instruction:
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.
question:
The story says the federal government is paying about $2,250 per patient for a standard 5-day treatment course. It also notes that the approved alternative treatments are less expensive. The story points out that the benefits of peramivir have yet to be proven and that it is being offered only because some patients are not helped by approved drugs or are they are so sick they need a drug that can be given intravenously. The approved antiviral drugs are currently available only in pill or inhaled form. The story should have mentioned the side effects seen in clinical trials so far, as well as the risk that patients could suffer harms like those sometimes seen in people who have been given similar antiviral drugs. These side effects are clearly spelled out in an FDA fact sheet prepared for patients and caregivers: “The most common side effects of PERAMIVIR are: • diarrhea • nausea • vomiting • white blood cell count decreased These side effects may go away after you stop receiving PERAMIVIR. These are not all the possible side effects of PERAMIVIR. Peramivir is still being studied so it is possible that all of the risks are not known at this time. Other medicines that are used to treat people with 2009 H1N1 flu have side effects that may also happen in people who receive PERAMIVIR. These side effects include: • Signs of unusual behavior. People with the flu, especially children and adolescents, may be at a higher risk for seizures, confusion, or abnormal behavior early in their illness. These events may happen after starting PERAMIVIR or may happen if the flu is not treated. These events are not common. Patients should be watched for signs of unusual behavior. • Allergic reaction or severe rash Not a lot of people have taken PERAMIVIR for 5 days or longer. Serious and unexpected side effects may happen. The side effects of getting any medicine by vein are brief pain, bleeding, bruising of the skin where the needle enters, soreness and swelling at that spot, and possible infection at that spot.”  Patient fact sheet available at: http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM187799.pdf Provider fact sheet available at: http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM187811.pdf The story points out more than once that peramivir is still being tested and that questions remain about its potential effectiveness. The story points out that the experimental drug is being offered only to patients who are already in the hospital and aren’t being helped by approved drugs. The story did not point out that one of the supporters of faster and broader access to peramivir, Dr. Richard Whitley, has long been a booster of the drug, which is being commercially developed by a spin-off of the University of Alabama department he works in. See Whitley comments in a 2005 article promoting the potential of peramivir: http://main.uab.edu/show.asp?durki=87834 Here we also point out that the story profiled only one patient and includes a quote from the patient’s father crediting peramivir with saving his daughter’s life. The story does not give any examples of similar patients who either survived after getting approved drugs or who received peramivir and yet did not survive. Despite the clear caveats in the story, the reliance on only a single anecdote may give readers a skewed sense of the benefits of the unapproved drug. The story makes clear that the approved antiviral flu drugs are Tamiflu and Relenza. The story makes very clear that peramivir is experimental and is being offered only because some patients cannot take or aren’t helped by approved antiviral drugs. The story is quite clear that peramivir is still being tested. The story does not appear to rely on a news release.
answer:
New Drug for H1N1 Flu Offers Hope


question:
The story does not talk about costs, which was disappointing. The costs of intensive medical therapy can easily be identified. Using an online pharmacy we calculated the costs to be about $1,500 to $2,000 annually for medical therapy, using generic drugs. Using the Health Care Blue Book, we found the average cost of coronary artery bypass sugery and hospitalization to be about $62,000. We think that this is important information for readers that should have been included. The quantification here was presented in such a way to make it clear to readers that there was no significant benefit found to surgical intervention, which is a fair conclusion to draw from the study. The story says, “In the Stich study, 41% of patients assigned to treatment with drugs alone died during the follow-up period, which averaged five years. That compared with a mortality rate of 36% among patients who received bypass surgery plus medication. Although the relative reduction in risk of death was 14%, the result didn’t meet tests for statistical significance, meaning it could have resulted from chance alone.” That’s a great way to describe the lack of statistical significance. It would have been even more powerful to show readers the actual number of patients who died in each group. The story provides great information about the study itself and about the overall state of the evidence supporting heart surgery. “How best to treat these patients has been fraught with uncertainty,” is one of the more notable phrases from the story. It also says, “Many patients aren’t evaluated for heart surgery to treat diseased arteries because they don’t suffer classic chest pain or because doctors worry that hearts weakened by heart failure won’t benefit from the procedure. Other doctors recommend immediate bypass surgery despite a lack of vigorous studies to support that strategy.” The story does not engage in disease-mongering and takes a very careful approach to describing the types of patients who would be affected by this study’s results. We also like the way they provided snapshots of patients who were in both arms of the study — surgery and non-surgery — at the end of the story, making it clear, as the study did, that both routes can be equally successful. The story brings in some strong independent voices who help make sense of this complicated study: James Fang, a cardiologist at University Hospitals Case Medical Center in Cleveland, who wrote an editorial accompanying the study, Raymond Gibbons, a cardiologist at the Mayo Clinic, and Clyde Yancy, chief of cardiology at Northwestern University’s Feinberg School of Medicine. Rarely do you see a story that spends as much time with independent experts as it does with the authors of the study. The story does a great job showing how the standard interventions for heart disease stacked up against each other in this study. We wish that some mention had been made of diet and exercise and that at least a sentence had been included about whether there might be differences in outcomes seen as a result of different medication patterns. The story doesn’t make it clear what exactly the patients were taking. The story makes it clear that the range of treatments studied by the authors are widely available. The story makes it clear that there is a great need for more evidence in this field and that this study will be surprising to many clinicians because of a long-held assumption that surgery is the superior option. tudies published in the early 1990s supported the view that bypass surgery provided a better long term outcome. The story does not rely on a news release.
answer:
More Options Before Bypass Surgery, Study Finds


question:
The story does not mention the cost of oral food challenges. That’s too bad because the economics of food challenges are part of the overall newsworthiness of the procedure, although it was not a focus of this particular study. Considering that oral food challenges take three to six hours and require multiple staff to provide adequate supervision, families with inadequate or no insurance may not consider looking into the time-consuming procedure. However, families of patients on special diets spend thousands of extra dollars per year on groceries. Prior research suggests that in the end, having a food challenge earlier rather than later could save money for children assessed as low risk. The story provides the percent of patients who were categorized as having no response, mild allergic response, and anaphylaxis. Because this wasn’t a randomized controlled trial, those numbers summarize the important findings of the study. As the story explains, patients who experienced either mild or serious allergic reactions to the oral food challenge were treated with antihistamines or epinephrine respectively. For the 86% of patients who passed their food challenges with no adverse reactions, no harm was involved. This story is based on a study in which data were obtained via a physician survey in five food allergy centers across the United States. The researchers used a statistical procedure called meta-analysis to pool the proportion of reactions and anaphylaxis. The fact that this study used secondary data generated between 2008 and 2013, and that the data came from clinical records rather than controlled trials isn’t a bad thing, but it should have been mentioned in the story, as well as the limitations that stem from this kind of research (all research has limitations). No disease mongering is present in the story. Severe food allergies can be life threatening, but the story focuses on the daily experience of children who live with them. The story cites one expert not involved in the research, and we could find no potential conflicts of interest that should have been disclosed. The independent source provided a quote that we wished had been explored more in-depth: “But it’s also possible [some of them] never truly had a food allergy.” This is an important point–how much did the study help actually overturn incorrect diagnoses? In one sense, the only alternative to having an oral food challenge is not having an oral food challenge, and possibly not discovering that a child has grown out of an allergy. That issue is covered in this story. Another important point is that skin prick tests have been found to produce misleading results in a large proportion of patients. There is a growing conviction among researchers and practitioners that the only way to confirm beyond doubt that an individual has a food allergy is to conduct a food challenge. That alternative was mentioned in the story, but more emphasis would have presented a fuller picture of the significance of the study findings. The story doesn’t discuss how easy it is to find an allergy clinic that does oral food challenges, but it does refer parents to allergists for further discussion. The study on which this story was based is described by the researchers as being the largest national survey of allergic reactions of clinical open oral food challenges in a nonresearch setting in the United States. The story doesn’t note this, making it unclear what’s novel about the research. The story quotes one outside expert, so it appears not to rely on a news release.
answer:

This Test Can Determine Whether You've Outgrown A Food Allergy