TASK DEFINITION: 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.
PROBLEM: Paragraph: Dr. Chris Baumert, a family physician at RiverStone Health, told the Billings Gazette there’s been a steep increase in the number of cases of syphilis, gonorrhea and chlamydia. The U.S. Centers for Disease Control and Prevention has labeled the threat of antibiotic-resistant gonorrhea one of the nation’s most urgent public health threats. The rate of gonorrhea cases in the United States has increased 75.2 percent since the historic low in 2009. Montana officials are projecting more than 1,000 cases of gonorrhea in the state this year, compared to 867 in 2017. ___ Information from: The Billings Gazette, http://www.billingsgazette.com Claim: STD cases increase in Montana.

SOLUTION: Health officials say cases of sexually transmitted diseases have increased in Montana.

PROBLEM: Paragraph: There is no discussion of cost in this release. The journal article says several institutions refused to provide their prices. Nevertheless, the high cost of robotic surgery is an important issue. The researchers wrote they were unable to say whether those high costs might be offset [or not] by certain potential benefits (such as shorter hospital stays), but the release should have at least acknowledged the cost issues. The release does report the percentage of patients in the robot-assisted and open surgery groups that were still alive with no signs of disease progression two years after their procedures: 72.3 percent of patients in the robotic surgery group compared with 71.6 percent in the open surgery group… and it notes the difference was not statistically significant. It also reports that the robot-assisted surgery patients checked out of the hospital after six days on average, compared to 7 days for those in the open surgery group. The release reports only half as much blood loss in the robot surgery group, but does not report the amounts, which averaged 300 mL in the robot-assisted group vs. 700 mL in the open surgery group… that’s a difference of less than one pint. The release reports that patients who had robot-assisted surgery spent more time in the operating room than those having open procedures (seven hours vs. six hours). It also reports overall rates of adverse effects (67 percent in the robot group vs. 69 percent in the open group), along with listing the most common problems: urinary tract infections and intestinal obstructions. It would have helped if the release had pointed out that these complication rates were not statistically different. In a way, the release is satisfactory and yet maddeningly unsatisfactory. It tells readers that the study was a randomly controlled trial with 350 patients, but it buries the most important point: that the ability of these researchers to do this sort of rigorous trial comparing robot-assisted surgery with open techniques highlights how few such trials are done. Deep in the release, the researchers are quoted as saying the findings “underscore the need for further high-quality trials to assess surgical innovation before this surgical technique is widely adopted in clinical practice” and further that “It is important to conduct these trials before widespread adoption of technology, as has been the case with robotic prostatectomy (removal of the prostate).” The quality of the evidence should have been the lead. The release does not exaggerate the prevalence of bladder cancer. It does not push treatment on those who are unlikely to benefit. The release could be interpreted as promoting a newer more expensive form of therapy that doesn’t provide any advantages over the standard therapy. Although the release reports that the study was supported by the National Cancer Institute, it fails to note the financial disclosures several researchers made about money they have received from companies relevant to this study. The comparison of robot-assisted to open surgery was the main point of the release. The release makes clear that both techniques are available… including at the institution that issued the release. The release could have informed readers that, according to the published paper, that all of the operators in this study had done at least 10 robot-assisted cystectomies before being allowed to participate in the study. When widespread adoption of the robot-assisted procedure occurs, it would be possible that many surgeons would not have completed that many robotic cystectomies. While the release does tell readers that what is really new here is the use of randomization to compare robot-assisted surgery to open surgery for bladder cancer, it manages to bury that lead so deep under the poorly worded description of the results of this non-inferiority trial that the thrust of the release is unsatisfactory. The release doesn’t employ unjustified, sensational language. Claim: Robotic surgery as effective as open surgery for bladder cancer

SOLUTION: This news release about a trial that randomly assigned people with bladder cancer to either robot-assisted or open surgery buried the real news under a weak lead that garbles the findings. The news here is that, contrary to assertions of many proponents of robot-assisted surgery, it is possible to randomize patients in order to get a valuable comparison instead of relying on weaker study designs that can’t answer the fundamental question about how old and new techniques compare. The release is rated as satisfactory on many criteria because key information was included in the body of the release, but the headline proclaiming that robot surgery is “as effective” as open surgery misses the larger point. The headline and lead also put a pro-robot spin on the results, which could also be summarized as robot surgery is “not clearly worse.” Also not explained: robot-assisted surgery is more expensive. The final sentence of the release, a quote from a researcher, should have been the lead: “It is important to conduct these trials before widespread adoption of technology, as has been the case with robotic prostatectomy (removal of the prostate).”  We are bombarded with releases and news stories trumpeting results from studies of robot-assisted surgery that don’t actually compare the new technology to existing practice. These studies often lack any control group or use historical data that may not be truly comparable. The promoters of expensive new devices then claim that they are relying on the best available evidence. This trial shows better evidence can (and should) be gathered. And in this case, good quality evidence indicates little difference in the techniques, despite what all the big hospital billboards about robot surgery proclaim.

PROBLEM: Paragraph: "No mention of costs, but given the comparison with other medications and acknowledgement of multiple sources to obtain the product, this is a relatively minor concern. The story clearly describes the impact of the therapies on a tangible outcome: the difference in the number of hot flashes or night sweats women in each group had each day. There is no mention of the possible harms of any of the herbal treatments; the statement by a researcher who led the study that they are 'safe' goes unchallenged. Story does a reasonable job of explaining the study that was done, but does not mention whether women knew which group they were in (that is, were they randomly assigned and blinded as to which therapy they received). None noted. The story identifies both the source of funding for the study and the two investigators who are quoted. An expert who was not involved in the study also commented on the findings. Other options for managing hot flashes and night sweats are mentioned, as well as how the role of traditional hormone therapies has shifted in recent years. The story says black cohosh is ""available in pill or liquid form and is sold over the counter in many health food stores and over the Internet."" It's clear from the context that the herbal remedies are not novel approaches. The story does not appear to have relied solely or largely on an a news release, and included input from an independent researcher." Claim: Menopause Study Disputes Herb Treatment

SOLUTION:
This story clearly and accurately summarizes the results of the recent trial concluding that common herbal therapies are no better than placebo at relieving menopausal hot flashes and night sweats. Especially commendable is the inclusion of the actual difference in the number of hot flashes or night sweats women in each study group experienced per day. Readers can easily understand and use information about the absolute difference in outcomes. Failure to mention the costs and any side effects of the herbal therapies are relatively minor criticisms of this otherwise high quality story.