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: Although there was no discussion of costs, the article was clear in stating that vaccines are for the most part in an early stage of development, so this omission is understandable. We wanted to see better coverage of the data here. The story leads with an anecdote about a patient who kicked a pack-a-day smoking habit after treatment with a nicotine vaccine in a study. And later, the story says that smokers who received that vaccine were “about three times as likely to be off cigarettes 44 weeks after vaccination than subjects given a placebo.” The story should have provided the absolute rates of success reported in the study, which were only 16% for the treatment group compared with 6% for the placebo group, according to theheart.org. Elsewhere, the story describes an experimental anticocaine vaccine that was apparently very effective in a mouse study; it could have reported on phase II human data that is available for the TA-CD anticocaine vaccine that was also mentioned in the story. These data again suggest that only a minority of patients may benefit from the use of anti-addiction vaccines. The story states that “clinical trials have so far revealed no significant side effects” from vaccine treatments. However, we think the story should have included an important caveat: that these are early stage trials involving small numbers of patients that can’t provide conclusive evidence of safety. In addition, it should be recognized that addictions are chronic conditions and these vaccine treatments are likely to be long-term as well. Therefore, longer-term adverse effects should be expected, especially for a treatment that interferes with molecules closely related to the body’s natural chemical messengers. The story could have been a bit more circumspect on this point. The promise of this new vaccine technology is counterbalanced by coverage of the uncertainties. The story gives appropriate weight to the disappointing results reported in a number of early clinical studies, noting: “Failures have so far outnumbered successes.” The story adds that even in one of the successful vaccine studies, the benefits were not as robust as those seen with a smoking cessation drug that is already on the market. There also is no prospect for a vaccine to treat alcoholism, according to the story. The article should have been more direct about the limitations of mouse research, and there was not enough detail on the data published in the various studies reported on (a deficiency we address under the “Benefits” criterion). However, since the story was trying to present a broad overview of happenings in the field and wasn’t attempting to summarize any particular study, we’ll give the benefit of the doubt here and award a satisfactory. The story didn’t exaggerate the effects of substance abuse disorders or otherwise engage in disease-mongering. The sourcing of this story was good. We hear from academics, government researchers, and industry executives. Their voices provide balance and give texture to the coverage. It should be noted, however, that most of these experts have a vested interest in the field or the success of a particular treatment, whether because of industry ties or because they are leading experiments on a particular approach. Even the government experts might be biased by their provision of significant financial support for research in this area. It would have been nice to hear a comment about the vaccines from someone who is certifiably free of all potential conflicts. But we can’t justify docking points since there is no voice that is overly enthusiastic about the concept. The story compares the potential of vaccines with the benefits of existing medications for addiction–and notes that the available drugs might work better. We would like to have seen more ink given to the role of behavioral approaches in the management of addiction, which are supported by considerable evidence. However, the story does acknowledge that vaccines “would likely be used alongside psychological therapy.” We’ll call it good enough for a satisfactory. The article helpfully states that “It could be years, if ever, before any vaccines to treat addiction reach the market.” The article does a good job of describing how far along the various experimental vaccines mentioned in the article are in their development. Although the story could have provided more background on the history of anti-addiction vaccines (a heroin vaccine was explored in the 1970s), the treatments being explored now are different from anything currently available. So we don’t think this story overstates the novelty of the research. This story is not based on a news release.

SOLUTION: Quest for Vaccines to Treat Addiction

PROBLEM: Four times as many black people are being detained as white people. If you're black, you're about four times as likely to be detained than if you're white. Overall, more white people are detained, since they make up a larger portion of the population. The number of people detained under the Mental Health Act has increased by 47% in ten years. Correct in England between 2005/06 and 2015/16. Claim 1 of 3

SOLUTION: People from black and minority ethnic populations are most affected by detentions under the Mental Health Act.

PROBLEM: Typically, we are asking that a release tell us the “cost” of a therapy or drug, but in this case, we wish the release had given some estimate of the cost savings from active surveillance for patients vs. surgery or radiation or both. This is an important point for both individual patients and the broader society since the population of men with prostate cancer is growing and most are likely to be on Medicare. The release did not provide many numbers. For example, it reported erectile dysfunction and urinary incontinence as “more common” in men treated with surgery than radiation, but did not give a quantity for the “more.” The release did include a numeral in this sentence, but it wasn’t very enlightening: “Urinary incontinence was reported as a moderate or big problem in 14 percent of men three years after surgery compared to 5 percent of men who had radiation,” Barocas said.” The study compared benefits and harms for three different situations: surgery, radiation and surveillance. In neglecting to provide us with the number of patients studied the release doesn’t establish the quality of the evidence. We want to emphasize that the study itself, which included more than 2,550 men that were followed for 3 years, appears to be of high quality. But the release did not demonstrate that to the readers. The release also omitted some limitations of the study. One of the main ones is that the study used an observational cohort (a like group followed over a period of time), rather than an experimental design that would show cause and effect, so there may be other unmeasured factors influencing the results. In addition, the study captured patient outcomes through surveys. Surveys after the fact are subject to recall bias. As well, the number and severity of side effects after 3 years may differ by treatment, “and 3 years is inadequate to estimate oncologic outcomes,’ according to the study. Further, the quality of care each individual patient received could influence outcomes. There was no disease mongering. Instead, the release provides some encouraging context on the use of all three therapies: “Three-year survival from prostate cancer was excellent in the study at over 99 percent for patients regardless of whether they chose surgery, radiation or active surveillance.” The release names the grant sources for the research. It would have been better if the release had also stated (as the study did) that there were no conflicts of interest among the authors. The study was about comparison of alternatives and the release did a good job explaining what the alternatives were — surgery, radiation and active surveillance. The release doesn’t say so explicitly but it’s generally understood that all the treatments studied are widely available and applied. The release did not make a strong claim of novelty. It states, “This study shows that, despite technological advances in the treatment of prostate cancer, both surgery and radiation still have a negative effect on quality of life.” That’s not a new finding, but what makes the study newsworthy is that it compared the degree of side effects associated with each treatment. In addition, the published study states that it was designed to be more diverse, representative and more broadly applicable than former studies. “In contrast to previously published studies, this study may be more generalizable, since the cohort is racially diverse, population based, and includes a range of disease severity.” That would have been good to include in the release. We found no unjustifiable language.

SOLUTION:
Active Surveillance Preserves Quality of Life for Prostate Cancer Patients