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:
This release makes no mention of the costs of the drugs compared in this study, even though the drugs have been in use for years and are widely available. Since the study is a comparison of various treatments for this form of cancer, it seems relevant to offer a cost comparison as well as a comparison of efficacy. It appears that the high dose methotrexate is given over a 24-hour period, presumably in the hospital, while the standard methotrexate is given as a single dose. Also, the high dose methotrexate is followed by leucovorin administration while the standard dose is not. According to the site GoodRx, the cost for methotrexate in low-dose (2.5 mg) pill form averages out to about $50 for a month’s supply. Newer, injectable variations of the drug cost upwards of $500 a month for the 25 mg dose. The release states that patients receiving high doses of the drug methotrexate “had a significantly better outcome, by 5 to 6 percent” than did patients receiving the current standard of care, which is gradually escalating doses of the drug. The release also explains that patients nine years old or younger who were also treated with a steroid called decadron (dexamethasone) for half as long as normal (14 versus 28 days) benefited from the treatment while patients 10 and older did not. We’re not sure of the meaning behind these results as portrayed in the release. Which outcome was better by 5 or 6 percent? The study has several. Does that mean the relapse rate was reduced or is it the event free survival that was better? It would be more meaningful to readers if the release had included the actual relapse and event free survival rates for each group analyzed in terms most people can understand. For example: “relapse rates were 5 percent lower in Group X compared to Group Y.” We’ll give this category a satisfactory rating largely due to the release including information that patients 10 and older receiving dexamethasone “were at much higher risk for a debilitating bone condition called osteonecrosis,” although we would have been happier if that greater risk would have been quantified. However, the published study explains that there were toxicity problems beyond that of dexamethasone and the release would have been stronger including that information as well. The release stated the study was randomized and controlled, and provides a broad overview of the study design, for which we give the release a borderline satisfactory under this criteria. However, these are the superficial results. On deeper delving into the study methodology, the statistical significances of the results were very close to not statistically significant. This is due to their planned interim stopping of the treatment and the fact that they were looking at multiple outcomes in multiple groups. This release doesn’t demonstrate disease-mongering. While the release does say that this clinical trial was run by the Children’s Oncology Group, which is funded by the National Cancer Institute and the National Institutes of Health, it makes no mention of possible conflicts of interest. Compounding that is the fact that the published study says, “Disclosures provided by the authors are available with this article at www.jco.org,” but that information is behind the journal’s paywall for most readers, so it’s unknown if there is, or is not, a conflict. It appears as though five of the authors (out of a total of about 20) have some conflicts of interest, mostly from several types of drug company payments. The release is comparing the efficacy of treatment regimens using different drugs so alternative treatments for B-acute lymphoblastic leukemia are noted. The release makes clear at the end that the treatment of this disease is improving thanks to refinement of the use of existing drug treatments, meaning that they are readily available for patient use. The release suggests the study findings could change the way childhood leukemia is treated. Modifying existing treatments to enhance a patient’s survival is certainly novel enough to warrant a release. There is no use of unjustifiable language in this release. However, the tone may be a bit overly optimistic given the study findings.
answer:
Relapses of childhood leukemia improve with high doses of common chemo drug


question:
The state Health Department says Tuesday that 42 days have passed with no new cases in Rockland. That’s the equivalent of two incubation periods and the timeframe when measles outbreaks are typically declared over. The nation’s worst measles epidemic in 27 years emerged a year ago, with most of the cases centered in Orthodox Jewish communities in Rockland and New York City. Health officials administered nearly 30,000 measles vaccinations in Rockland County as part of efforts to stop the outbreak. Over the summer, the state eliminated non-medical exemptions for measles vaccinations required for school children and tightened rules for granting medical exemptions.
answer:
Measles outbreak that sickened 312 in Rockland declared over.


question:
The story made no mention of costs, societal, personal, or otherwise. Benefits, or lack thereof in this case, were not quantified. Instead, the journalist reported that men who were alive were no more likely to be screened for prostate cancer than men who were deceased. But, the actual numbers of men alive and deceased were not provided nor the proportion who indicated they had been screened or not screened. The potential harms of screening are appropriately discussed, namely that screening could be wrong (false positive or false negative), could lead to further testing (biopsy), and that detection could lead to treatment which has serious side effects without knowing for sure whether the cancer would have harmed you in the first place. The observational study design is described to readers (e.g. that two groups were chosen during a particular time period and matched). IThe story also talks about limitations–that this is a small study and that this is not the final word on screening (presumably because study is observational and not a randomized clinical trial). The natural history of prostate cancer is appropriately reflected here — that is, that prostate cancer may not kill you or even cause problems because it is often slow-growing and that screening and early treatment may do more harm than good. It tells readers in the opening lines that there is an on-going debate about screening. The study co-author is quoted, but his relationship to the study is disclosed. Representatives from medical organizations that issue recommendations about prostate cancer screening were quoted as well, namely confirming the uncertainty of screening. A U.S. Preventive Services Task Force review from 2002 is also mentioned, further providing support for uncertainty of screening based on an objective review of the evidence. These sources also highlight that this uncertainty is not new. This story does provide information on the alternative to screening, in other words, not to be screened. Phrases such as “men should decide for themselves whether to get screened” and “for some men, detecting prostate cancer early can do more harm than good” appropriately develop the concept of not being screened compared to being screened. Disadvantages/advantages of screening and not screening are discussed (potential for downstream consequences, may not help men live longer, etc.). The story provides information on how long screening has been available. Likewise, it also states that these screening tests are performed millions of times each year in the U.S. The story states that results from study on prostate cancer screening are based on data from 24 through 129–the “early years of prostate cancer screening.” So, the story does tell us that prostate cancer screening is not new.
answer:

Study Questions Prostate Cancer Screening