TASK DEFINITION: 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.
PROBLEM: Paragraph: Researchers around the world are working to develop potential treatments or vaccines against the respiratory disease that has killed nearly 47,000 people and infected almost a million in just a few months. A team at the University of Pittsburgh School of Medicine in the United States said they were able to move quickly in developing a potential COVID-19 vaccine after working on other coronaviruses that cause Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). “These two viruses, which are closely related to SARS-CoV-2 (the new coronavirus causing the COVID-19 pandemic), teach us that a particular protein, called a spike protein, is important for inducing immunity against the virus,” said Andrea Gambotto, an associate professor at Pittsburgh. “We knew exactly where to fight this new virus.”  When tested in mice, the prototype vaccine - which the researchers have called PittCoVacc - generated what they described as “a surge of antibodies” against the new coronavirus  within two weeks. The Pittsburgh researchers cautioned that because the animals have not been tracked for very long as yet, it is too early to say whether and for how long the immune response against COVID-19 lasts. But they said that in comparable tests in mice with their MERS experimental vaccine, a sufficient level of antibodies was produced to neutralize the virus for at least a year. So far, the antibody levels of the SARS-CoV-2 vaccinated animals seem to be following the same trend, they said in peer-reviewed study in the journal EBioMedicine. The team said they hope to start testing the vaccine candidate on people in clinical trials in the next few months. The potential vaccine uses a needle patch design, called a microneedle array, to increase its potential potency. This array is a fingertip-sized patch of 400 tiny needles made out of sugar and the spike protein, Gambotto explained. It is designed to deliver the spike protein pieces into the skin, where the immune reaction is strongest. Claim: Potential COVID-19 vaccine shows promise in mouse study.

SOLUTION: Initial tests in mice of a potential COVID-19 vaccine delivered via a fingertip-sized patch have shown it can induce an immune response against the new coronavirus at levels that might prevent infection, U.S. scientists said on Thursday.

PROBLEM: Paragraph: The story does not say how much this new procedure costs or compare it with existing treatments for patients who don’t respond to medication. Deep brain stimulation, the current treatment standard, can run anywhere from $30,000 to $70,000, according to various online cost estimates. There also may be additional costs incurred by those patients who have adverse effects. The story is long on description but short on numbers. Saying the treatment “has had an immense impact on patients’ lives,” the story devotes quite a bit of print along with video footage to show rapid functional and quality-of-life improvements experienced by patients, focusing on one women who said her tremor “has almost disappeared” since she had the procedure in June. Video showing this patient before and after treatment–including her attempts to write her name, trace a spiral and pour water from one cup to another–do a great job of conveying the improvements. This is terrific news for this woman, but we’re not told how representative her experience is of overall outcomes. Is she a best-case scenario? Middle of the road? There are also inspiring quotes from a researcher, including a description of the “remarkable moment” patients experience when they realized the tremor has subsided. “They can write their names again, they can feed themselves, they are not embarrassed about being in public. So it really is extraordinarily helpful for people,” he says. In terms of study data, the story says researchers “found that the severity of essential tremor reduced significantly” in patients who underwent the treatment as well as reported improvements in quality of life. But there are no figures. In fact, according to the study, patients experienced a 47 percent improvement in tremor scores, dropping from 18.1 points on a 32-point scale at baseline to 9.6 points three months after the procedure. That data should have been included. Also, the story should have spelled out that 56 patients received the treatment, versus 20 who experienced a fake procedure. Also worth pointing out: We don’t know the meaning or clinical significance of a reduction of this magnitude in the total score. The story addresses adverse effects, and that’s sufficient for a Satisfactory rating. We do wish the story had quantified the harms that were measured in the study. The fourth paragraph says the procedure “brings lasting side effects in some patients” and later the story quotes a physician who is not involved in the research as saying, “It’s a pretty high incidence of side effects.” But nowhere do exact numbers appear. Rather than citing data from the study, the story quotes the physician as saying that “over a third of patients actually experienced either gait disturbance or paresthesia,” or numbness. This information isn’t very useful because the story does not explain when these rates were measured. According to the study, three months after the procedure 36% of patients had gait disturbance and 38% had numbness. After 12 months, the numbers dropped, to 9 percent and 14 percent respectively. Also worth mentioning is that one patient was reported to have permanent diminished sensation of the dominant thumb and index figure, which was categorized as a serious adverse event. That did not appear in the story. The story clearly spells out that there isn’t data on the long-term efficacy of this procedure, and that more study is needed, so we’ll give this a barely passing Satisfactory. Several important study limitations were not included in the story, such as the fact that the treatment did not provide significant improvement for some types of tremors, and the treatment is not appropriate for people who are unwilling or unable to undergo an MRI. We’re also not told that the sham group was only followed for 3 months, while the experimental group was followed for a year. This is not usually recommended in clinical trials and both groups should be followed for the same length of time. The story cites a figure from the International Essential Tremor Foundation, an advocacy group, that an estimated 10 million people in the United States suffer from the condition. However, a 2014 analysis of existing research put the number of cases at around 7 million as of 2012, or about 2.2% of the U.S. population. While this may not qualify as disease mongering, the story could have pointed out that the exact number of cases isn’t clear. Also, the story should have noted that not all people with essential tremor have symptoms severe enough to require treatment. The story only fulfills part of our criteria. It does use one independent source, a physician who was not involved in the study. It also accurately reports the trial’s funding sources: InSightec, which developed the device; along with Focused Ultrasound Foundation, which is funded by device makers and philanthropic organizations; and the Binational Industrial Research and Development Foundation, an Israel-U.S. government partnership that receives corporate support. However, the story falls short because it does not report the fact that nine of the study authors reported conflicts of interest, with most receiving financial compensation of some sort from device makers in the field. Lead researcher G. Rees Cosgrove, M.D. who is quoted in the story, reported receiving consulting fees from InSightec. The story states, “Doctors usually treat essential tremor with medication, but the drugs don’t work well for all patients.” That’s true, and so we’ll give this a Satisfactory rating for at least mentioning alternatives. But it should be noted that other procedural treatment options were not compared or even mentioned in the story and received only a brief mention in one of the videos. The current standard for tremor patients who don’t respond to medication is deep-brain stimulation, in which a probe connected to a pacemaker is implanted in the thalamus to suppress the tremors. Gamma Knife thalamotomy, which delivers precise doses of radiation to the thalamus, is also considered to be a safe and effective therapy for patients who don’t respond to medication. Also, some patients have mild symptoms that can be treated with relaxation techniques and the avoidance of triggers such as caffeine. The story states that the device was approved by the FDA in July. The story could have done readers a service by giving a sense of how many medical centers around the country are geared up to perform the procedure, or will be soon. This is indeed a new treatment option for essential tremor, though the story may leave readers with the false impression that the concept of killing off neurons in the thalamus is new. Rather, it’s the use of focused ultrasound to destroy brain tissue, rather than a probe inserted in the brain, that constitutes an advance. The story does not appear to rely solely on the news release, which we also reviewed. Claim: New treatment offers some hope for an unshakable tremor

SOLUTION: This story describes a recently FDA-approved device to treat essential tremor in patients who have not responded to medication. The ExAblate Neuro, made by Dallas-based InSightec, uses magnetic resonance images taken during the procedure to deliver focused ultrasound that destroys tissue in the thalamus, the part of the brain where tremors are believed to originate. Results of a randomized clinical trial on the device’s safety and efficacy were published this month in the New England Journal of Medicine. The story and accompanying video (seen at right) vividly illustrate rapid symptom improvements, highlighting a 72-year-old woman who says the procedure changed her life by allowing her to “eat like a normal person” and easily perform basic tasks such as signing her name and folding a scarf. This powerful patient anecdote throws the balance off: Imagine how different the story would seem if the video instead showed a patient who had improved, but also was affected by one of the serious adverse effects caused by the treatment. Also, the story needed specific numbers on the measured benefits and harms, along with a discussion of costs and alternative treatment options. Note: We also reviewed the news release that was issued to journalists about this study. While not life threatening, essential tremor can be debilitating, especially affecting people in their advanced years. The ExAblate Neuro, which the FDA calls the first focused ultrasound device to treat essential tremor in patients who have not responded to medication, offers a somewhat less invasive treatment option than traditional surgical approaches. It’s certainly newsworthy. But all of the facts, including long-term efficacy data, are not in. Stories that feature glowing patient anecdotes and positive physician commentary need to be balanced with plenty of data that can help patients and their families decide whether this treatment might be worth seeking out.

PROBLEM: Paragraph: "The story tells readers the scans cost about $200-$400 and are generally not covered by insurance. The benefits in this case are estimates of 10-year survival in those found to have lung cancer through screening, which is provided. Since there is no control group, there would be no way to provide an absolute risk reduction. But, the story does provide a 5-year chance of death estimate for those diagnosed conventionally, e.g. as a result of symptoms. This provides some relative comparison of what screening MIGHT offer, although it's not known for sure and readers are cautioned that direct comparisons are not possible. The story mentions potential harms from screening, namely ""serious health risks from examining and treating tumors that may not be harmful."" The story could have been clearer about what some of these risks are (like undergoing unnecessary surgery with all of its risks and anxiety to the patient), but it appropriately mentions that screening may have harms, which is often overlooked. The story tells readers that the latest study is uncontrolled, meaning direct comparisons cannot be made between groups of people who were screened and groups of people who were not screened. The article does describe this limitation to the study. The story could have been clearer that this is an observational study vs. a randomized controlled trial–which is the gold standard in research. Direct comparisons between groups will be difficult to make in the absence of a future randomized controlled trial. The story tells readers that lung cancer is the leading cause of death from cancer in the U.S. The story does also describes the burden of lung cancer, providing estimates of 5-year survival without screening (estimates from the general population who were diagnosed as a result of symptoms). No obvious embellishments or overstatements. The story obtains information from physicians not associated with the research who can provide a range of perspectives on what screening may or may not offer to provide balance. The story provides some historical alternatives to CT screening for lung cancer (serial x-rays in the 1970s) and does indirectly describe the de facto alternative, that is, finding lung cancer as a result of symptoms. It does this by telling readers that lung cancer is rarely found curable in the absence of screening and providing estimates of chance of death within 5 years when diagnosed this way. The story indirectly states that lung cancer screening is not widely available (e.g. ""would widespread screening reduce cancer deaths?""). The story tells readers that interest in this technology increased in the late 1990s as a result of early work with lung cancer screening, providing some historical information about when lung cancer screening came onto the scene. The story also indirectly states that this is not widely available, implying that widespread lung cancer screening would be new, although a CT scan, the technology used for lung cancer screening, is not new. The story is well-researched and uses input from many experts, which would not normally be contained within a press release." Claim: Early screening for lung cancer gets mixed reviews

SOLUTION:
"The story does a nice job of reporting on a new study of CT scan screening for lung cancer, including mentioning availability, novelty, the strength of the evidence, quantitative benefits, potential harms, costs, and independent sources. One cautionary note: Although not technically part of our review criteria, the story does have elements of ""treatment mongering."" One example is that the story reports one man's experience with screening as part of the study. He had a tumor surgically removed and now claims ""he's healthy."" Anecdotal accounts like this are potentially biasing and overly-dramatic. There is no opposing perspective, such as a patient who experienced harms from screening, which would help balance this one person's rosy perspective. Another example is including one physician's perspective that he hopes lung cancer screening is included in routine healthcare, like mammography. Readers may not be aware that there is controversy surrounding widespread use of mammography screening and the statement assumes there is a survival advantage to lung cancer screening, which is not yet known. But overall, the story is reported in a balanced, comprehensive way. It earns a five-star score."