TASK DEFINITION: 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.
PROBLEM: The story doesn’t address costs for any of the treatment options discussed. Is MBSR comparable to CBT? Does insurance cover either treatment option? The story tells readers what percentage of study participants who got MBSR treatment reported improvement in pain, as well as what percentage of MBSR participants “reported improvement in the activities they could do.” It also offered the same numbers for participants who received CBT and for the control group, which received typical medical care for this condition. These details deserve a Satisfactory rating. But: The story notes: “The study did caution that 30 of the 103, or about one-third, of the participants in the meditation group reported an ‘adverse event,’ most often an increase in pain due to yoga.” It’s good to see that included. Since the story is effectively comparing MBSR to CBT and conventional treatment, it would also have been worth noting “adverse events” for those groups in the study. According to the study, 10 percent of the CBT group also experienced “adverse events,” and no adverse events were mentioned for the control group. Defining “adverse events” would also have been good, since it’s not clear whether they mean momentary pain or a debilitating flare-up of long-term pain. According to the study, the pain–for both MBSR and CBT groups–was “mostly temporary” and no “serious” adverse events were reported. Those things are worth mentioning. (It’s also worth finding out what “mostly” and “serious” mean.) The story describes the study in detail, explicitly stating the study size and the absolute percentages in each arm that had benefit. It also acknowledged the study was randomized. We’ll count this as sufficient for Satisfactory, keeping in mind the following: As explained in the summary above, the story doesn’t make clear MBSR and CBT were used in addition to conventional medical treatment, rather than instead of medical treatment. The story didn’t mention that the study excluded participants with what the study authors term “a specific diagnosis (eg, spinal stenosis).” In other words, the study did not address treatments for back pain caused by issues like a herniated disc or rheumatoid arthritis. Many readers have these conditions, and should be informed that these study results may not be applicable to their situation. Lastly, we would have welcomed a discussion of the high rates of success within the control group. Forty-four percent in that group experienced a gain in functionality, for example. That seems pretty good! What do the researchers have to say about that? No disease mongering here. However, we did want to point out that the story “fear mongers” in a sense, by stating back pain is “one reason why more and more people are addicted to painkillers.” The story insinuates that these other treatment methods–especially meditation–could help with that. And maybe they could. But the study itself says “No overall differences in treatment effects were observed for…self-reported use of medications for back pain.” So why the mention of painkiller addiction? Conflicts of interest don’t appear to be an issue here, and the story includes statements from an accompanying editorial in JAMA, which was written by experts unaffiliated with the research. This squeaks by as Satisfactory, though it should be noted that most of this material was available via news releases (see below). The story is effectively all about comparing alternatives, though–again–it should have made clear that MBSR and CBT were used in conjunction with conventional medical treatment, and it left out discussion of other well-known non-medication treatment methods, such as exercise. It’s not clear from the story whether MBSR is widely available, is available in mainly metropolitan areas, or is a relatively new field that is still uncommon. The story does quote from a separate editorial in JAMA that says health care systems “should provide access to affordable mind-body therapies,” implying that it’s not widely available. Is this the case, or can it be easily accessed? Given the constraints of a brief news story, the piece does a nice job of articulating the differences between MBSR and CBT. It would have been even more helpful for the story to mention previous studies on the impact of MBSR and CBT on low back pain, to help us understand how novel this new study is. There is little in the story that is not found in the two news releases issued on this study. (Those releases can be found here and here.)

SOLUTION: Mindful meditation may be the answer to relieving chronic back pain, study suggests

PROBLEM: On December 20 2018, the Facebook page “Teanderthal Party” posted the following meme about healthcare, “illegal immigration,” terror attacks, and the mortality rate in the United States:It stated:FACT:More Americans die every year from lack of affordable healthcare than from terrorist attacks and illegal immigration combined.Teanderthal Party didn’t share any commentary alongside the meme, nor was it accompanied by any citations, sources, or even references backing the point the page was attempting to convey by sharing the meme. Presumably, its creators singled out “illegal immigration” and “terrorist attacks” as common political fears in the United States, and it aimed to suggest that those concerned about those dangers were possibly likelier to die from lack of access to healthcare services. (But without additional context, that remains a guess as good as any. )Regardless of the page’s editorial intent in sharing the meme, its claims remained fact-checkable — to a degree. However, questions remain: If fact-based resources were consulted to compose the meme, did its creator simply reference 2018 (the year in which it was posted to the page)? Was it created and based upon an earlier year? And how far back should we go to examine the claim’s truthfulness?Further, did the meme intend to reference terrorism-related deaths of Americans within the United States, or did it include Americans killed while visiting other countries? Were combat deaths involving the Islamic State (for example) included in the creation of the meme? And with respect to the number of “Americans [who die] … from illegal immigration,” did it mean people murdered by undocumented immigrants, or something else? With such nebulous benchmarks, answering these questions was a dicey prospect.Finally, the precise meaning of dying “from lack of affordable healthcare” was undefined. Would such a number encompass people who succumbed to illness or injury because they were unable to pay for treatment, people whose health declined because they did not maintain any form of medical insurance, or some other category? Would any other scenario be included in the calculation of deaths due to a lack of affordable healthcare?Although vague, the meme pinpointed three metrics of debatable description with which we will try to approximate a truth rating:The first number might be the easiest of the bunch, due to related research appearing from time to time in the news. Fact checkers PolitiFact and FactCheck.org have both tackled variations of the claim, the latter with no rating, while the former assigned a “” decision to a claim no one died from a lack of access to healthcare.Figures from the American Journal of Public Health [PDF] published in 2009 often serve as a benchmark number for deaths linked specifically to a lack of health insurance in American adults. In their study, “Health Insurance and Mortality in U.S. Adults,” researchers provided several numbers in different years prior to 2009, estimating that 46 million Americans were uninsured. For the year 2000, researchers estimated 27,424 deaths due to a lack of health insurance among adults in the United States. For 2005, using the same methodology, they calculated between 35,327 deaths in non-elderly people and 44,789 deaths overall.The study was conducted at Harvard Medical School and Cambridge Health Alliance, and was based on data obtained from the Centers for Disease Control and Prevention. In a September 2009 Harvard Gazette article about the findings, researchers said that the larger 44,789 figure was conservative at the time of its publication:Steffie Woolhandler, study co-author, professor of medicine at Harvard Medical School, and a primary care physician at Cambridge Health Alliance, noted: “Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives.”“The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance,” remarked David Himmelstein, study co-author, associate professor of medicine at Harvard Medical School, and a primary care physician at Cambridge Health Alliance.“Even this grim figure is an underestimate — now one dies every 12 minutes.”A major change to policy in the United States took place between the publication of those figures in 2009 and the meme’s circulation in December 2018 — the passage of the Patient Protection and Affordable Care Act (known colloquially as “Obamacare”) in March 2010. At the time the paper quoted above was published, 46 million American citizens lacked health insurance.We were unable to locate a one-to-one comparison of estimated deaths from lack of health insurance after passage of the Affordable Care Act, but research published in the Annals of Internal Medicine in September 2017 indicated that 28 million Americans were uninsured at that point. Using the American Journal of Public Health figures of 46 million uninsured Americans and 44,789 deaths for 2005 (published in 2009), we calculated a .097 percent mortality rate. Applying that ratio to the 28 million uninsured Americans referenced in September 2017, 27,160 uninsured Americans could be expected to die of the same general cause.Although figures on deaths due to a lack of health insurance in several given years were relatively easy to find, the other two metrics proved far harder to decisively pin down. Nevertheless, it seemed possible to arrive at a simple “true or false” based on disparity alone.The question of how many Americans are killed annually by undocumented immigrants has come to the forefront of the public discourse, most notably when President Donald Trump referenced a completely unsubstantiated figure of 63,000 American deaths at the hands of undocumented immigrants since September 11, 2001.The Washington Post located the origin of the 63,000 murders figure in June 2018:We traced that number back to its source. On May 5, 2006, [Rep. Steve] King posted an article on his official website in response to national pro-immigration protests held that month. The post is a catalogue of anti-immigrant scaremongering … he explained the math behind his numbers.“The crimes that are committed by those who enter this country illegally are in significantly greater numbers than the crimes that are committed by American citizens,” King said, “to the extent that 28 percent of the inmates in our prisons in the United States are criminal aliens, 28 percent.”That figure he got from a Government Accountability Office report issued in April 2005 …King figured (admitting that [his referenced] number would go up or down a percentage point or two):“That means then that criminal aliens are committing 28 percent of the crimes in the United States. And so that means 28 percent of the murders, 28 percent of the rapes, 28 percent of the violence and the assaults and battery, first- and second-degree murder and also manslaughter attacks are committed by criminal aliens.”In other words, since 28 percent of the prisoners were immigrants in the country illegally, they must also therefore have committed 28 percent of each and every crime! Quod erat demonstratum. Recognizing that this sounded like a lot even at the time, King rationalized it by asserting that for every undocumented immigrant in the country we know about, two or three sneak in without our knowing it. Here’s how we know that’s not true.There is an almost impossibly large number of problems with King’s argument.The first is that, of course, crime is not evenly distributed among populations. If 10 percent of prisoners are named John, that doesn’t mean that people named John commit 10 percent of murders. Many of those undocumented immigrants in federal custody were probably there for a very specific type of crime: felony immigration violations. Very, very few native-born Americans were there for that. In fact, in 2014, half of criminal arrests were for immigration violations. Since the GAO data are only for federal prisoners, that’s significant. (It’s also worth noting, as a reader did, that federal prisoners make up only a small percentage of the entire prison population. )The Post concluded that “King seems to have basically made the number up more than a decade ago,” adding that the Congressman did not even stick with the same figure himself in later reference to the subject:In 2011, King presented a resolution that offered a different calculus.“According to the Government Accountability Office,” it read, “there have been 25,064 homicide arrests of criminal aliens since 1955.”That’s about 1.2 per day.We were unable to locate any trustworthy estimate for the number of Americans killed (intentionally or not) by undocumented immigrants in any given year. And even if that number had been correct instead of specious, 63,000 deaths divided by 17 years equals 3,706 deaths annually — a figure dwarfed by the lowest number of deaths from lack of health insurance by any metric in any year.There is no basis whatsoever to assume the “63,000 since 2001” figure was based in anything at all, but if we apply King’s second formula (1.2 per day) to an annual basis, we get 438 deaths a year, which we can round up to 500 for comparison purposes.Finally, we come to the number of Americans killed annually in terrorist attacks. The National Consortium for the Study of Terrorism and Responses to Terrorism (START) provided figures [PDF] for the number of Americans killed both on and off American soil in terrorist attacks between 1995 and 2016. In that 21-year period, START calculated 3,393 deaths in total in the United States, 3,277 American fatalities on US soil, and 3,658 total American fatalities due to terrorism abroad.Those figures included all deaths during the attacks of September 11, 2001, which totaled 2,902. Averaging the largest number of the three (3,658) per year without adjusting for the outlying events of a single large-scale attack provided a figure of 174 deaths. Subtracting 9/11 from the larger figure and again calculating the number provided an annual average of 36 Americans killed by terrorists each year.In summation, the lowest number of estimated deaths among Americans due to a lack of health insurance in any given year (regardless of the Affordable Care Act’s passage in 2010) totaled more than 27,000. We found no solid figures for the number of Americans killed by undocumented immigrants in any given year, but even the incorrect number of 3,706 annual deaths based on the baseless 63,000 deaths-since-9/11 figure did not approach the number of deaths from lack of access to affordable healthcare. And combining that inaccurately large number with the unadjusted number of terrorism-related deaths (174 deaths per year), the highest comparative total was 4,881 deaths due to undocumented immigrants and terrorism. But once again, the latter two numbers were far likelier under 700 deaths total combined, versus 27,000 deaths on the first count.The meme’s statement that more people die every year from a lack of affordable healthcare than terrorist attacks or “illegal immigration” is true any way you slice it. The latter two numbers in any permutation (even when wildly inflated) come nowhere near matching the very credible figures informing the healthcare deaths estimate, and that remains true regardless of the meme’s extremely poor explanation of its own claims.

SOLUTION: More Americans die every year from a lack of affordable healthcare than by terrorism or at the hands of undocumented immigrants.

PROBLEM: The World Health Organization said Sunday that Malagasy authorities have confirmed a basketball coach visiting the island from the Seychelles for a sports event died from the disease Wednesday. It says authorities are trying to trace people he may have come into contact with to administer antibiotics against pneumonic plague. WHO says it is deploying further staff and supplies amid concerned the disease could spread further because cases have already been reported in several cities. So far at least 114 people have been infected with the plague since the outbreak was identified in late August. Both pneumonic and bubonic plague are endemic on the island.

SOLUTION:
UN steps up aid to plague-hit Madagascar after 21 deaths.