Given a paragraph and a claim, classify it this way: If the claim contradicts the evidence present in the paragraph, classify the claim as '0'. If the claim has multiple supporting *AND* contradicting evidences, classify the claim as '1'. If the claim has supporting evidence and the paragraph is in overall favor of the claim, then classify the claim as '2'.

Paragraph: There is no mention of costs in the release, but overuse of medical technology such as MRI scanning is one major reason for soaring health care costs. According to personal finance website Nerdwallet.com, median prices of a brain MRI range from $525 in Atlanta to a whopping $3,310 in Milwaukee. The main contention of the news release is that “imaging findings can help spur beneficial lifestyle changes in patients to reduce risk for Alzheimer’s disease.” But there’s no evidence presented to show that these images have any effect — good or bad — on patients’ adoption of beneficial lifestyle changes. Does performing an MRI increase the likelihood that someone will lose weight, exercise, and stop smoking? The release also states, “institutions… meld these approaches into novel ways to improve patient care,” but the report doesn’t detail what those “novel” therapies are. Experts in the report talk about pinpointing “volume loss in the brain” and characterizing imaging markers, but these are all surrogate endpoints. In other words, how do these translate to tangible health outcomes for patients? Bottom line: The idea that a brain MRI is going to help motivate people to adopt meaningful lifestyle changes — and that those changes will, in turn, lead to an actual reduction in the number of Alzheimer’s disease cases — requires several leaps of logic that have very limited support from evidence. The release owed it to readers either to point out the preliminary nature of the hypothesis or provide some evidence to back it up. The release did neither. Procedures almost always carry risks, and MRI is no exception. Some physicians are concerned with “MRI abuse,” pointing out that MRIs often pick up abnormal – but harmless – findings that muddy up the clinical picture. These so-called “incidentalomas” can lead to more tests and treatments that cause harm and add to costs. Unnecessary imaging is a major contributor to spiraling health care costs in the US, since a single scan on average in the US costs $2,611, according to Medicare data. Beyond stating that it exists, this news release provides no information about the journal article that is the subject of the release. Nor does it detail any of the studies that supposedly support the value of imaging for Alzheimer’s disease prevention. We’d add that the journal article itself provides limited-quality evidence — it doesn’t detail the process for selecting articles that are included in the review (raising the possibility of “cherry-picked” studies) and includes little in the way of critical evaluation of the studies that are cited. Strangely, three physicians, who weren’t listed as authors of the study, are quoted in the release and allowed to tout the benefits of quantitative MRI technology. They make sweeping statements, such as that this technology “will have a huge impact in the future” and that imaging “can have a powerful impact [on patients]” But the report fails to go into detail. One of these experts adds, “Patients seem to enjoy reviewing results of their imaging studies, more so than reading the results of their blood tests or other clinical evaluations.” But one physician’s anecdotal observation is not evidence of enhanced quality or effectiveness of care. Again, supporting data is needed. The news release does not engage in disease mongering and states that as many as three million cases of Alzheimer’s dementia could be prevented with lifestyle changes. However, it does imply that there would be more cases prevented with the addition of brain imaging, a claim that is not supported by the release or the underlying review article. The release does not specify funding sources for the work, which included the National Institute of Biomedical Imaging and Bioengineering and the National Institutes of Health. Many of the authors are consultants for medical device and pharmaceutical companies, including Toshiba (cited as “related” or relevant in the original research report). The release does not disclose this. The main premise of the news release is that MRI imaging can help people lower their risks for cognitive decline by encouraging them to make lifestyle and behavioral changes. It states that risk factors include obesity, diet, sleep, hypertension, diabetes, depression and smoking. However, the release does not address any alternatives — besides brain imaging — that might help people make the desired changes. Behavioral change counseling, which is an established approach to reducing problematic behaviors, is not discussed. The release doesn’t address the availability of quantitative MRIs of the brain. MRI in general has been used since the 1970s, and its availability is not in question. But since the issue is not specifically addressed by the release, we’ll rate it Not Applicable. Using quantitative MRI technology to diagnose Alzheimer’s disease in its early stages is not a new concept. There have been blog posts and numerous studies in the past 10 years devoted to this topic. We’re not really sure what’s new here. The news release refers to “novel ways to improve patient care,” but does not specify what these new approaches are. The language of the release bordered on sensational, with neurologist Majid Fotuhi touting the benefits of quantitative MRI technology and claiming it will have a “huge impact in the future of diagnosis and treatment of Alzheimer’s disease.” The release never clarifies the how and why of this statement. Claim: Preventive neuroradiology: Brain imaging bolsters efforts to lower Alzheimer's risk
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Paragraph: Those candidates include Lauren Underwood, a 31-year-old registered nurse from Illinois and part of the Democrats’ master plan to regain control of the House. While Underwood is no fan of President Donald Trump, she said her No. 1 concern — and the top concern of the voters she hopes to will send her to Washington — is access to health care. Attacking the Republican president hard just isn’t necessarily a winning play in Illinois’ 14th congressional district, said Underwood, who served as an adviser to the Department of Health and Human Services under Democratic President Barack Obama. “I don’t talk about him that much. He has a higher approval rating than my congressman does, so we talk about our congressman,” said Underwood, who’s hoping to oust incumbent Republican Rep. Randy Hultgren in a district that narrowly backed Trump two years ago. Other Democrats aiming to flip House seats say they’re also trying to zero in on policy more than the president. The Democratic Congressional Campaign Committee has its hopes pinned on 50-plus candidates looking to upend enough seats — 23 — to wrest control of the chamber from the GOP for the first time in eight years. Republicans have their own plan to retain control, but Democrats are banking they have more than just both momentum and history on their side. U.S. Rep. Denny Heck is helping lead the effort to flip the House. The Washington Democrat said the Democratic Congressional Campaign Committee can assist candidates with a range of tasks — from tapping into a national donor base to aiding with the basic mechanics of building a campaign. But he warned that trash-talking Trump will get a candidate only so far. “What candidates ought to be doing is talking about that crowded freeway that they need to get additional funds to widen or additional funds to provide mass transit for, or that lake that is becoming polluted and they need the EPA to step up,” Heck said. Debbie Mucarsel-Powell is also on the “Red to Blue” list. Mucarsel-Powell, who came from Ecuador as an immigrant with her mother, said Florida’s 26th Congressional District — the state’s southernmost district — is one of the most vulnerable for Republicans in the country. She pointed to a 16-point win by Hillary Clinton there in 2016. The seat is currently held by Republican Rep. Carlos Curbelo. While Mucarsel-Powell doesn’t shy away from talking about Trump, she says she’s more focused on the struggles of local residents. “They don’t have access to health care. They don’t have good quality education,” she said, adding that tens of thousands depend on the Obama 2010 health care law that Republicans have worked to undo. Talk of a Democratic blue wave is overblown, according to Matt Gorman, communication director for the National Republican Congressional Committee. He said the committee — which has its own “Young Guns” program — is raising impressive sums and has battle-tested incumbents who know they’re going to be targets. Gorman said the NRCC is also urging candidates to run on local issues and not focus on the latest headlines on cable new or Twitter. He said polling shows the party is in better shape than many assume. “This is going to be a fight and certainly we’re going to work like we’re 10 points down as we do every day, but for the bedwetters out there who are claiming that all hope is loss I would encourage them to actually look at the data,” he said. “It’s simple math.” Democratic Rep. Katherine Clark, who is also heading up the DCCC’s “Red to Blue” initiative, said many candidates she’s been working with are more eager to dig into what’s on the minds of voters than taking swipes at Trump. “They’re not concerned with talking about Donald Trump as much as they are about talking about how people in their communities want their children to have job opportunities in the communities that they grew up in,” Clark said. While defeating Trump may galvanize the Democratic faithful, the party is still fumbling for a wider unifying message, according to Tobe Berkovitz, a Boston University professor and former political media consultant. And Democrats may have trouble finding issues, local or not, for voters to latch onto in November. “The problem is that unemployment is low, economic confidence is relatively high, so to tell people you’ve never had it so bad when compared to eight years ago they’ve got it pretty good, that’s sort of also a tough road to hoe,” he said. “The Democrats may have history on the side. The question is A, will they blow it? And B, is Trump such an anomaly that history is being rewritten?” Roxane Pirayesh, a 32-year-old from Sacramento, California, who works for an education nonprofit, said in the end, the pitch from Democrats has to be more than just an anti-Trump drumbeat — and she’s not sure everyone’s gotten the message. “I think that’s probably the biggest flaw coming out of the Democratic Party,” she said. Claim: Democrats hoping to flip House not just trash-talking Trump.
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Paragraph: Dr. William D. Parham will oversee the union’s new program designed to help members with mental health issues. The program will be headquartered in Los Angeles. NBPA Executive Director Michele Roberts says the union has “heard our players’ stories and are making mental health a priority now.” Earlier this season, NBA stars Kevin Love of the Cleveland Cavaliers and DeMar DeRozan of the Toronto Raptors revealed issues they’ve struggle with on and off the court. Love detailed his experience with panic attacks and anxiety. DeRozan talked about battles with depression. Claim: NBA players’ union hires director of mental health.

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