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 not only mentions the cost of a scan to individuals ($100 to $500), it also notes that about $50 million dollars was spent on this type of scanning nationwide in 2008. A longer story could have also reported on the costs of additional testing and treatments triggered by screening apparently healthy individuals. As mentioned above, the story notes that while some experts recommend CT screening for coronary artery calcium deposits in order to increase the number of people receiving treatment to reduce the likelihood of a heart, others are skeptical about the real value of this type of screening for apparently health people. The reporter points out that many heart attacks strike people who do not have very high cholesterol levels or other indicators of elevated risk, but also that “no study has linked the use of CT scans with better patient outcomes.”   The potential cancer risk caused by CT screening for signs of heart disease is the point of this story. Also, by highlighting uncertainty about the benefits of the screening and recapping debate over the Texas law mandating coverage of the scans, the story emphasizes the importance of considering potential harms when setting public policy on screening tests. A longer story could have considered other potential harms, including the side effects of treatments prescribed based on screening tests. The story does a good job of summarizing the results of this study of potential cancer risk from CT screening. In addition, it outlines the positions of experts and organizations on the broader body of evidence on the use of CT scans to identify people who may have plaque buildups in their heart arteries. It would have been better if the reporter stated that the estimate was based on several assumptions, that it wasn’t a definitive point estimate, but just the center of a range, and that it was higher than earlier estimates. Readers still got the point that there is a cancer risk which needs to be considered. The story notes that heart disease is the leading cause of death in the U.S., but it also points out doubts about whether screening with CT scans for calcium buildup in heart arteries can reduce the toll. The story includes experts and advocates that represent the key perspectives in debate about CT screening for calcium deposits in coronary arteries. However, it does not include information on possible conflicts of interest. Although this story points out that alternative screening techniques are available and it makes reference to cholesterol, it does not include any details about the alternatives. The story says that the CT scanners used for this test are “all over the city” and included an estimate that in 2008 about 200,000 people around the country were scanned for calcium buildups in their coronary arteries. not in question in this story The story includes quotes from independent experts and other information that was not in the news release about the journal article.

SOLUTION: Warning sounded on heart scan law

PROBLEM: The University of Kansas will have what it says is the smallest four-year medical education site in the country when eight students begin taking classes on Monday on a satellite campus in Salina, Kansas. The move is in response to a shortage of rural doctors in the United States. “By training physicians in a nonmetropolitan area, we are showing young medical students that life can be good, and practice can be stimulating, outside of the big city,” said Dr. William Cathcart-Rake, the physician who directs the University of Kansas School of Medicine-Salina. Students will get some course work via tele-video and podcasts from the school’s other campuses, but they will also train through visits to doctors’ offices in small communities and at the hospital in Salina, school officials said. “It’s a bold and innovative move,” said Dr. Roland Goertz, president of the American Academy of Family Physicians. He said students at rural clinics will be exposed to a potential medical career they wouldn’t see in urban hospital settings. Cathcart-Rake said six of the eight students being taught at Salina, as part of their scholarships, have committed to practicing in a rural area. Seven of the eight students are from rural areas to begin with, he said. “They see the value of living in wide open spaces and going back to where their friends are,” Cathcart-Rake said. Attending medical school in a place such as Salina reduces chances they will change their minds, which could happen if they went to a big-city school, he said. Salina, with 46,000 residents, is about 175 miles west of the Kansas City metropolitan region where the university’s main medical school is located. Small-town America has become increasingly under-served by doctors. About 21 percent of U.S. residents live in rural regions but only about 10 percent of physicians practice there, according to data cited by the family physicians group. In Kansas, 12 counties don’t have a full-time doctor at all, said Barbara Atkinson, executive dean of the University of Kansas School of Medicine. Several factors are often cited for a shortage of rural doctors. Rural doctors tend to be paid less, partly because they are more likely to treat patients on Medicare and Medicaid, which reimburses at rates below standard insurance. General practitioners make up the largest share of rural doctors, but until recent years fewer medical students were going into general medicine, putting a strain on rural care. Older doctors who practice in small towns and retire are sometimes not replaced because younger doctors may prefer the greater cultural amenities urban regions tend to offer. Recent changes in federal healthcare laws are intended to make rural practice more acceptable to doctors. Doctors who practice in certain underserved areas will get bonuses beyond the 10 percent boost in Medicare reimbursements they were already receiving, Goertz said. He said another reason why there are fewer rural doctors is that the large majority of medical students come from urban areas, where medical schools are usually located, making them less like to consider rural medicine. “You tend to gravitate to where you grew up,” Goertz said. Cathcart-Rake is optimistic that the Salina medical school will be a success and that in future years admissions may grow from eight to 12 students.

SOLUTION: Rural doctor shortage prompts opening of medical school.

PROBLEM: Shares of Antigenics Inc, the tiny New York-based  biotechnology company which has been developing the vaccine for  11 years, rose as much as 58 percent on the news. It is the first time the Russian government has approved a  drug that was not first cleared in its country of origin,  according to Antigenics, and clears the way for the company to  start generating revenue from Oncophage later this year. The company plans to file for approval of the vaccine in  Europe by the end of the year, based on a relatively new set of  guidelines in that jurisdiction. Regulators in Russia approved Oncophage based on a subset  of data from a late-stage clinical trial that in 2006 failed to  show the vaccine delayed the recurrence of kidney cancer. In the subset of patients — those whose cancer was least  likely to recur following surgery — Oncophage lengthened the  period before which the disease recurred by 45 percent, or an  average of 1.8 years, versus those in the control group. The U.S. Food and Drug Administration does not consider  subset analysis a valid measure of success or failure since all  manner of sub-populations can be carved out retrospectively. Therefore the vaccine stands little chance of approval in the  United States. “What this company needs to do now is a trial based on  their findings with the good prognosis patients,” said Dr. Otis  Brawley, Chief Medical Officer at the American Cancer Society. “If they have a positive finding at that point then I’m going  to be excited, and then I believe it would go before the FDA  very quickly.”    Conducting such trials, however, could take up to 10 years  and vast sums of money, and would take the product’s  development cycle to 20 years. “No one in their right mind would authorize that,” said  Garo Armen, the company’s chief executive, in an interview. “Even if we had the money it wouldn’t be practical.”     Unlike their U.S. counterparts, Russian regulators have  accepted the validity of the subset — in part because roughly  a third of the 604 patients enrolled in the late-stage trial  were tested in Russia, and about 70 percent of those fell into  the subset of patients whose prognosis following surgery was  better than that of the total population. Antigenics thinks it will be able to win approval elsewhere  in the world too. European regulators can now approve drugs on a conditional  basis, meaning companies can market their products while  simultaneously conducting additional follow-up of patients or  further clinical studies. If at the end of the trial period the regulatory agency  were not satisfied, it could pull the drug from the market. “Filing in Europe won’t be a slam dunk, and will probably  be more difficult than in Russia,” said Armen, who added that  the European review process would likely take 12 to 18 months. The Russian approval caps years of dogged determination to  bring the vaccine to the market despite multiple setbacks and  investor skepticism of cancer vaccines in general. Oncophage is designed to reprogram a patient’s immune  system to target cancer cells from a specific tumor. The company takes tissue from a tumor following surgery,  extracts proteins it says activate the immune system and then  injects the enriched proteins back into the body through the  skin. Unlike a vaccine such as Merck & Co’s Gardasil, which is  designed to ward off a virus that is believed to cause some 70  percent of cervical cancer cases, Oncophage is designed to  target the cancer directly and delay or prevent it from  spreading once it has developed. There are about 16,000 new cases of kidney cancer a year in  Russia, according to Armen, of which about a quarter fit the  profile of patients most likely to benefit from Oncophage — a  market theoretically worth about $200 million to Antigenics. The Russian pharmaceuticals market is one of the fastest  growing in the world. It will grow by nearly 60 percent to  $19.4 billion in 2009 from about $12.3 billion in 2006, the  research group DSM estimates. Armen said he expects the initial sales growth for  Oncophage to be “modest.”    “We would have to price this probably at the low- to  mid-range of other new-generation cancer drugs,” Armen said. Such drugs can cost as much as $60,000 per patient per  year, he said. “How much of that market we achieve depends on how well we  iron out reimbursement issues and how effectively we can reach  every single patient,” Armen said. Shares of Antigenics were up 62 cents or 25 percent to  $3.09 in late afternoon trading on Nasdaq after touching $3.90  earlier in the day, an increase of about 58 percent.

SOLUTION:
Antigenics wins Russian approval of cancer vaccine.