t provide quantified information about quality of life improvement. The fact that patients prefer home infusion to travel to a clinic is not by itself a proof that their lives have been improved. As we wrote in the benefits section above — we are not given numbers to prove by what amount patients prefer home infusion. Claim: CVS Health Research Institute Study Shows that Home Infusion Care Improves Patient Outcomes and Quality of Life While Reducing Overall Costs
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This news release describes the cost savings and safety of home infusion services from 13 previously published studies compared with infusion services at a clinic or hospital. Home infusion appears safe and clinically effective while saving money in the studies reviewed, but the release does not address limits in the review. We aren’t given any numbers to back up the claims that clinical outcomes were equal and that patients preferred the home setting. The release notes that CVS has a home infusion business–Coram–so at least they make this transparent. We applaud CVS for attempting to quantify the cost savings and other potential benefits of the service — and the claim that there are advantages are likely valid — but some context/background from other, independent studies would be helpful. Besides the lack of quantification, the release doesn’t delve into the potential risks from using the home infusion service. Treatments for chronic diseases, which often require drugs administered through infusion, are one of the fastest growing costs in the US health care system. If patients can be served at home, rather than in outpatient clinics or hospitals, it saves both money and time. But outcomes studies, which compare outcomes and safety between locations, are essential to judging whether home infusion is equal to clinic or hospital infusion. This release does not go far enough with numbers to quantify benefits and risks. We also see that CVS has a conflict of interest, because they have a business arm, Coram, that sells home infusion services. It appears this release (and study) are getting attention just as Congress is “discussing how to implement a comprehensive home infusion benefit for Medicare beneficiaries.”


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Paragraph: The death toll increased by 683 on Wednesday. That was lower than a spike of 743 on Tuesday but more than the totals of the previous two days and the third highest daily tally since the outbreak emerged in northern regions on Feb. 21. Italy has seen more fatalities than any other country, with latest figures showing that 7,503 people have died from the infection in barely a month. The northern region of Lombardy, by far the hardest-hit, showed a steep decline in the number of deaths and new infections on Wednesday, raising hopes that the epidemic may be slowing at its original epicentre. However, optimism was tempered by warnings from the south, where contagion and deaths are far less widespread but are rising steadily, and could overwhelm a health service which is much less well equipped than in the rich north. “At this point there is the real prospect that Lombardy’s tragedy is about to become the south’s tragedy,” Vincenzo De Luca, president of the Campania region around Naples, wrote in an open letter to Prime Minister Giuseppe Conte. “We are on the eve of a major expansion of infections which may not be sustainable,” he said, complaining that the central government had failed to provide Campania with promised ventilators and other life-saving equipment. So far there have been 74 deaths in Campania, the worst affected southern region. The central region of Lazio, around the capital Rome, has registered 95 fatalities. The total number of confirmed cases in Italy rose to 74,386 from a previous 69,176, the Civil Protection Agency said. The rise of 7.5% was the lowest since the outbreak began, but only severely ill people are being tested and the head of the agency, Angelo Borrelli, said this week that the true number of infections was probably 10 times those officially recorded. Borrelli was not present at the customary news conference to illustrate the latest figures because he came down with a fever on Wednesday and was himself being tested for coronavirus. With Italy in lockdown for the last two weeks and its economy on its knees, Conte on Wednesday promised a second stimulus package in April worth at least as much as the 25 billion euro ($27.17 billion) one he adopted in March. With his approval ratings at record highs, the prime minister appealed to the opposition to get behind the government’s efforts and halt its attacks on his handling of the crisis until it is over. “There will be a time for everything, but now is the time for action and responsibility,” he told the Chamber of Deputies. One source of potential conflict for Conte was defused on Wednesday when the government reached an agreement with trade unions who had threatened strikes because they wanted more companies shuttered to protect workers’ health. Conte agreed to extend the production sectors that will be  temporarily closed because they are not deemed essential to the country’s supply chain. Claim: Italy coronavirus deaths pass 7,500 amid fears of spread to south.
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More than 680 people have died from coronavirus in Italy in the last 24 hours, the Civil Protection Agency said on Wednesday, as concerns grew that the disease was spreading more towards the south of the country.


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Paragraph: He Jiankui, associate professor at Southern University of Science and Technology in Shenzhen, attracted condemnation from the global scientific community when he said he had used a technology known as CRISPR-Cas9 to alter the embryonic genes of twin girls born in November. Chinese authorities launched an investigation into He’s work and said they had halted the kind of research he was undertaking. Under the draft laws sent to China’s legislature for review on Saturday, medical and human trials would face closer scrutiny and stricter requirements, such as ensuring human subjects are properly briefed, state media outlet Xinhua reported. The rules would also require all future trials to be approved by administrative authorities as well as ethical committees, it said. The report did not specify a timeline for the approval of the regulations, or make specific mention of He’s research. In videos posted online and at the November 2018 conference where He made his controversial presentation, He said he believed his gene editing would help protect the girls from infection with HIV, the virus that causes AIDS. Chinese authorities and institutions, as well as hundreds of international scientists, condemned him and said any application of gene editing on human embryos for reproductive purposes was against the law and medical ethics of China. Claim: Most Texans aren't millionaires.
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China’s top legislature will consider tougher rules on research involving human genes and embryos, the first such move since a Chinese scientist sparked controversy last year by announcing he had made the world’s first “gene-edited” babies.