Given a paragraph and a claim, classify it this way: If the claim contradicts the evidence present in the paragraph, classify the claim as '0'. If the claim has multiple supporting *AND* contradicting evidences, classify the claim as '1'. If the claim has supporting evidence and the paragraph is in overall favor of the claim, then classify the claim as '2'.

Q: Paragraph: The article does not mention the cost of hormone therapy or compare its cost against that of other therapies. Since the story suggests that treatment might be helpful in younger women with severe hot flashes, cost is relevant. The article suggests that hormone therapy might help younger women control hot flashes. But the primary subject of both the Newsweek story and the new research is harms of therapy, not benefits, so we consider this criterion not applicable in this case. The Newsweek story summarizes the previously published analyses of the Women’s Health Initiative trials, which found that women who received hormone therapy had a slightly higher risk of heart attacks, strokes, blood clots, and breast cancer than women who received placebo. It reports new data on the harms of hormone therapy in women who have hot flashes and night sweats. However, the story does not report the frequency of these potential harms, making it difficult for readers to judge their risks. Some readers with bad hot flashes and night sweats might think the risks of heart attack and death are too small to worry about, others might not. (See “Comments” below.) The article fails to alert the reader to the provisional quality of the new findings. As the researchers note in their published manuscript, the current subgroup and secondary analyses are “exploratory” and “not statistically significant.” In other words, they represent very interesting hypotheses for further exploration. The also demonstrate how little we know about menopausal symptoms and their management. The news story says only that the analyses “had some technical issues.” According to the story, hot flashes might be “dangerous” because they might predict heart disease. Thus, the article adds another normal feature of aging (postmenopausal hot flashes) to the list of experiences that are not only distressing and uncomfortable but also apparently perilous to a woman’s health. Unfortunately, the article fails to note that none of the research findings are statistically significant. Hot flashes might be important, or they might not. The article cites the lead author of the new study, who is also the head of the Women’s Health Initiative. But a second source not associated with the research might have added a valuable and different perspective, perhaps pointing out that the evidence is weak and does not warrant action by women or their health care providers. The story mentions one option to hormone therapy for managing difficult symptoms of menopause—doing nothing. The current evidence suggests there are few other good options. But there are several strategies for preventing and treating heart disease and stroke, including exercise and diet, as well as monitoring risk factors such as high blood pressure and cholesterol. The story does not mention availability, but most readers affected by hot flashes will be familiar with hormone therapy. The article accurately suggests that hormone therapy is not a new treatment. The story did not appear to rely solely or largely on a news release. Claim: Menopause: A flash of concern

A: 0
****
Q: Paragraph: "As the national effort ramps up to beat back Ebola, the Obama administration has been taking heat. Critics say the president and top public health officials painted too rosy a picture of the country’s state of readiness. As proof, they point to the infection of two Dallas health care workers who treated the first person to die of Ebola on U.S. soil. Conservative pundit George Will attacked what to him was the hubris in those early statements. ""The problem is the original assumption, said with great certitude if not certainty, was that you need to have direct contact, meaning with bodily fluids from someone because it’s (Ebola) not airborne,"" Will said Oct. 19 on Fox News Sunday. ""There are doctors who are saying that in a sneeze or some cough, some of the airborne particles can be infectious."" Will also said Ebola could survive on a dry surface ""for a number of days."" Show host Chris Wallace cut Will off, asserting that Ebola does not spread like the flu, which does move from person to person when someone with the illness is out in public. When another guest challenged Will to cite his source, he ultimately referred to scientists at the University of Minnesota. Here, we’re fact-checking Will’s claim that scientists say a cough or sneeze can spread Ebola. From the context of the discussion, we understand that Will was talking about the risk to the general public. We reached out to Will and did not hear back but thanks to the rumor website Snopes, we have a pretty good idea where he got his information. In mid September, the University of Minnesota’s Center for Infectious Disease Research and Policy posted a commentary from two University of Illinois professors. The commentary, co-written by Lisa Brosseau and Rachel Jones, argued that health care workers treating patients with Ebola should wear respirators. Face masks, they said, are not enough. We asked Brosseau if Will had correctly relayed her work. Brosseau said her views had nothing to do with Ebola spreading among the public at large. The focus was on health care workers treating people in the isolation wards. ""We were concerned about aerosols generated by infected patients in the most severe stage of the disease,"" Brosseau said. Will had mistakenly connected the pathway of infection in a hospital room with someone coughing or sneezing in public. As has been well documented, the first symptom of infection is a fever. As the virus multiplies in the body, vomiting and diarrhea set in. Brosseau had written that it is possible that for patients in that condition, tiny water particles from violent vomiting and diarrhea could get into the air and be inhaled. In a laboratory experiment, monkeys with hoods over their heads could acquire the Ebola virus, but Brosseau said that lab experiments should be put in context. ""We are not aware of any published data about the viability or infectiousness of the Ebola organism in aerosols in the real world,"" Brosseau told PunditFact. ""It appears unlikely that the public will be exposed to infectious aerosols because they are not likely to encounter infected people experiencing the severe symptoms."" We found similar views in the Oxford Journal of Infectious Diseases, and summaries issued by the Centers for Disease Control , the World Health Organization and the New England Journal of Medicine. Adam Lauring, an infectious disease researcher at the University of Michigan, emphasized that Ebola is not a respiratory disease. Coughing and sneezing are not symptoms in the way that they are with the flu. Stephen Gire, a research scientist in the Sabeti Lab at Harvard University, said if someone with Ebola sneezed or coughed into your face when you were close to them, that could transmit the virus through droplets. But, ""It’s important to note that this form of transmission does not constitute 'airborne,' "" Gire said. ""This is still a form of direct contact."" ""If you were on a plane, and someone sneezed, you wouldn’t be at risk of getting infected unless you were sneezed on directly within close quarters, and that cough or sneeze transferred droplets into mucosal membranes. This is very unlikely scenario, but not out of the realm of possibility. I think I can count on one hand the number of times I’ve been sneezed on directly, and only one of those times was by someone I didn’t know."" One of the problems with the public debate over Ebola, Lauring said, is that science can’t prove that something will never happen. On the other hand, he also said we ought to look at what has happened. ""If airborne transmission was an imminent concern, one would have to ask why no one in the United States has been infected except for two people who had close contact with the patient,"" Lauring said. ""Importantly, none of the people who were living with the patient prior to his second trip to thee Texas hospital have been infected."" While we are not fact-checking Will’s statement about infectious particles remaining alive for several days on a dry surface, Lauring said he knows of no evidence of that. Gire said it's theoretically possible under the right conditions, though it's highly unlikely. Our ruling Will said that some scientists say that Ebola can be transmitted in public by a sneeze or a cough. The source of that was a commentary about the risks to hospital workers treating people in advanced stages of the disease. One of the authors of that commentary said her work applied only to health care workers in those settings. The medical literature says sneezing and coughing are not part of the disease’s typical symptoms, and experts we reached drew a bright line between what might happen in a hospital isolation ward and a person with early symptoms of Ebola before he or she is admitted. There is no evidence that Ebola has been transmitted in the general public through coughing or sneezing. Will took a medical commentary out of context. Update (Noon, Oct. 20): After we published this item, we heard from some folks who disagreed with our ruling. Read our response here." Claim: "Some doctors say Ebola can be transmitted through the air by ""a sneeze or some cough."

A: 0
****
Q: Paragraph: The story makes no mention of costs. Instead by saying, “could be on the market and available for thousands of patients in about five years’ time” it leaves readers with the impression that cost is not an issue. This is exactly the kind of device that an insurance company might put on its “ineligible” list. A quick review of the business media suggests the cost of the device will exceed $75,000 if it becomes commercially available. according to this Medical Device Technology Alert. It is hard to imagine why this important fact was overlooked in the story. Beyond saying in the lead that three people were able to “see shapes and objects,” there is not much else in the story to help readers understand the levels of vision improvements that were seen and how those should be compared to the preexisting conditions or other treatments. Then, confusingly, the story narrows its focus to just one patient saying, “one blind patient who had the device implanted was able to identify and find objects placed on a table in front of him, and was able to walk around a room independently. He could even read a clock face and differentiate between seven shades of grey, the researchers said. Tests were conducted starting from seven to nine days after the device was implanted.” It’s tough when writing a story about a study this small to put hard numbers to the benefits, but even some acknowledgment of this limitation would have been better than some of the overly optimistic sentiments expressed. The study itself and the press released provided more ways for the story to quantify the benefits. The story provides absolutely no information on the implant requirements for the device nor the potential downsides associated with this surgical procedure. There are some caveats tossed into this story, but they can’t overcome the hype. The story says in the lead that the implant “allowed three blind patients to see shapes and objects within days of treatment”. The next sentence says, “Experts described the study results as phenomenal”. The story does deserve credit for saying in the lead that only “three blind patients” saw vision improvement, but the story does little else to describe the limitations of the study or to place it in any context. The story engages in disease mongering by throwing in some sketchy numbers about the frequency of the disease. It says the device “could eventually change the lives of up to 200,000 people worldwide who suffer from blindness due to a degenerative eye disease called retinitis pigmentosa.” Later it says, “Retinitis pigmentosa in a genetic eye condition that leads to blindness and affects about 1 in 4,000 people worldwide.” By our math, 200,000 out of 6.8 billion people worldwide means that 1 out of every 34,500 people is affected. And if we’re just talking about adults, that number drops to 1 out of every 22,105 people, a far cry from 1 out of every 4,000. If it were truly one out of every 4,000 people worldwide, that would mean that 1.1 million people have the disease. The story does quote one presumed independent source, Robert Maclaren, a professor of Ophthalmology at Britain’s Oxford University. In the above mentioned Medical Technology Alert, the manufacturer announced that Dr. Maclaren will be the lead investigator on a clinical study expected to enroll six subjects to advance this same retinal implant technology. As a result, Dr. Maclaren can hardly be described as an independent expert. Overall, we felt that the story was missing a strong, independent analysis. Had the reporter talked with more researchers in the field or more clinicians, perhaps the story would have had a more thoughtful tone. The story mentions that there are other implants, saying, “Other types of retinal implants, known as epiretinal implants, sit outside the retina and because they bypass the intact light-sensitive structures in the eyes they require the patient to wear an external camera and processor unit.” But that’s not a true comparison, nor does it provide readers with the true picture of how much R&D is happening right now in this field. As is often the case in medicine, surgical options and devices are not the only solution. Lowly old Vitamin A is often the first step for treating retinitis pigmentosa. The story does a credible job noting that the device is under study and not commercially available. Unfortunately it also suggests, based on the manufacturer’s statement, that the device in a very early stage of development will be available in 5 years. The hyperbole used is indefensible – “the device could become routine for some kinds of blindness in five years” and “could eventually change the lives of up to 200,000 people worldwide.”  This comes after a test in 3 people. The novelty of the device is established. The story does not rely on a news release, and, in fact, this news release from the University of Tubingen contains more interesting information about the study than the story. Claim: Retinal implant trial helps blind people see shapes

A:
0
****