Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.

Ex Input:
The story reports not only the cost of the blood test ($60), but the cost to detect one case (including follow-up), which the researchers calculated to be $28,600. This is excellent context. The story would have been better if it had noted that the people included in this study were at unusually high risk for developing this cancer. The 34 cases found after screening 20,000 people is almost 200 times the typical annual rate in the US and other countries (less than 1 per 100,000 people per year). The ultimate measure of cost is cost-effectiveness (cost per life-year saved) which requires survival data. These analyses can also be adjusted for quality of life. While most of this story is careful to note that this test has yet to show clinical effectiveness, that caution is trampled by the claim that this blood test “boosted patients’ chances of survival,” something that this type of study cannot determine. The claim that this test is more accurate than existing methods is also premature, since the study did not directly compare the blood test to existing methods. Finding more early-stage cancers is a necessary but hardly sufficient step in the pathway of demonstrating benefit for a new screening test. Clinical trials are needed to address issues of false positives, over diagnosis, over treatment, and survival. The story reports that developers of this blood test still need to show low rates of false positive or negative results. A low false negative rate means there are fewer missed cases of serious disease. The trade-off, though, is a higher false positive rate. All positive tests will need to be evaluated with a gold standard diagnostic test and the safety, acceptability, and costs of that gold standard test will profoundly affect the uptake of the new screening test. While the story reports that this study was a “proof-of-concept” experiment, it then says the test boosted survival, something that can only be known after directly comparing the new test to existing methods. Making treatment “dramatically more effective” can be proven only with randomized trials. All screening tests that can detect cancers at an earlier stage will be associated with an apparent increase in survival time, but as explained in more detail below, this does not necessarily mean that patients with screen-detected cancers actually live longer than they would have otherwise. Efficacy can be established only with an RCT. The story could have done a better job pointing out the many limitations in the work. For example, there was no follow-up testing for people who had negative blood test results. Even though the researchers surveyed participants a year after the testing, they didn’t produce any data on how many of the people with negative blood tests actually had cancer. What’s more, the researchers compared the survival rates of their patients to a different group of cancer patients from another study, which raises questions about how comparable the groups really are. There was also no discussion of the possibility that at least some of the tumors discovered through this screening might not have developed into dangerous cancers. The story does not address lead-time bias (that longer survival might be at least partly due to finding the tumor earlier in its natural course, rather than to just the effect of treatment). The researchers noted that the effect of lead time bias can only really be known through a randomized, controlled trial. We will rate the story satisfactory on this criterion because it is careful to note that this test is not ready for clinical use and that the study results apply to only one type of cancer. However, the story would have been better if it had pointed out just how rare this cancer is, less than one case per 100,000 people in the US per year. That is about 3,000 cases in the US per year — out of about 1.7 million cancers diagnosed annually. And the comment that the cancer “is prevalent” in southern China and Southeast Asia may be misleading. While it may occur more often in the region, rates are still on the order of 10 to 20 per 100,000 which is hardly widespread. The story squeaks by on this criterion because it includes a quote from an editorial in the journal that was written by an independent source. It would have been more useful to readers to include more comment and context from someone without financial ties to this study. The story is upfront about the financial interests of the researchers themselves and the company that owns the rights to their work, noting the keen interest in bringing this test to market. Although the story reports that “that nasopharyngeal carcinoma typically goes undetected until later on, when patients report symptoms such as recurring nosebleeds,” it does not tell readers anything about how often these cancers are found at an early stage. Readers are not given a sense of how patients typically fare with existing methods of diagnosis. The story clearly reports that the test is still experimental and that developers have yet to show that it could be practical and effective in clinical practice. The story highlights the desire for a new blood test that could be clinically useful. The story doesn’t appear to rely on a news release. It includes quotes from a telephone interview with an executive at the company developing this test.

Ex Output:
Silicon Valley Startup Grail Sees Hope for Cancer Blood Test


Ex Input:
"In a September 2011 floor speech, Democratic U.S. Rep. Lloyd Doggett of Austin spoke of two concerns he said are growing in the Lone Star State: poverty and hunger. Doggett said that in tough times, more families are turning to food banks, creating ""immense"" demand. Among his examples: The Austin-based Capital Area Food Bank of Texas ""this year is delivering 50 percent more food to poor people than it did three years ago."" In his speech, Doggett attributed that figure to John Turner, a food bank official. We wondered if the proclaimed increase was correct, and if so, whether that accurately reflected a surge in hunger in our area. The food bank, founded in 1981, takes in donations of food and money from the government, the food industry and the public, then distributes food to Central Texas residents directly and through more than 350 agencies in its 21-county service area roughly centered on Travis and Williamson counties. (Click to view a map.) The region’s north edge runs from Mills County in the west to Freestone County in the east; its south edge runs from Gillespie and Blanco counties in the west to Fayette County on the east. Doggett spokeswoman Sarah Dohl told us by email that Doggett drew his 50 percent figure from a Sept. 4, 2011, news story in the Guardian, a British newspaper, which quotes Turner saying the food bank was delivering 50 percent more food to the poor than it had done three years ago. In an interview, Turner, the food bank’s senior director for marketing and branding, recently told us he’d given the Guardian a conservative estimate: The pounds of food distributed by the bank had actually increased 64 percent, going from 15.4 million pounds in 2007 to 25.3 million pounds in 2010. Turner noted, too, that the 2010 poundage was inflated by one-time federal stimulus aid enabling the bank to buy an additional 2.3 million pounds for the Summer Food Nutrition Program. Subtract that, and the 2010 figure becomes 23 million pounds -- up 49 percent from what the bank gave out in 2007. So, do the poundage figures mean hunger in the area shot up 49 percent or more over the past few years? J.C. Dwyer of the Texas Food Bank Network, the state association of food banks, told us pounds of food distributed generally isn't the best measure of need in a food bank's region: ""It’s more of a metric for how we’re dealing with the needs,"" Dwyer said. A better way of gauging needs, he said, is to track the number of residents requesting food assistance. That is, the amount of food distributed doesn't necessarily reflect ups and downs in need. In the holiday season, donations and distributions surge, for instance, but that doesn’t necessarily mean surges in need. Dwyer and Turner each suggested we check on changes in food demands through ""Hunger in America,"" a report commissioned every four years by Feeding America, a national charity that acts as a clearinghouse connecting food supplies to 200 food banks, including the one in Austin. There was no ""Hunger in America"" report for 2007, the first year in Doggett’s statement, but the reports based on surveys in 2005 and 2009 were broken down into smaller reports covering the Austin bank’s 21-county region: In 2005, the Capital Area bank fed an estimated 174,900 people. In 2009, the estimated number of people served was 284,900 for the year, up 63 percent from those who were served in 2005. That change outstripped population growth, according to U.S. census estimates. In 2005, the 21 counties had 2,265,981 residents. By 2009, the region’s population was 2,547,559 -- up 12.4 percent. Put another way, the food bank provided sustenance to nearly 8 percent of the region’s residents in 2005 while about 11 percent of a greater total of residents got food in 2009. Finally, we wondered if Doggett was correct in saying the food aid went to the poor alone. Turner told us the bank does not question people who come seeking food as to their income -- if you show up, you are fed, he said, though depending on the lines that form, it could take an hour or two. However, the ""Hunger in America"" report using 2009 data states that 73 percent of the Capital Area food bank’s clients had incomes below the federal poverty level. Census figures for 2010, drawing on 2009 data, show that poverty in the 21-county region matched the percentage for Texas overall: Seventeen percent of residents had income below the federal poverty level. According to the United States Department of Agriculture, Dwyer told us, ""food insecurity"" across Texas -- the percentage of households at risk of missing meals because of financial pressure -- rose from 14.8 percent in the three-year period 2005-07 to 18.8 percent in 2008-10. Our conclusion: Changes in the amount of food distributed over several years, which Doggett cited, might not be the best way to gauge changes in residents’ needs. That said, the number of Central Texas requestors for food aid over those years outpaced regional population growth. The 63 percent increase in requestors also exceeded the 50-percent increase in food distributed that he stressed, though, contrary to his statement, not all those pounds of food went to ""the poor."""

Ex Output:
Lloyd Doggett Says the main Central Texas food bank is delivering 50 percent more food to the poor than three years ago.


Ex Input:
She is in a bind because of her persistent refusal during two straight presidential debates to say whether she would raise taxes on the middle class to pay for the universal health insurance plan known as “Medicare for All.” By not acknowledging taxes would almost certainly increase for a wide range of income earners, Warren avoids becoming a caricature of a Democrat itching to raise them. But she also threatens to undermine the image she’s fostered of a plainspoken former professor ready to tackle any issue in her quest to protect the middle class from the excesses of corporations and the wealthy. Warren’s progressive rival, Bernie Sanders, has said middle-class taxes would have to rise to pay for Medicare for All. Other White House hopefuls said Wednesday that Warren should be just as direct. “Look, I’m not picking on Elizabeth Warren, but this is ridiculous,” said former Vice President Joe Biden, currently Warren’s chief competitor for the Democratic nomination. Warren “is going to have to tell the truth” or face questions about her willingness “to be candid and honest with the American people.” Minnesota Sen. Amy Klobuchar said Warren “needs to come forward and say” how she’d pay for a new health insurance system. “I’m sure she will eventually,” Klobuchar said. Pete Buttigieg, the mayor of South Bend, Indiana, echoed that thought from the campaign trail in Ames, Iowa. “Everybody should be prepared to defend their plans,” he said Wednesday. “It’s serving us well to be very clear about how our plan works and to lay out the fact that it’s paid for.” Warren argues pundits are missing the point by focusing on taxes instead of the bottom-line cost that Americans pay for their health care. She insists that eliminating premiums and co-pays under Medicare for All would lower overall costs for all but wealthy Americans. Her top supporters say she should keep pressing that message. “Democratic voters are actually very appreciative that, on the substance, she wants to bring down health care costs, and, on the politics, she’s not taking the bait and giving Republicans and the insurance industry the TV ad moment that they want to deceive voters,” said Adam Green, a liberal activist and close Warren ally. Still, the lack of specificity on paying for Medicare for All is tricky since Warren famously is the candidate who “has a plan” for everything and proudly sweats even the smallest, wonkiest details. On health care, she says that she’s “with Bernie,” referring to the Vermont senator who authored the Medicare for All legislation in Congress. Warren’s campaign says that no one yet knows Medicare for All’s final price tag — but that Warren is still “reviewing the revenue options” previously suggested by Sanders and that she has been very consistent and clear in saying she’ll pay for it by adhering to the principles of lowering overall costs for middle-class families and raising them for rich people and major corporations. Democratic presidential candidates traditionally go to great lengths to avoid the idea that their party is tax happy. But being blunt about raising taxes is not necessarily an election loser, as long as their effect is targeted. President Barack Obama was reelected in 2012 following a pledge to raise taxes on top earners and did so by allowing previous tax cuts on the wealthy to expire. And Warren’s promises of a 2% wealth tax on households with a net worth of more than $50 million elicits chants of “2 cents!” at her rallies, bolstering her reputation as an economic populist. The generous benefits Warren is promising — surpassing other countries with government-run health care — would require tax increases of a historic magnitude to guarantee cradle-to-grave care for every U.S. resident, however. And that will make it harder to finance the program with surgically targeted tax increases on corporations and the wealthy. A study released Wednesday from the Commonwealth Fund and the Urban Institute estimated the government would need $2.7 trillion in additional revenues if Medicare for All were fully implemented next year. That’s more than half the current federal budget, and Washington is already borrowing heavily to meet its obligations. “It’s a huge tax increase,” said Urban Institute health economist John Holahan. “If you just lay it on a small group of people, how do you get those numbers?” Targeting income brackets also means necessarily picking winners and losers — and a person’s health status at any given time could determine what side of the ledger they wind up on. “The success or failure of major health reform plans always hinges on who would win and who would lose, and we don’t have the detail for the Medicare for All plans to judge that,” said Larry Levitt, a senior health policy expert with the Kaiser Family Foundation. Support for Medicare for All has fallen slightly since the beginning of the year, even as Warren and Sanders have championed it. An October poll by the Kaiser Foundation found 51% of Americans favor the plan, while 73% said they support a public option that would compete with private health insurance. Among Democrats, support for a public option has outpaced support for Medicare for All, 85% to 71%. A public option is backed by more moderate Democratic hopefuls, including Biden and Buttigieg. Traditionally, the U.S. has paid for social insurance programs with broad-based taxes. Medicare’s financing includes a payroll tax, money from the Treasury’s general fund and premiums paid by seniors. Sanders has laid out some options for Medicare for All, including a payroll tax on employers, a “premium” tax on households making more than $29,000 for a family of four and higher taxes on the wealthy — which is further than Warren has gone in explaining where the funding will come from. Releasing a more detailed health care proposal of her own could at least start to address these issues for Warren. But her advisers have long maintained that, while she may eventually do so, it isn’t imperative. “What resonates is not an academic version of her plan — it’s her personal story of struggle connecting with the real-world impact of her plan on everyday families,” Green said. “Medicare for All is about the principles, not the micro-mechanisms for putting it altogether.” ___ Associated Press writers Emily Swanson in Washington, Hunter Woodall in Keene, N.H., Thomas Beaumont in Ames, Iowa, and Julie Carr Smyth in Columbus, Ohio, contributed to this report.

Ex Output:

Warren, candidate with the answers, dodges tax hike question.