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.

Paragraph: It’s too bad this story didn’t mention costs. Considering that the trial found only small differences in the effectiveness of the treatments, it seems that cost might be a key deciding factor for many people with neck pain. It’s notable that two educational sessions about home exercise were as effective as 15 chiropractic sessions. The story includes both some of the specific results reported by researchers as well as more conversational descriptions of the overall experiences of people in this trial. Readers get the message that people with neck pain tend to feel better as time passes no matter which treatment option they used and that none of the treatments is clearly superior or can deliver sure-fire pain relief. This rating is a close call. The story does warn readers that spinal manipulation can pose “rare, but serious risks.” Also, none of the trial participants reported a serious adverse event. But the story could have been more specific and reported that, as the editorial accompanying the research article pointed out, “neck manipulation has a rare but potentially catastrophic risk for vertebral artery stroke.” Also, the story should have at least briefly mentioned some of the harms that can be caused by the pain medications (including acetaminophen, narcotics and muscle relaxants) that were prescribed to some participants. This story gives readers the important highlights of the study design and how the researchers measured effectiveness. It also includes a comment from an independent source that the trial would have been better if it had included a no-treatment group (in order to look for improvements that were due simply to the passage of time or a placebo effect). The story could have pointed out that unlike major drug trials that use placebo pills there was no way to prevent patients from knowing which treatment they received, which means the researchers can’t be sure that the reports from patients weren’t partially influenced by their beliefs about how effective a treatment might be. For instance, it could be that people who got spinal manipulation from a professional (and paid for it) might tend to believe that the treatment was more effective than a set of exercises that they did themselves at home. The story accurately reports that neck pain is common. It also includes cautionary statements about the uncertainty that exists about what sort of treatment works best, thus helping readers keep expectations in line with reality. The story includes quotes from multiple independent sources. It reports that funding for this trial was provided by “U.S. National Center for Complementary and Alternative Medicine.” It might have been helpful to point out that the center is part of the National Institutes of Health, so that it would be clear to readers that it is a public institution. Although the story does not report on any potential conflicts of interest on the part of the researchers, the article authors did not disclose any conflicts in their journal article. The trial was set up as a direct comparison of popular treatments for neck pain, and that is just how the story presents it. It even includes a comment from an independent source that this sort of neck pain tends to improve on its own. As mentioned above, the story could have provided more details about the potential harms of the various treatment options. It is clear that all of the treatments included in this trial are widely available. The story points out that this trial was designed to address the lack of solid evidence comparing common treatments for back pain, while also noting that this trial doesn’t answer all of the questions. The story does not appear to rely on a news release. Claim: Spinal Manipulation, Home Exercise May Ease Neck Pain
When researchers randomized 272 neck pain patients to receive either spinal manipulation, medication, or instructions on home exercises, they found some differences that were statistically significant. But the big picture is that all the patients tended to get better and those who got manipulation or home exercise instructions fared about the same. And that the bottom line message that readers get from the news story. The story didn’t mention costs and it could have provided more details about potential harms, but overall it gives readers a fair overview of the research and the broader background of neck pain treatment. News reports should always distinguish between study results that really mean something to people dealing with illnesses and those that are merely statistically significant, but clinically underwhelming. This story reports key findings about measured differences, but also helps readers to see the main message; that those differences didn’t make a dramatic difference to how patients felt… and that important questions remain. The study raises some interesting questions. It’s difficult to know if similar results would be seen for patients coming for care in usual practice settings, rather than in response to newspaper and radio ads recruiting subjects. It’s also worth looking at effective care versus efficient care. If two group instructional sessions are as good as 15 individual chiropractic sessions on average, one could surmise that home exercise might provide more bank for the buck. The story could have done a better job driving this point home. AS

Paragraph: The story devotes its second paragraph to cost, including how that cost may differ depending on whether patients have insurance. Well done. This is a really close one. The story does a lot of things well here. It notes that, in one trial, there was no difference in the benefits between Xofluza and existing flu treatment drug oseltamivir (better known as Tamiflu). However, it does not actually quantify the benefits associated with Xofluza. Instead, the story states that it “may alleviate some symptoms and shorten the time patients feel sick.” We approve of the cautious language used throughout the story, but we like to see quantified benefits in instances where the information is available. In this case, an article published in the New England Journal of Medicine in September reported that Xofluza reduced the “time to alleviation of symptoms” by a mean of 25-38 hours, compared to placebo (the difference depended on the age group of the patient). Ergo, a not satisfactory rating here. The story addresses this issue head on, earning it a solid satisfactory rating from us. One point that would have made it even stronger would have been to note that the company selling Xofluza warns that pregnant women and nursing mothers may want to avoid the drug, as it is not known whether the drug may harm the fetus or if it would pass into breastmilk for nursing mothers. The story does a good job of describing the supporting evidence clearly and concisely. No disease mongering here. In fact, the story provides good context on the risks posed by influenza. The story incorporates input from two sources at the FDA, but the information appears to stem from an FDA statement. Information from pharmaceutical companies is clearly marked, but we really look for news stories to incorporate input from independent sources — beyond what may be available in a news release. The story addresses the similarities (and differences) to other drugs that address flu symptoms, particularly oseltamivir (Tamiflu). The story notes that Xofluza has received FDA approval. As noted above, the drugs similarities and differences to existing pharmaceutical treatment options was laid out clearly. The news peg here was FDA’s approval of the drug, which is also made clear. The work goes well beyond what you would find in any news release. We particularly applaud the story’s discussion of viruses developing resistance to antiviral drugs. Claim: F.D.A. Approves New Drug for Flu
This story is one of two we are reviewing that focuses on FDA’s approval of a drug designed to speed patient recovery from flu symptoms (the second story is from ABC News). The drug is baloxavir marboxil, marketed under the trade name Xofluza. This New York Times story hits most of the points that we want to see in a story about a new drug. The criteria that we use at HealthNewsReview.org to review health-related news stories were not developed in a vacuum. Rather, these are the criteria we feel are essential to allow patients and health care providers to make informed decisions about diagnosis and treatment options. While we do ding it on a couple things, the story does not exaggerate the findings, and provides people with the fundamental details they need to be informed patients. We were especially pleased that this story did not perpetuate misinformation that’s developed around this drug — that is, that it could help reduce transmission of the virus. To date, there is no evidence to show that as a benefit.

Paragraph: The city’s health commission said in a statement Tuesday that 27 people had fallen ill with a strain of viral pneumonia, seven of whom were in serious condition. It said most had visited a seafood market in the sprawling city, apparently pointing to a common origin of the outbreak. Unverified information online said the illnesses were caused by Severe Acute Respiratory Syndrome, which emerged from southern China and killed more than 700 people in several countries and regions. SARS was brought under control through quarantines and other extreme measures, but not before causing a virtual shutdown to travel in China and the region and taking a severe toll on the economy. However, the health commission said the cause of the outbreak was still unclear and called on citizens not to panic. Claim: China investigates respiratory illness outbreak sickening 27.

Chinese experts are investigating an outbreak of respiratory illness in the central city of Wuhan that some have likened to the 2002-2003 SARS epidemic.