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:
Montreal Canadiens Max Pacioretty lies on the ice after being hit into a glass stanchion by Boston Bruins Zdeno Chara during the second period of NHL hockey play in Montreal, March 8, 2011. REUTERS/Shaun Best With the National Hockey League playoffs under way after a season where jarring head shots grabbed headlines, researchers said the number of concussions was leveling off. But the ice time a player loses more than doubles with each subsequent concussion, so there were more absences. “Either concussions are becoming more severe or physicians are becoming more conservative with their management decisions,” said Brian Benson, a physician at the University of Calgary’s faculty of kinesiology and the lead author of the report. “We’re uncertain of the exact reason but it’s certainly an observation of the study.”   The report now goes to the NHL’s concussion working group, which will examine ways to prevent concussions, or work out how to respond when they do happen. “The goal in hockey in general is to reduce the risk of this potentially devastating injury without necessarily changing the nature of the game that millions love and enjoy watching,” Benson said. “You don’t want to make haphazard decisions but you certainly want to base it on evidence and try to reduce this foreseeable, predictable risk.”   The league has faced many calls for tougher penalties for potentially career-ending hits to the head, including some this season after a March incident in which Max Pacioretty of the Montreal Canadiens was injured after a body check that sent his head into a stanchion. He suffered a concussion and fractured vertebra. Sidney Crosby, Canada’s gold-medal goal-scorer in the 2010 Winter Olympics, has been off the ice since suffering a concussion in January. The researchers worked with the NHL and NHL Players’ Association to analyze 559 doctors’ reports of concussions suffered by players between 1997 and 2004. Their findings are published in the Canadian Medical Association Journal. The researchers estimated that there were 1.8 concussions per 1,000 player hours, a number that leveled off through the study period. The most-often reported symptom was headache at 71 percent. But players also reported dizziness, nausea, neck pain, fatigue, blurred vision or amnesia. Some 18 percent lost consciousness. For each recurrent concussion, the typical number of days lost increased by 2.25 times. Benson has worked with the NHL and its players union since 1997 studying the medical science behind brain injury.
answer:
Concussions keep hockey players off ice for longer.


question:
Although this therapy is not yet available for patient use, the story makes a point of noting that the cost may well be “stratospheric,” should it make it to market. If approved, such treatments are expected to command stratospheric prices. For example, a separate Spark gene therapy for a rare type of childhood blindness, which is on track for Food and Drug Administration clearance soon, could cost $1 million per patient for infusions in both eyes, according to some Wall Street analysts. Still, the therapies can produce at least some offsetting savings. Porteus noted in his editorial that the hemophilia therapy resulted in savings of about $200,000 a year per patient because of the elimination of clotting-factor infusions. The story summarizes the outcome of the small, 10-person trial that dominates this narrative: Lindsey George, the lead investigator and a hematologist at Children’s Hospital of Philadelphia, said that nine of the 10 men in the trial didn’t experience any bleeding episodes after the gene therapy treatment. The one patient who needed clotting factor because of bleeding used 91 percent less than before, she said. Although the story does not address harms directly–and should have–it does note that one of the worrying side effects of gene therapy—spurring the body to attack itself—was not present in this study. It is clear from the story that the study is small and an “early-stage trial.” One source also notes that the researchers tracked individuals in the study for no more than a year and a half, making longer term assessments unavailable. The story could have done more, though, to signal to the reader that, despite the encouraging outcomes of the study, the treatment is still very much under development. The next stage—Phase 3 trials—requires more participants, more careful study design, and takes, on average, three years to complete. The treatment described here, if ultimately proved worthy, could have a profound impact on a serious genetic condition. Independent sources are identified in the story, as are the funders. But missing from the text is information describing linkages between the two funders—Spark Therapeutics and Pfizer—and the lead researchers. It’s not clear from the story that there is a financial relationship. Individuals coping with hemophilia B have few options, and the story describes the main one: injections of blood-clotting factor to stem runaway bleeding. Since the story notes that the research is at an early stage with only 10 participants, a reader can easily infer that the treatment is not yet available. However, additional information about remaining evaluation stages for this treatment would have been a useful reinforcing addition. Hemophilia B sufferers who see this story will likely be contacting their doctors. The story establishes novelty with this: The researchers presented earlier findings on the gene therapy a year ago at the American Society of Hematology’s annual meeting, but the latest data covers a larger patient group and a longer time period. A news release issued by Children’s Hospital of Philadelphia did a good job of describing this study; the Post story could have picked up more of the salient details from that text but reveals independent reporting nevertheless by including sources not connected to the study.
answer:
Gene therapy makes a big advance treating hemophilia B blood disorder


question:
"A comment about the overall cost of endoscopic sinus surgery, as well as insurance coverage and likely out-of-pocket expenses for patients, would have been appropriate in this story. In addition, the costs associated with the equipment and upkeep are also important considerations. However, the story didn’t mention costs. This story focuses almost exclusively on the experience of one patient, a practice we generally think should be avoided. In this case, however, the patient in question was a health columnist with the Boston Globe who brings a well-informed and appropriately skeptical perspective to the story. Whereas many stories seek out patients who embody the best possible outcome for a new technology or procedure, this patient describes an incremental benefit that was ""disappointing"" in size but in the end, still worth the trouble. Instead of getting 5 or more sinus infections per year, she now gets 3 or 4 infections that are not as bad as before. In addition, the story emphasizes that surgery is ""rarely a cure"" and should be viewed as a ""last resort"" for most patients with sinus problems. We wish more stories were this measured in their assessment of medical benefits. The story refers off-handedly to the possibility of ""poking through to the brain or into the orbit of an eye,"" but it fails to explain that these events are very rare but real risks of the surgery. While extremely unlikely, it’s possible for surgeons to accidentally damage the optic nerve, resulting in blindness, or to puncture the base of the skull, resulting in cerebrospinal fluid leakage. Other less serious, but more common complications are also possible. The story didn’t mention any of them. While we appreciated this story’s carefully calibrated tone and conspicuous lack of hype, we felt its discussion of the evidence was inadequate. The story  quotes a surgeon who says that endoscopic surgery improves quality of life for patients ""probably in over 90 percent of the cases."" But we’re not given enough information to determine how this estimate was formulated or if it is representative of typical patient outcomes. The surgeon might be talking about his own personal experience treating patients, which could be much better than average if he’s an experienced surgeon working at a top-tier institution. Adding to our concerns, there is at least some published evidence suggesting that endoscopic sinus surgery is less effective than this story indicates. For example, a systematic review of randomized controlled trials couldn’t find evidence that the procedure was more effective than medical therapy. Granted, this review included only 3 studies and could have involved slightly different procedures than the one discussed in this story. But if there is more persuasive evidence to substantiate the procedure’s benefits, the story should have referred to it directly instead of passing along the surgeon’s second-hand estimates. There was no disease-mongering in this story. The story makes it clear that the surgery being described is a last-ditch approach for people with intractable problems. The story relies heavily on the perspective of Judy Foreman, the health columnist and patient, and her surgeon, Ralph Metson, neither of whom have any conflicts of interest that we could identify. While it would have been nice to hear from an expert who wasn’t involved in this particular case, the story does enough to satisfy the criterion. The story’s sidebar gives detailed descriptions of alternatives to surgery, including nasal irrigation and corticosteroid nasal sprays. The story states that about 300,000 people a year undergo sinus surgery, making it one of the most commonly performed procedures in the U.S. However, it does not provide statistics on the number or percentage of those procedures that are performed endoscopically and the type of hospital setting in which they are done. Enodoscopic surgery with CT guidance as described in the story may be out of the reach of smaller community based practitioners. We’ll call this satisfactory, but some additional detail would have been appropriate. The story didn’t attempt to oversell the novelty of this procedure. It is clear that this story didn’t rely on a news release."
answer:

Surgery For Sinus Misery: Better, But Still No Cure