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: Not applicable. The cost of olive oil is not in question. This story did the best job of the three stories we reviewed in quantifying the potential benefits observed in the study. “Over the next five to six years, those intensive users suffered strokes at a rate of 0.3 percent per year. That compared with just over 0.5 percent among non-users, and 0.4 percent among moderate users. When the researchers factored in other diet habits, exercise levels and major risk factors for stroke — like high blood pressure and diabetes — heavy olive oil use was tied to 41 percent reduction in the odds of stroke.” There are better ways to try to communicate numbers of less than one percent. But we applaud the detail provided. Not applicable. Excellent. The story devoted almost 200 words to the potential limitations of such an observational study. Also a clear description of the cohort design. No disease-mongering of stroke in the story. The story included strong input from a researcher who wrote in an editorial on the study. The story at least mentioned other factors that could be at play – “no single food is consumed in isolation, he points out in his editorial. Olive oil is one part of the Mediterranean diet that has been tied to heart benefits. The diet also boasts plenty of fruits and vegetables, legumes, whole grains, fish and moderate amounts of red wine.” Not applicable. The availability of olive oil is not in question. The story attempted to put the new finding into the context of past research on olive oil and the Mediterranean diet. It’s clear the story did not rely on a news release. Claim: Olive oil lovers show lower stroke risk

A: This story explored the nature of an observational study about the stroke-reducing risks of olive oil. The story appropriately discussed other possible reasons for the findings and why a clinical trial is stronger evidence. With so much news coverage touting an apparent benefit from olive oil in this study (CBS had a headline about “huge decline in stroke risk”), it is refreshing to see so much time and space given to a clear-eyed evaluation of the evidence as this story provided.
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Q: Paragraph: 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. Claim: Relapses of childhood leukemia improve with high doses of common chemo drug

A: This release reports the findings of a large clinical trial testing whether alternative dosing regimens of standard chemotherapeutic drugs can improve the treatment of B-acute lymphoblastic leukemia. The study showed that using high doses of the drug methotrexate, rather than the standard regimen of gradually increasing doses, improved the outcomes for patients with the disease. The study also showed that using the steroid dexamethasone increased a debilitating bone condition in patients 10 and older but not in patients nine or younger. While the study results are promising, they are by no means clear-cut in the release. The release needed some qualifiers in order to give a clear picture of the benefits. The release also neglected to discuss costs and potential conflicts of interest among the investigators. This form of cancer — B-acute lymphoblastic leukemia — is the most common cancer in children and a major cause of cancer death in patients under 40 years old. And while the majority of patients survive with appropriate treatment, anywhere from one-fifth to one-quarter of patients do not. This study showed that refining the dosing of standard cancer drugs may improve the outcome for some high-risk patients.
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Q: Paragraph: "No discussion of costs. Is this OK because this is still experimental? We don’t think so, not when the drug company is allowed to project possible approval within a year. Much better to say, as a Wall Street Journal story did, that the company said it was too early to set pricing. But to ignore costs entirely is a mistake in our view. good job providing absolute benefit data from the trial. Good job on harms as well – ""Serious side effects also became clear. Nearly two-thirds of patients on ipilimumab experienced side effects caused by over-active immunity, such as severe itching, intestinal irritation and diarrhea. Researchers linked 14 deaths to the study drugs, half caused by immune-system reactions."" Good job explaining the nationwide study and the local participation. No disease mongering in this story. Story quoted one independent source in addition to one of the study co-authors. The story explained that ""Other drug companies are at work on competing versions of the immune-enhancing antibody therapy."" It’s clear from the story that the approach is experimental. The story also states: Minor quibble:  perhaps the story should have reminded readers that a drug company’s timetable predictions may not be the most reliable. For local readers it explained: The relative novelty of the approach is clear in the story – ""one of the first antibody-based therapies that use the body’s immune defenses to destroy cancer cells"" and ""Drug companies are racing to develop competing versions of the immune-enhancing therapy, an antibody produced through genetic engineering."" It’s clear that the story did not rely solely on a news release." Claim: Portland cancer center among those offering experimental immune therapy ipilimumab

A:
It’s really refreshing to see a local newspaper localize a national story and to do so in a responsible way. Sure, the story led with its personal anecdote. But the personal trials of being in a trial came through in that anecdote. And sure, there were company predictions of how quickly this might be approved and on the market (something we think could have been handled better). But there wasn’t hype. After a week’s worth of news out of the American Society of Clinical Oncology meeting, and some published concerns about how that news was covered by bigger national news organizations, it was good to see this local paper’s measured efforts.
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