instruction:
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.
question:
Paragraph: The Office of Inspector General on Friday released two reports that look into the longstanding challenges of the 28 hospitals directly operated by the federal Indian Health Service. The OIG, which acknowledged that reports of inadequate health care services for Native Americans have been of concern to the federal government for almost a century, criticized the agency’s limited oversight regarding compliance with federal regulations and quality of care, detailing how the agency’s regional administrators have few sources of information to assess the services provided at the facilities. The Indian Health Service, commonly referred to as IHS, is responsible for providing health care services to enrolled tribal members as part of the government’s treaty obligations to Native American tribes. But the agency has faced challenges for decades, and within the past year it has been under increased scrutiny from Congress after inspections of hospitals in the Great Plains uncovered severe deficiencies. The OIG says IHS’s eight regional offices conduct activities to monitor the quality of the facilities, but those efforts are minimal in some areas. One of the reports states that the primary source of information that the regional offices use to detect quality problems is a small number of complaints and patient harm reports. “However, according to hospital administrators, most patient complaints relate to customer service and wait times, rather than medical care,” according to the report. “Further, most hospitals (20 of 28) receive fewer than 100 complaints per year for inpatient and outpatient visits combined, averaging about 1 complaint per 1,000 patient visits. ... Considering the quantity and subject matter of complaints and patient harm reports, they are unlikely to provide hospital staff with the breadth of information needed to identify and diagnose systemic quality or compliance breakdowns.” The OIG, which gathered the information for the reports between April and October 2014, also said that only half of the regional offices conducted mock inspection surveys that could provide insight regarding the facilities’ quality practices. The watchdog also faulted the IHS for staggering findings of outdated facilities and the weekslong process that job applicants must follow, even when the physician vacancy rate was 33 percent at the time the information for the reports was gathered. According to the report, in 15 of the 28 hospitals, administrators reported that aging or inadequate physical environments affected their ability to give quality care. Corroded pipes in one hospital caused sewage to leak into the operating room. The IHS has now been under scrutiny for more than a year after inspectors from the Centers for Medicare and Medicaid Services, known as CMS, found several quality-of-care deficiencies at hospitals in South Dakota and Nebraska. At one facility, the alarming conditions of its emergency room led officials to close it for seven months. The OIG on Friday recommended that CMS inspectors survey IHS facilities more frequently. The IHS in a statement Friday concurred with recommendations made by the OIG, including the need for more training for staffers and new ways to monitor hospital quality. The IHS also said it began a mock survey initiative at 26 hospitals in May 2016 to assess compliance with the standards that facilities must meet to be able to participate in the Medicare program. The IHS’s statement also highlighted a team that was formed in February 2016 “to ensure that dependable, quality care is delivered consistently across IHS facilities.” ___ Follow Regina Garcia Cano on Twitter at https://twitter.com/reginagarciakNO ___ Associated Press writer James Nord contributed to this report from Pierre, South Dakota. Claim: Watchdog: Staff issues affect care at reservation hospitals.
answer:
The internal watchdog of the U.S. Department of Health and Human Services says the often-substandard quality of care at hospitals serving Native Americans is the result of outdated equipment and technology, lack of resources and difficulty attracting and keeping skilled staff.


question:
Paragraph: "The story mentioned that the test carried a $399 price tag. Of course there are larger cost perspectives. If this diagnostic test truly has value, it might lead to more targeted therapy – perhaps decreasing overall medical costs. If it is a poor test, it may increase medical costs beyond the initial $399 for the test itself. The story included discussion about how this test might be of benefit; it did not include quantification of benefit (i.e. :how much faster could it enable a clinician to make a diagnosis?) though one of the points of the story was that the actual benefit of this test was somewhat imprecise. Lastly – the statement that any information is good is a red herring. However, we’ll again give the story the benefit of the doubt on this criterion. The story discussed problems associated with false positive or false negative results. It mentioned that physicians might not have the appropriate training to understand what to do with the results of the test and could make, what an expert quoted in the story described as ""foolish decisions"" The story mentioned that this and other genetic test kits prey on individuals’ deepest anxieties. That said – there are many more harms possible. Creating the precedent for direct marketing of lab tests – even if the results go to the doctor carries significant risks. It could prey on peoples’ insecurities, cause financial harm, adversely affect the patient-clinician relationship, and lead to other family members of test positive patients (family members without symptoms) getting a meaningless test due to worry. It was good that the story pointed out that there is little oversight for the accuracy of genetic test kits. Overall the story did a good job; it gave data such as 1% rate of genetic abnormality in unaffected vs. 3% in bipolar patients. It said, ""The report that accompanies those results instructs doctors that a positive test means patients are two to three times more likely to have bipolar disorder."" If the reporter had gone the next step, it would have been even better. For example, if someone has no symptoms of bipolar disorder, then the likelhood of current bipolar is 0% – so a 2-3 time increase in risk is still 0. For someone with many symptoms, the risk of bipolar disorder might be 50-60% (rough estimate) and an abnormal test might increase that substantially. Granted, interpreting the quantitative data for readers may be difficult but it would have been helpful to put it into terms that were easier to understand. But in discussing why the test was useful, the company founder said that it was important ""even if it just helps a little bit"". The story should have noted that this lack of quantification of benefit is problematic. We’ll give the story the benefit of the doubt on this criterion. The story did not engage in overt disease mongering. The story included quotes not only from the scientist who developed the test discussed, but from several experts in the field. The story did not make clear how diagnosis of bipolar disorder with the test vs. without the test differed. However it would appear that this may have been intentional as it isn’t actually clear how diagnosis of this disorder is dramatically altered in the era where this test is available. The story mentioned that this was a commercially available product. (Though it failed to mention that this test would likely not be covered by insurance, it also did not imply that it would. This, of course, will affect availability.) The story was clear that the test for bipolar disorder it described had been commercially available for about a month. It also mentioned that there about 1000 other test kits (for other genetic traits) which are available. Does not appear to rely on a press release." Claim: At-home gene test stirs up debate
answer:
This is an excellent story that used a concrete example (i.e. bipolar disorder) to highlight the pitfalls involved with the use of genetic test kits for gene alleles. Rather than write a story heralding the first commercial availability of a test to identify genetic markers associated with risk of bipolar disorder, this was a thoughtful piece that presented both the hope and the hype associated with the product. While failing to provide concrete estimates for the benefit from the product or diagnostic alternatives, the story painted an accurate picture of the uncertainty for deriving benefit.


question:
Paragraph: Sangamo shares jumped as much as 30 percent to a six-year high of $17.73 on the Nasdaq on Thursday morning. Biogen will use Sangamo’s genome-editing technology to develop drugs targeting sickle cell disease and beta-thalassemia. It will provide Sangamo $20 million upfront and reimburse costs related to research and development. Sangamo will also be eligible for milestone payments of about $300 million, as well as double digit royalties on product sales. The upfront payment and the terms of the milestone payments and the double digit royalties were pretty high, Wedbush analyst Liana Moussatos said. “The deal terms are very lucrative for a pre-clinical platform. So I think Biogen must have been impressed with the pre-clinical data that Sangamo presented last month.”  Sangamo presented the data last month at the annual meeting of the American Society of Hematology. The company will be responsible for research and development for the first proof-of-concept study for beta-thalassemia, according to Thursday’s deal. Beta-thalassemia impairs the body’s ability to produce hemoglobin, the protein in red blood cells (RBC). Sickle cell disease changes the shape RBCs, tending to block blood flow. Moussatos said Sangamo also had a promising HIV program, with a patient to stay with undetectable viral load for six months. “That’s another viable treatment and I won’t be surprised if they announce another partnership for that,” Moussatos said. Claim: Sangamo to develop blood disorder drugs with Biogen.
answer:

Sangamo Biosciences Inc said it would collaborate with Biogen Idec Inc to develop treatments for a group of inherited blood disorders in a deal for up to $320 million.