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.

Ex Input:
Paragraph: Costs are mentioned reasonably early in the story, and with specificity. This was good to see. Benefits of these tests are touted, but not quantified. An officer of the National Ovarian Cancer Research Fund Alliance, an advocacy group, testifies that the outcomes of women who have surgery from a gynecologic oncologist “are much better.” But we don’t know what that means. Is it longer survival? Later the story explains that combining the two blood tests with assessment by a clinician “better determined the patients who should be referred to a [gynecological oncologist], identifying well over 90 percent of the women who actually had cancer.”  (Note that this statistic reflects only referral to a gyn-onc, not patient survival.) But how does that compare to the standard assessment tools? A 2016 study described as publication “of the first clinical utility data” demonstrating that use of OVA1 resulted in referral of ovarian patients to gynecologic oncologists offers similar outcomes but is not mentioned in the story. We’re told that experts fear that these tests could lead to unnecessary surgery or delayed diagnosis, and that’s sufficient for a Satisfactory rating. The story could have delved into a bit more of the specifics: What is the evidence for these concerns? What are the false positive and false negative rates? These details are useful because the point of the story is that clinicians are not using these tests to try to improve outcomes of ovarian cancer patients. Are the possible debits–or uncertainties driven by lack of clinical data–contributing to these decisions? There isn’t sufficient information on the evidence behind these tests. The FDA has approved ROMA and OVA1 for use, but the studies that led to that decision are not discussed. Nor is there sufficient discussion of why the physician groups that write guidelines haven’t endorsed the tests. Their concerns are raised, but the evidence is not presented or analyzed. A late diagnosis of ovarian cancer is way too common, and the outcome is grim. At the same time, the anecdotes seem to highlight the sad aspect of the disease without necessarily providing a relevant case in which the tests described would have helped (any more than a basic blood test would have). The companies responsible for developing and marketing these two tests are front and center in this story, with scientists affiliated with the companies clearly identified. At least two sources in the story—one of them a scientist affiliated with the National Comprehensive Cancer Network—appear to be independent of the companies. The story makes it clear that no effective early detection screening test exists. Existing strategies—the CA125 blood test and vaginal ultrasound—are mentioned and then discounted, in part via a personal narrative of a young woman who received a late diagnosis of cancer. While data-driven specifics aren’t included on why standard methods aren’t sufficient, this is enough to rate Satisfactory. A direct comparison of survival stemming from existing diagnostic tests relative to survival stemming from ROMA and OVA1 would have strengthened the story. If those numbers aren’t available, that should have been pointed out. The story makes it clear that the two blood tests have been available since 2009. The story mentions that the tests are combinations of existing tests with a “proprietary” formula (essentially a risk prediction tool) to translate the results to likelihood of cancer. But, the article should have talked about whether the tests, other than CA-125, have been used before. This appears to be an enterprise story, and does not rely on a news release. Claim: Ovarian cancer blood tests: Available, not widely used

Ex Output:
This is a story about the apparent underuse of two blood tests—ROMA and OVA1—that are FDA approved to help clinicians decide whether surgery to investigate abnormal growths should be performed by a gynecologic oncologist (“gyn-onc”) trained to remove malignant ovarian cancer, rather than an obstetrician-gynecologist or a general surgeon. The gist of the story is that the tests have not been widely adopted in the ensuing years, “largely because they haven’t been recommended by the physician groups that write the care guidelines.” The story hit on a lot of important notes–it told readers the cost of these tests, and it included comments from independent sources. What is not clear is the extent to which clinical evidence supports the increased use of the two tests. We’re told they accurately picked up about 90 percent of cancer cases. But we’re not told how that compares to standard methods of detection. As the story notes, surviving ovarian cancer is an uphill battle–it is often a deadly disease caught too late. Any procedure that increases the probability of survival is worth careful consideration.


Ex Input:
Paragraph: A developmental biologist and tissue engineer, Dr. Mironov, 56, is one of only a few scientists worldwide involved in bioengineering “cultured” meat. It’s a product he believes could help solve future global food crises resulting from shrinking amounts of land available for growing meat the old-fashioned way ... on the hoof. Growth of “in-vitro” or cultured meat is also under way in the Netherlands, Mironov told Reuters in an interview, but in the United States, it is science in search of funding and demand. The new National Institute of Food and Agriculture, part of the U.S. Food and Drug Administration, won’t fund it, the National Institutes of Health won’t fund it, and the National Aeronautics and Space Administration funded it only briefly, Mironov said. “It’s classic disruptive technology,” Mironov said. “Bringing any new technology on the market, average, costs $1 billion. We don’t even have $1 million.”   Director of the Advanced Tissue Biofabrication Center in the Department of Regenerative Medicine and Cell Biology at the medical university, Mironov now primarily conducts research on tissue engineering, or growing, of human organs. “There’s a yuck factor when people find out meat is grown in a lab. They don’t like to associate technology with food,” said Nicholas Genovese, 32, a visiting scholar in cancer cell biology working under a People for the Ethical Treatment of Animals three-year grant to run Dr. Mironov’s meat-growing lab. “But there are a lot of products that we eat today that are considered natural that are produced in a similar manner,” Genovese said. “There’s yogurt, which is cultured yeast. You have wine production and beer production. These were not produced in laboratories. Society has accepted these products.”   If wine is produced in winery, beer in a brewery and bread in a bakery, where are you going to grow cultured meat? In a “carnery,” if Mironov has his way. That is the name he has given future production facilities. He envisions football field-sized buildings filled with large bioreactors, or bioreactors the size of a coffee machine in grocery stores, to manufacture what he calls “charlem” — “Charleston engineered meat.”   “It will be functional, natural, designed food,” Mironov said. “How do you want it to taste? You want a little bit of fat, you want pork, you want lamb? We design exactly what you want. We can design texture. “I believe we can do it without genes. But there is no evidence that if you add genes the quality of food will somehow suffer. Genetically modified food is already normal practice and nobody dies.”   Dr. Mironov has taken myoblasts — embryonic cells that develop into muscle tissue — from turkey and bathed them in a nutrient bath of bovine serum on a scaffold made of chitosan (a common polymer found in nature) to grow animal skeletal muscle tissue. But how do you get that juicy, meaty quality? Genovese said scientists want to add fat. And adding a vascular system so that interior cells can receive oxygen will enable the growth of steak, say, instead of just thin strips of muscle tissue. Cultured meat could eventually become cheaper than what Genovese called the heavily subsidized production of farm meat, he said, and if the public accepts cultured meat, the future holds benefits. “Thirty percent of the earth’s land surface area is associated with producing animal protein on farms,” Genovese said. “Animals require between 3 and 8 pounds of nutrient to make 1 pound of meat. It’s fairly inefficient. Animals consume food and produce waste. Cultured meat doesn’t have a digestive system. “Further out, if we have interplanetary exploration, people will need to produce food in space and you can’t take a cow with you. “We have to look to these ideas in order to progress. Otherwise, we stay static. I mean, 15 years ago who could have imagined the iPhone?” Claim: South Carolina scientist works to grow meat in lab.

Ex Output:
In a small laboratory on an upper floor of the basic science building at the Medical University of South Carolina, Vladimir Mironov, M.D., Ph.D., has been working for a decade to grow meat.


Ex Input:
Paragraph: As part of President Barack Obama’s healthcare reform law, the efforts center around more than 360 accountable care organizations (ACOs), which are networks of doctors, hospitals and other providers specially organized to help move Medicare away from traditional fee-for-service medicine. The U.S. Centers for Medicare and Medicaid Services (CMS) said preliminary data show that the ACOs produced $380 million in savings vis-a-vis traditional Medicare in 2012 by giving doctors and other healthcare providers the incentive to focus on improved outcomes for patients instead of fees from tests and services. Medicare, the $575 billion government healthcare system for 51 million elderly and disabled beneficiaries, faces growing financial pressures as a result of America’s aging population. A mainstay, the trust fund that pays for hospitalization, is expected to be exhausted in 2026. Deficit hawks view Medicare as a future driver of the federal debt and have called for major systemic reforms. But the Obama administration has pursued gradual changes including the reform of care delivery systems. So-called fee-for-service medicine is widely viewed as a cause of rising healthcare costs, because it calls for paying healthcare providers for tests and services that are sometimes unnecessary. Obamacare seeks to tackle costs by exploring ACOs and other new healthcare business models intended to find savings that do not jeopardize care. A main goal is to generate savings large enough to be shared between Medicare and providers. But some experts are skeptical, saying significant cost reductions could be hard to maintain over time. But CMS, an agency within the U.S. Department of Health and Human Services, runs two different ACO programs. In its largest, 54 of 114 ACO networks achieved lower than expected expenditures. But only 29 saw savings big enough to share with providers. All told, the program produced $128 million in net savings for Medicare’s trust funds. “Overall, the ACO program’s a net saver to the Medicare program,” CMS principal deputy administrator Jon Blum told reporters in a conference call. “It’s giving us great confidence that this is the right course for the Medicare program and we are confident that it will continue to show quality improvement and cost savings.”  Officials said the ACOs also achieved a wide range of quality goals. But CMS released no quality statistics. Thursday’s government release drew some cautious optimism from the healthcare industry. “Today’s report reflects important steps. More work is needed to modernize our antiquated Medicare payment system and base payment on evidence-based quality measures and proven patient outcomes,” said Dr. John Noseworthy, chief executive of the Mayo Clinic in Rochester, Minnesota, which is not part of the government’s program. “As results of the team-based care models are analyzed, those most effective in driving down health care costs without compromising safety and quality should become part of the healthcare system,” he said. Claim: U.S. says results encouraging for healthcare delivery reforms.

Ex Output:

The Obama administration on Thursday reported what it called encouraging results from efforts to reduce healthcare costs and improve the quality of care for more than 5 million Medicare beneficiaries under Obamacare