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: Sen. Charles Schumer of New York said the VA needs to provide Congress more information about a recent bulk order for $208,000 worth of hydroxychloroquine. President Donald Trump has heavily promoted the malaria drug, without evidence, as a treatment for COVID-19. Schumer’s request comes after a whistleblower complaint filed this past week by former Health and Human Services official Rick Bright alleged that the Trump administration, eager for a quick fix to the onslaught of the coronavirus, wanted to “flood” hot spots in New York and New Jersey with the drug. Major veterans organizations have urged VA to explain under what circumstances VA doctors initiate discussion of hydroxychloroquine with veterans as a treatment option. “There are concerns that they are using this drug when the medical evidence says it doesn’t help and could hurt,” Schumer said in an interview with The Associated Press. He said given the fact the malaria drug, despite being untested, had been repeatedly pushed publicly by Trump, VA Secretary Robert Wilkie must address whether anyone at the department was pressured by the White House or the administration to use hydroxychloroquine for COVID-19. Schumer said Wilkie also should answer questions about a recent analysis of VA hospital data that showed there were more deaths among patients given hydroxychloroquine versus standard care, including how much patients knew about the drug’s risks before taking it. In a statement Sunday, VA spokeswoman Christina Noel called it “preposterous” for anyone to suggest that VA would make treatment decisions based on anything other than “the best medical interests of patients.” “VA only permits use of the drug after ensuring veterans and caretakers are aware of potential risks associated with it, as we do with any other drug or treatment,” she said. Wilkie in recent weeks has denied that veterans were used as test subjects for the drug and that it was instead administered at government-run VA hospitals only when medically appropriate, with mutual consent between doctor and patient. Still, Wilkie and the department have repeatedly declined to say how widely the drug was being used for COVID-19, including how many veterans were given the drug, and whether VA doctors were given guidance by VA headquarters on specific scenarios when it should be used. In a weekly call with veterans’ groups this past week, Wilkie continued to defend VA’s use of hydroxychloroquine. He dismissed the recent analysis of VA hospital data showing no benefits to patients, suggesting the poor outcomes were because the cases involved older, very sick veterans. “Use of this medication for treatment of COVID-19 is considered ‘off label’ — perfectly legal and not rare,” he wrote in an April 29 letter to veterans’ groups. The analysis of hospital data, done by independent researchers at two universities with VA approval, was not a rigorous experiment. Researchers analyzed medical records of 368 older male veterans hospitalized with confirmed coronavirus infection at VA medical centers who died or were discharged by April 11. About 28% of veterans who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. The VA recently said most of its recent bulk order for hydroxychloroquine was being used for approved uses, such as treating lupus and rheumatoid arthritis, but it didn’t provide breakdowns. Wilkie in recent weeks took advocacy of the drug even further than Trump by claiming without evidence that it has been effective for young and middle-aged veterans in particular. In fact, there is no published evidence showing that. Veterans are “very concerned that we still do not have clarity on the VA’s past and present use of hydroxychloroquine in treating veterans with COVID-19,” Jeremy Butler, chief executive officer of Iraq and Afghanistan Veterans of America, told the AP. “Now that the federal government issued an emergency use authorization for remdesivir to treat COVID-19, we need answers to these questions as well as the VA’s plans for administering, or not administering, remdesivir,” he said. That action by the Food and Drug Administration came after preliminary results from a government-sponsored study showed that remdesivir shortened the time to recovery by 31%, or about four days on average, for hospitalized COVID-19 patients. In a tweet Sunday, former VA Secretary David Shulkin urged the department to immediately curtail use of hydroxychloroquine for COVID-19. “With studies showing no benefit, VA should restrict use exclusively to clinical trials,” he wrote. Shulkin was fired by Trump in March 2018, and Wilkie replaced him. Schumer said his main concern is determining whether the VA had conducted any “clandestine studies to determine whether hydroxychloroquine was effective without their permission.” He said there’s also concern that the department won’t address specifically where the drug was sent. “These are people who risked their lives for us,” Schumer said. “They should be treated only with the utmost dignity, respect and high standards of care.” The drug has long been used to treat malaria and other ailments. A few, very small preliminary studies suggested it might help prevent the coronavirus from entering cells and possibly help patients clear the virus sooner. But the FDA last month warned doctors against prescribing the drug for COVID-19 outside hospitals because of the risks of serious side effects and death. Claim: Schumer calls on VA to explain use of unproven drug on vets.

SOLUTION: The Senate’s top Democrat on Sunday called on the Department of Veterans Affairs to explain why it allowed the use of an unproven drug on veterans for the coronavirus, saying patients may have been put at unnecessary risk.

PROBLEM: Paragraph: None of the stories we reviewed gave readers sufficient information on the cost of the research scans used in the study. This story includes a comment from a researcher saying that increased use of this type of brain scan would bring the “high cost” down, but it doesn’t provide an estimate of the current cost or any comparison to alternative methods of assessing reading ability or other features of dyslexia. We will give this story a satisfactory rating because it portrays this research as providing information for researchers seeking to understand dyslexia, rather than offering important direct benefits to individuals. However, most of the story is about what it is like to live with dyslexia. These anecdotes have little or nothing to do with the research. The list of celebrities who may have or had dyslexia also seems irrelevant and distracting. Then the story tosses in discussion of a study that looked at correlations between dyslexia and spatial skills; again, unrelated to the topic of the primary study reported here. The jumble of extraneous personal tales and other research muddles the point of the story. MRI brain scans are generally considered to present little physical risk, so the issue here is really the potential negative effects of the information the test produces. At least the story raises that issue by including comments from parents who worry that this sort of scanning could further stigmatize children who have trouble reading or writing. This story fails to point out that the “children” studied were not beginning readers, but teenagers who were already identified as having dyslexia and may have been involved in special reading programs for many years. It also fails to mention several of the caveats and limitations that the researchers noted in their journal article, including the possibility that misclassification of the participants based on their initial testing could affect the results. In other words, rather than actually improving during the study, it is possible some of the teens were actually better readers from the beginning, but just scored low on the baseline tests. Nevertheless, the story appropriately describes this study as helping researchers to understand the disease, rather than evaluating the clinical usefulness of brain scans. Also, one paragraph deep in the story highlights the preliminary nature of the research; specifically that the study included only 25 participants with dyslexia, “which is too small a sample size to prove anything.” It also notes that the study did not look at whether different varieties or reading instruction or other interventions might have had some effect and it includes a comment from an independent expert about the lack of data on instruction or other factors that could influence reading ability. The story would have been better if the alert to the preliminary nature of the study had been near the top, rather than buried near the end. The story refers to estimates that between 5 percent and 20 percent of the population has dyslexia. Unlike the Reuters story we also reviewed, this story provides a useful definition of dyslexia as “a condition that, broadly speaking, hinders a person’s ability to interpret language.”  The story does include independent experts. Although it does not discuss conflicts of interest, the authors of the main study declared no conflicts and reported that their study was supported by a number of grants from public agencies and foundations, though the baseline assessment of the participants was supported by a company that markets treatment interventions for people with dyslexia. One troubling point: the story describes one person who claims to have been helped by “training at a learning development center.” If this individual was associated with the company that helped sponsor this research, the story should have disclosed that connection. The study authors wrote that although standardized tests did not accurately predict changes in reading ability during the study period, “it is possible that there are behavioral measures not included here that may predict outcome.” Indeed, their journal article specifically referred to other research into clinical testing that did appear to predict how children with poor reading skills responded to teaching. The story fails to make clear that the study reported here did not attempt to make a comprehensive comparison of the predictive power of scans and other methods of assessing children with reading problems. The story notes that the type of scan used in this study is not widely available. The story implies that this study is the first to suggest young people with dyslexia use a certain area of the right hemisphere of their brains more than average readers. Actually, the study authors pointed out that their research provides some additional data to support the findings of many other studies of differences between the brains of people with dyslexia and those who read normally. The story does not appear to rely on a news release. Claim: Dyslexia: Scanning the brain for clues

SOLUTION: This story is the best of the three we reviewed about a study indicating that brain scans may help researchers understand brain structure and function in people who have dyslexia. It refrains from claiming that the work has near-term clinical implications for people who have trouble reading and writing. However, the bulk of the story is made up of personal stories about living with dyslexia, while key features of this research are buried deep in the story or left out entirely. What’s more, the story describes the study participants as “children,” thus leaving readers with the impression that researchers looked at beginning readers, when they actually were studying teenagers who presumably had been dealing with dyslexia for many years. In addition, the story tosses in a discussion of an unrelated study of dyslexia and spatial skills. Even people with advanced reading skills are likely to come away from this story befuddled about the scope, findings and implications of the research. Good reading skills are fundamental to educational, social and financial success. Dyslexia is a type of reading disability characterized by difficulties in word recognition, spelling and decoding. Most studies suggest early intervention is important, but little is known about why some children respond better than others. This research suggests that brain scans can provide insight to underlying mechanisms of dyslexia and perhaps help track and refine interventions that could be tailored to individuals. But for readers to understand the value of this study, stories must clearly describe the research and its implications.

PROBLEM: Paragraph: "Just before commemorating World AIDS Day on Tuesday, Fulton County’s health department released some rare good news on its efforts against the disease. Citing a report from an independent program of the National Association of County and City Health Officials, the press release said the number of people dying here from HIV-related diseases plunged 59 percent between 2004 and 2012. ""Fewer people are dying from HIV/AIDS in metro Atlanta, in part, due to our Integrated Care Service Delivery of services,"" Dr. David Holland, chief clinical officer of Fulton’s Communicable Disease Prevention Branch, said in the release. Could this be the same department that had to give back between $7 and 8.7 million of $20 million in federal grant money because it didn’t have enough programs to help stop the spread of HIV? And are deaths declining even though at least a quarter of all new HIV diagnoses in Atlanta are for people who have already developed AIDS? PolitiFact Georgia was skeptical. The numbers The 27th anniversary of World AIDS Day comes at a time when both the rate of HIV infection and AIDS-related deaths are on a global decline. Effective antiretroviral drugs can control HIV and help those with the disease live longer lives. As of June, 15.8 million people were receiving antiretroviral treatment. Worldwide, that has pushed down new HIV infections, which have fallen by 35 percent since 2000, and deaths, which have fallen 42 percent since a peak in 2004. The 2015 report from NACCHO’s Big Cities Health Coalition examines health data from the nation’s 27 largest cities and counties, including a look at more local HIV and AIDS figures. According to the Big Cities Health Inventory report, released in late November, cities experienced new cases of HIV and HIV-related deaths in higher numbers compared with the rest of the country. But Atlanta (as reported by Fulton County’s health department) and every other city except Detroit saw drops, some significant, in mortality rates since the last report. Atlanta had the fourth highest mortality rate of the cities, with 24.1 deaths per 100,000 people in 2004, according to the report. In 2012, the last year data was available for a majority of the cities, the rate was 9.8 – a 59 percent drop just as Fulton touted in the press release. Data from Georgia’s Department of Public Health back up those figures on the mortality rate and also provide the specific numbers of deaths. The number of people dying annually from HIV/AIDS in Fulton County dropped from 195 to 96 in those eight years, a 51 percent decline. Further bolstering Fulton’s claim are figures showing continued drops in deaths for the past two years. By 2014, 80 people in Fulton had died from HIV or AIDS, a rate of 8 percent. That’s a 59 percent decline by number or a 66.8 percent decrease in rate from the peak a decade ago. Statewide, HIV/AIDS deaths also declined during this period by 47 percent said Nancy Nydam, spokeswoman for the Georgia Department of Public Health. The state death rate from HIV/AIDS was 7.9 per 100,000 in 2004 and 4.2 in 2012, a 47 percent drop, she said. The context All of this is to say, Fulton is on target with its figures. Missing from the press release, though, was the context that Atlanta remains in the top 5 cities for HIV-related deaths (and top 3 for new infections). And, its 10 per 100,000 mortality rate is five times greater than the national average of 2. ""It’s a big improvement but obviously some big improvements still need to be made,"" said Chrissie Juliano, director of the Big Cities Health Coalition. ""We know from other sources that challenges remain in Atlanta-Fulton County regarding HIV and AIDS."" Fulton is making headway. It completed an internal audit in October that found mismanagement and bureaucratic delays cost it the nearly $9 million in federal money to fight HIV. It has since replaced the health department director and strengthened oversight of its grants. Patrick Sullivan, an epidemiologist at Emory University’s Rollins School of Public Health, cautioned against reading too much into Atlanta’s ranking in comparison to national mortality rates. He added that it would not be ""informative"" to directly compare Atlanta, or any city, to the overall U.S. rates on HIV mortality. ""HIV-related deaths are much higher in cities, because people living with HIV are more concentrated in cities,"" Sullivan said. ""The high HIV-related mortality rate reflects the high impact of HIV in Atlanta."" Our ruling At a time when new HIV infections and AIDS-related deaths are down globally, Fulton County touted a report that showed its mortality rate dropped 59 percent from a peak in 2004. The report, and state data, back up the dramatic decline. While Atlanta remains in the top five cities in the nation for such deaths and still struggles with executing prevention programs, it also has seen the mortality rate drop since the report." Claim: The number of people in Atlanta dying from HIV and AIDS declined 59 percent between 2004 and 2012.

SOLUTION:
At a time when new HIV infections and AIDS-related deaths are down globally, Fulton County touted a report that showed its mortality rate dropped 59 percent from a peak in 2004. The report, and state data, back up the dramatic decline. While Atlanta remains in the top five cities in the nation for such deaths and still struggles with executing prevention programs, it also has seen the mortality rate drop since the report.