TASK DEFINITION: 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.
PROBLEM: Paragraph: Given that the premise of the story is explaining there is no benefit to taking these supplements, we’ll rate this N/A. That said, it would have been interesting to explore the cost-savings for people if they decide to stop buying calcium and vitamin D. The story does a good job of letting readers know that there was no statistically significant benefit to taking calcium and vitamin D, based on the researchers’ systematic review of the evidence. The story cited one instance of harms, saying: “… for people who started out with at least 20 nanograms of vitamin D per milliliter of blood, adding more vitamin D through supplements was associated with a greater risk of hip fractures.” We also wanted to see a mention of potential harms of calcium, such as kidney stones. Another common side effect is excess gas and one potential harm of high doses is cardiovascular complications such as heart attack. The story hits some key points including the number of studies reviewed, potential confounding factors accounted for, and details about selection criteria. For instance, women on hormone replacement therapy, for whom there’s evidence for the benefits of supplementation were excluded from the current analysis. That’s a key point for postmenopausal women reading the story. Also the story makes clear that this study examined older adults who live in their own homes and therefore does not apply to older adults who live in nursing homes or similar institutions. Well done. The story does not engage in disease-mongering. It correctly states the risk of broken bones in people over age 50 and the risk of death in older people who break a hip. This story will also help reduce over-treatment and over-medicating of older adults, which is common. The only source quoted for the article is the study itself. There are no quotes from independent expert sources. The story references getting calcium from one’s diet and getting vitamin D from sun exposure. We think it’s safe to presume that readers know that vitamin and mineral supplements are widely available. The story does a good job of making clear previous claims of benefit from calcium and vitamin D supplementation. This large meta-analysis will provide some clarity of the questions surrounding using these supplements for bone health. The story does not appear to rely on a news release. Claim: Do you take calcium and vitamin D to protect your bones? A new study says it doesn't help

SOLUTION: Getty Images Reporting on a large review study, this Los Angeles Times article walks readers through the conflicting advice and evidence about calcium and vitamin D supplements. Both compounds play roles in bone health and the routinely accepted claim is that supplementation can help prevent bone breaks in older people. This new meta-analysis shows that claim is not supported by evidence: not for calcium pills, vitamin D pills, or the two in combination. The story is well-done on several points, particularly on explaining how this study worked and what it found. The story would have been stronger if it had included some commentary from experts in the field who were not associated with the study to help put this recent, apparently strong finding, into context for readers. More than two million so-called fragility fractures — breaks that wouldn’t happen in a younger person, often related to the bone loss of osteoporosis–occur every year in the US. Preventing fragility means attending to bone health, which currently centers around exercise and getting enough calcium and vitamin D. Supplementation is an easy way to make sure a person takes in enough of the mineral and the vitamin, and yet, it’s important to understand whether routine supplementation actually prevents bone breaks.

PROBLEM: Paragraph: The lawsuit seeking class-action status was filed in U.S. District Court on behalf of a dozen children against Gov. Jim Justice, the state Department of Health and Human Resources and other state officials. The 105-page complaint describes stories of neglect and harm done to foster children while under the department’s care. Many were in inadequate and dangerous placements, left without necessary services or forced to languish in foster care for years, including a 17-year-old suicidal boy who sleeps in a locked cell at a juvenile detention center. Filed by a Charleston law firm and nonprofit advocacy groups A Better Childhood and Disability Rights West Virginia, the lawsuit said the state’s child welfare system has “significant administrative problems that hinder its ability to operate effectively.” “For years, the state has ignored repeated recommendations about how to fix the damaging West Virginia foster care system,” Marcia Robinson Lowry, executive director of A Better Childhood, said in a statement. “Children are being sent to institutions, placed in foster homes without any services, and abandoned by the state.” New York-based A Better Childhood has filed similar lawsuits in several states. DHHR Secretary Bill Crouch said changes were made to the child welfare system starting in 2013 and efforts have increased every year since. Crouch said the lawsuit will cost the state millions of dollars “and was filed by a company that has never contacted us to ask the question: ‘What are you doing to fix these problems?’ We welcome the opportunity to make our case in court.” The governor’s office did not immediately respond to a request for comment. Earlier this year, West Virginia agreed to expand mental health services for children after a federal investigation found the state unnecessarily institutionalized kids with emotional or behavioral disorders. In the case of the 17-year-old boy, the lawsuit said he was physically abused by his family and has been under DHHR care since 2012. He lived in group homes and residential care centers before being sent to a juvenile detention center, where he sleeps on a mattress on a cement floor in a locked cell. He suffers from depression, has attempted suicide several times and will be homeless when he ages out of the system within the year, the lawsuit said. In September, the DHHR told lawmakers that 651 foster care children, mostly teen boys, have run away from group care settings or schools in less than a year. “Not only are we failing to provide federally mandated care, but we are also failing to prepare these children for what lies ahead and instead condemning many of them to a life of abuse and homelessness once they age out of foster care,” plaintiffs’ attorney Richard Walters said. The DHHR’s foster care ranks have swelled to about 6,900 children — an increase of more than 60% from the same time in 2015 — as the state grapples with the opioid addiction epidemic. West Virginia has by far the highest rate of drug overdose deaths in the nation. The lawsuit said three siblings ages 2, 3 and 4 were placed under DHHR care because of drug-addicted parents, but the children have moved from one foster home to another “due to DHHR’s inability to appropriately develop case plans and to follow department procedures.” West Virginia can no longer use the opioid epidemic as an excuse, the lawsuit said. “The foster care crisis in West Virginia is not an issue that just arose in the last 4-5 years, it’s a systemic problem that has festered in the state for almost 20 years,” said Jeremiah Underhill, legal director of Disability Rights West Virginia. The lawsuit also says the state failed to maintain an adequate number of appropriate foster homes and resorts to quick placements among relatives without vetting or monitoring to ensure children’s safety. The reliance upon kinship caregivers has increased more than 30 percentage points over the past five years. State lawmakers have limited placement of a child in an out-of-state facility unless it’s closer to the child’s family or the child has a health issue that cannot be addressed by an in-state facility. Claim: Federal lawsuit targets West Virginia foster care system.

SOLUTION: The overwhelmed foster care system in opioid-ravaged West Virginia has failed to protect children, according to a federal lawsuit filed Monday.

PROBLEM: Paragraph: Presumably this genotyping is for research purposes only and not ready for public use, and thus no estimates of cost are yet available. This could have been explicitly stated. The article did present quantitative estimates for the accuracy of the test for lung cancer and by including the measures on two different samples, provides the reader with a glimpse into the kind of variability that exists. The story mentions that it can be predicted that 1/3 of lung cancer patients will get worse and die but that few get chemo because doctors currently can’t distinguish between this third and the two thirds that won’t get worse. And it mentions that many women with early breast cancer get chemo even though the majority don’t benefit from it . But no quantitative estimates are given about how many might benefit from these tests. There was no discussion about the burden of treatment decisions based on the results of the tests or the possibility of insurance coverage ramifications based on the results of the tests. These are significant potential harms. The article explained that the information was derived from two articles published in the most recent issue of the New England Journal of Medicine. However, there was no discussion about the current study design or the prospective clinical trials that will be needed in order to evaluate the value of these genetic screens. The article did not actively disease monger about cancer or cancer risk. However, it painted a perhaps unnecessarily dismal picture for treatment of cancer, stating that “treatment guidelines for cancer are relatively crude — based on a tumor’s size, whether it has spread, and other characteristics” when in fact not all cancers are managed in this way and there are already a number of lymphomas and leukemias, for example, for which treatment is determined by the biology of tumor. The article did mention possible financial conflicts of interest present for one of the two groups of investigators. Although a spokesperson for the American Cancer Society was quoted, it would have been more helpful to have insight provided about what the study results mean in terms of breast or lung cancer treatment decisions that patients could be facing sometime in the future. Although these genetic screens appear to provide information on which to base clinical treatment decisions, prospective clinical trials have yet to be conducted. This was not mentioned in the article. However in presenting the problem of potential over-treatment of early breast cancer and under-treatment of lung cancer, the article provided valuable information for individuals with these conditions to think about when facing treatment decisions for these conditions even with only the widely available treatment options. Atlhough the article did not explicitly mention how widely available the two genetic screens discussed are, or when patients might expect to see analysis such as this in common use, it did state that the tests might “someday” be able to predict which patients should get chemotherapy. With the advent of the human genome project, there are a number of panels of genes being investigated to see whether they can be used to better match treatment to the precise disease of the patient. Although the article failed to put these two new reports within this context, the article also did not make claims about novelty of the approach. Does not appear to rely solely on a press release. Claim: Tumor profiles can help improve treatment

SOLUTION:
This story gives a glimpse of some of the nuances for treatment of cancers that will be begin to be available sometime in the future. One strength of the article was that it pointed out some of the current tumor-specific treatment decision-making dilemmas – that currently there are a number of women with early breast cancer who are given unnecessary chemotherapy which contrasts with the situation of lung cancer patients, many of whom might benefit but currently do not receive chemotherapy. But the article missed a golden opportunity to educate readers that not all types of cancer are similarly aggressive or hazardous. While a spokesperson for the American Cancer Society was quoted, it would have been more helpful to have insight provided about what the study results mean in terms of breast or lung cancer treatment decisions that patients could face sometime in the future. Overall, this wire service story covered a lot of the bases in only 385 words.