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.

Q: Paragraph: Employees of Novartis Pharma K.K. (NPKK) transferred some data from research centers to a Tokyo hospital when that data should have been sent directly without first passing through Novartis hands, according to a report by Japanese broadcaster NHK that was picked up by the Wall Street Journal. “NPKK is currently investigating the allegations,” Novartis said in a statement. The data was from a not yet fully enrolled 55-patient trial testing the Novartis cancer drug Tasigna, the company said. “Novartis Pharma K.K. is aware of the media report regarding a small investigator-initiated clinical study ... conducted to assess side effects in patients with chronic myelocytic leukemia,” Novartis said in a statement. “NPKK has conducted employee trainings on proper protocol related to investigator-initiated clinical studies and believes that any involvement of our medical representatives in investigator-initiated clinical studies is inappropriate.”  The University of Tokyo Hospital said it was re-examining test results it had received but had uncovered no evidence that Novartis employees had manipulated any of the data during the transfers, according to the Wall Street Journal report. Claim: Novartis employees may have violated trial protocol in Japan.

A: Swiss drugmaker Novartis said on Friday it was looking into a report that employees of is Japanese unit may have violated clinical trial protocol by handling data from a small independent study of one of its cancer drugs.
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Q: Paragraph: Costs are mentioned reasonably early in the story, and with specificity. This was good to see. Benefits of these tests are touted, but not quantified. An officer of the National Ovarian Cancer Research Fund Alliance, an advocacy group, testifies that the outcomes of women who have surgery from a gynecologic oncologist “are much better.” But we don’t know what that means. Is it longer survival? Later the story explains that combining the two blood tests with assessment by a clinician “better determined the patients who should be referred to a [gynecological oncologist], identifying well over 90 percent of the women who actually had cancer.”  (Note that this statistic reflects only referral to a gyn-onc, not patient survival.) But how does that compare to the standard assessment tools? A 2016 study described as publication “of the first clinical utility data” demonstrating that use of OVA1 resulted in referral of ovarian patients to gynecologic oncologists offers similar outcomes but is not mentioned in the story. We’re told that experts fear that these tests could lead to unnecessary surgery or delayed diagnosis, and that’s sufficient for a Satisfactory rating. The story could have delved into a bit more of the specifics: What is the evidence for these concerns? What are the false positive and false negative rates? These details are useful because the point of the story is that clinicians are not using these tests to try to improve outcomes of ovarian cancer patients. Are the possible debits–or uncertainties driven by lack of clinical data–contributing to these decisions? There isn’t sufficient information on the evidence behind these tests. The FDA has approved ROMA and OVA1 for use, but the studies that led to that decision are not discussed. Nor is there sufficient discussion of why the physician groups that write guidelines haven’t endorsed the tests. Their concerns are raised, but the evidence is not presented or analyzed. A late diagnosis of ovarian cancer is way too common, and the outcome is grim. At the same time, the anecdotes seem to highlight the sad aspect of the disease without necessarily providing a relevant case in which the tests described would have helped (any more than a basic blood test would have). The companies responsible for developing and marketing these two tests are front and center in this story, with scientists affiliated with the companies clearly identified. At least two sources in the story—one of them a scientist affiliated with the National Comprehensive Cancer Network—appear to be independent of the companies. The story makes it clear that no effective early detection screening test exists. Existing strategies—the CA125 blood test and vaginal ultrasound—are mentioned and then discounted, in part via a personal narrative of a young woman who received a late diagnosis of cancer. While data-driven specifics aren’t included on why standard methods aren’t sufficient, this is enough to rate Satisfactory. A direct comparison of survival stemming from existing diagnostic tests relative to survival stemming from ROMA and OVA1 would have strengthened the story. If those numbers aren’t available, that should have been pointed out. The story makes it clear that the two blood tests have been available since 2009. The story mentions that the tests are combinations of existing tests with a “proprietary” formula (essentially a risk prediction tool) to translate the results to likelihood of cancer. But, the article should have talked about whether the tests, other than CA-125, have been used before. This appears to be an enterprise story, and does not rely on a news release. Claim: Ovarian cancer blood tests: Available, not widely used

A: This is a story about the apparent underuse of two blood tests—ROMA and OVA1—that are FDA approved to help clinicians decide whether surgery to investigate abnormal growths should be performed by a gynecologic oncologist (“gyn-onc”) trained to remove malignant ovarian cancer, rather than an obstetrician-gynecologist or a general surgeon. The gist of the story is that the tests have not been widely adopted in the ensuing years, “largely because they haven’t been recommended by the physician groups that write the care guidelines.” The story hit on a lot of important notes–it told readers the cost of these tests, and it included comments from independent sources. What is not clear is the extent to which clinical evidence supports the increased use of the two tests. We’re told they accurately picked up about 90 percent of cancer cases. But we’re not told how that compares to standard methods of detection. As the story notes, surviving ovarian cancer is an uphill battle–it is often a deadly disease caught too late. Any procedure that increases the probability of survival is worth careful consideration.
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Q: Paragraph: “In Chinese tradition, a girl and a boy means good, perfect,” said the mother, who requested anonymity. “There’s nothing wrong with girls, but in Hong Kong and Chinese tradition all families like boys.”  The mother is one of hundreds of women from mainland China, Hong Kong and Australia who visit Bangkok each year for in vitro fertilization (IVF) with the option of choosing the child’s gender by discarding fertilized eggs, or embryos, of the unwanted sex. The only other countries where the technique is permitted and available are the United States and South Africa - in both cases at a higher financial cost. The dozen or so clinics that offer the service in Bangkok say it gives parents the chance to “balance” the genders in their growing families, but medical authorities want the practice banned. The Medical Council of Thailand, an independent agency that supervises the country’s medical system, says it could encourage embryo trafficking. Still, its efforts to stop IVF gender selection have been complicated by a number of factors. It has no powers to prevent clinics providing the service because there is no law governing its practice in Thailand. Despite years of lobbying, the issue has remained low on the list of political priorities for successive governments – a point underlined by Thailand’s latest political upheaval and military coup. In standard IVF practice, a woman’s eggs are removed and fertilized before being returned to the womb. In gender selection IVF, only embryos of the desired gender are implanted, a practice mostly shunned amid concerns about couples making a choice on the right to life based on gender. “Sex selection for non-medical reasons is not encouraged, but neither is it prohibited in the U.S., according to the latest guidelines,” the American Medical Association says on its Website. As in Thailand, South Africa currently has no legal provision governing the technique. The business is estimated to be worth about $150 million last year, according to one Hong Kong agent who organizes gender selection packages. Demand is growing about 20 percent a year, some Thai providers told Reuters, with the number of clinics rising to meet it. With parliament dissolved since last December and an army government now in power, calls for legislation remain in limbo. Thailand’s Health Ministry referred questions to the Royal Thai College of Obstetricians and Gynaecologists, the only agency in the country which gathers specialized information about IVF treatment. Prof. Clin. Wiboolphan Thitadilok, president of the college, said the agency is working on a fresh set of recommendations on IVF treatment in general. “We have worked to put this issue into law for more than 10 years” she told Reuters. “It’s not an issue that politicians will pay much attention to.”  Thailand now has 44 IVF clinics in total, with seven new facilities opened last year and two or three applications for new clinics being submitted every month, according to the college. The Asian country has become the go-to destination for Chinese couples not willing to leave the gender of their baby to chance. They pay fees that can run close to $30,000 in some cases for packages including a cycle of treatment lasting two to three weeks. Alfred Siu Wing-fung, a Hong Kong agent selling Bangkok gender selection packages to about 200 Chinese couples a year, said as well as people from poorer rural areas his business, Eden Hospitality, had strong demand from wealthy professionals wanting certainty about their offspring. Siu estimates about 10,000 gender selection cycles were carried out in Bangkok last year, at an average cost of $15,000 per treatment. While medical equipment and drugs are imported, clinics are staffed mostly by Thai doctors and nurses trained overseas. He offers two packages: 280,000 Thai baht ($8,700) for a basic service including flights and accommodation, and 900,000 baht ($27,800) for VIP treatment, including nannies and catering. Interest is growing in Australia, where gender selection treatment is unavailable. Dr Robert Woolcott, director of Genea Ltd, the third-largest IVF company in Australia, said Genea routinely recommends that couples wishing to choose the gender of their baby visit Bangkok’s Superior A.R.T. (for Assisted Reproductive Technology), a clinic it partly owns. Overall, Australians numbering “in the hundreds per year” travel to Thailand for gender selection, Woolcott told Reuters. Back in Hong Kong, the mother, now 28 with a healthy 18-month-old son, is planning for her third child. She probably won’t go back to Bangkok. “I think the third one should be natural,” she said. ($1=32.3500 Thai Baht) ($1=1.0639 Australian Dollars) Claim: In Thailand, baby gender selection loophole draws China, HK women to IVF clinics.

A:
At 26, with a baby daughter, a Hong Kong mother and her husband wanted a second child. To make sure it would be a boy, they paid $9,000 and flew to Thailand, the last place in Asia where gender selection treatment is available and breaks no law.
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