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.

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.
Silicon Valley Startup Grail Sees Hope for Cancer Blood Test

Campaigning in the early caucus state of Nevada, the 78-year-old Vermont senator said one of the things that disturbed him about Thursday’s debate was that he was hoping “to have a serious discussion about the health care crisis in America.” “I was not pleased that Vice President Biden distorted what Medicare for All is and, in fact, simply parroted the line coming from the health care industry,” Sanders told about 300 people at a town hall meeting at the Carson City Community Center gymnasium. “Apparently the vice president thinks it is just wonderful for people to be paying $1,000 a month ... just for health care premiums. Having deductibles of $4,000 or $5,000 or more — not a problem. Paying the highest prices in the world for prescription drugs — not a problem. Well, I think those are problems,” he said. Sanders took heavy fire on his single-payer health insurance proposal at Thursday night’s debate in Houston, with Biden and others hammering the Vermont senator for the cost and the political palatability of effectively eliminating the existing private insurance market. The former vice president went hardest at Sanders when the senator argued that the estimated $30 trillion cost over a decade is cheaper than the “status quo,” which he put at $50 trillion — with most of the money being what Americans spend privately on premiums, copays and out-of-pocket costs. Sanders’ argument is that most U.S. households would pay less overall under his system, even if their taxes go up. Biden said that Sanders would effectively be handing Americans a pay cut, arguing that employers who now pay a share of workers’ premiums would pocket that money instead of giving workers raises if the government were to cover all health care costs. Biden punctuated the point with one of the quotes of the night: “For a socialist, you’ve got a lot more confidence in corporate America than I do.” Biden has aggressively defended the Affordable Care Act that was created while he was vice president under President Barack Obama. Biden released a proposal in July to add a “public option” to the 2010 health care overhaul, with expanded coverage paid for by tax increases on the wealthiest Americans. Sanders repeated his refrain Friday that health care is a human right and that Medicare for All would cover every man, woman and child in the country. It requires no premiums, no deductibles and no out-of-pocket costs and would expand Medicare to include such things as dental care, hearing aids and home health care, he said. “It’s not a terribly radical idea because in one form or another it exists in countries all over the world, including Canada,” Sanders said. “Is it free? No. It is funded out of the general fund in a progressive manner.” Sanders said the primary function of the existing American health care system — the costliest in the world — is to make profits for drug and insurance companies. Sanders and a supporter of President Donald Trump — who said he recently lost his insurance and job — initially shouted over each other when Sanders asked for input from the audience. But they eventually put their arms around each other as Sanders asked him to help deliver the message to health care corporations and pharmaceutical drug companies that “the function of health care is to provide quality care to all of these people.” Sanders dismissed others who suggested Medicare for All would prevent people from selecting their own doctor. “You can go to any doctor you want,” Sanders said. “Anybody who tells you Medicare for All limits your choices of doctors are not telling you the truth.” Sanders lost the 2016 Democratic caucuses in Nevada to Hillary Clinton 55% to 45% primarily because of her strength in Las Vegas and Clark County but has maintained fierce support in the key Western swing state. He carried northern Nevada’s Washoe County, where he drew loud cheers later Friday from hundreds of students at an outdoor “College For All” rally on the campus of the University of Nevada, Reno. He also planned to campaign Saturday in Las Vegas.
Sanders accuses Biden of distorting ‘Medicare for All’ plan.

In this very narrow discussion of a small study in mice, the suggestion is that someday maybe walnuts (or some nutritional element of walnuts) could help people by slowing the growth of colon cancer. But while the study doesn’t mention how much (or how little) such a therapy might cost, we think this criterion is Not Applicable here for two reasons: 1. the cost of walnuts is generally well known, and 2. the research is at early enough stage — and the release establishes the preliminary nature of the study — that it’s hard to know what any walnut-related therapy might cost. Furthermore, while the criteria of cost is integral to what we all agree is good reporting about health outcomes, incorporating information about the potential cost of walnuts — or any other foodstuffs — in a release about a study that’s so preliminary might actually reinforce the suggestion of a useful therapy. Including that info wouldn’t improve anyone’s understanding of the importance of the research. The research on a small group of mice showed slowing of the growth of colon cancer tumors. The research proved that tumors in mice fed walnuts had “10 times the amount of total omega-3 fatty acids, including plant-based alpha-linolenic acid (ALA), in the tissue compared to the mice fed the control diet.” Although the quantification here is limited, we’ll give the story credit for accurately reporting the outcomes in broad strokes. The detailed results of what happened in a mouse study have limited use for the average human reader anyway. But while the release does not state that the mouse study could lead to prevention for humans, we’re worried that a normal reader may see the suggested effects of an enhanced walnut diet — increased anti-inflammatory activity, reduced angiogenesis, increased protective lipid content — and assume that these affect actual cancer outcomes. Set aside the major caveat that it is an animal study for a moment — the release says that walnuts “may” slow the growth of colon cancer. It also equally may not. The limited study did not appear to investigate potential harms, and the release didn’t comment on them. For humans, consumption of too many calorie-dense walnuts could precipitate weight gain. But the equivalent of two ounces a day doesn’t sound like it could be very harmful. We’ll rate this Not Applicable. While the main headline was not upfront about the fact that the study involved mice, the body of the release itself was carefully worded and did a fair job of describing the evidence. It’s always helpful to see “animal” in the very first sentence of a study involving mice. microRNAs are a complicated topic, as are changes in gene expression, which is at the root of the questions that the study addressed. The release adequately describes the evidence drawn from the work but does so sparsely. The eight-page paper is reduced to an eight-paragraph release, only three paragraphs of which actually convey an explanation of the work. What the release offers is acceptable by our standards but more information, properly couched, could aid readers in assessing the study’s true value. There was no disease mongering. Funding sources were identified, netting this release a Satisfactory rating, but when a fundor is integrally related to the substance of the research, that mention belongs higher up in the story or release, rather than tagged onto the end, allowing readers to consider the context of the funding early in their reading of the material. The release discusses the chemistry of inflammation and the growth of tumors in the mice. It briefly mentions “diet and lifestyle changes” as means to reduce risk, but does not discuss what specific changes are shown to be helpful. It also does not discuss screening and polyp removal, arguably the best-supported intervention for catching colon cancer before it spreads. We accept that walnuts are widely available. There has already been research on the potential protective influence of omega-3 fatty acids for inflammation. The release clearly explained the novelty of this specific mouse study investigating underlying chemistry and how it may work. While we aren’t happy with the headline, we think this release squeaks by because the main text is accurate and we applaud the first sentence clearly labeling it an “animal study.” The release clearly avoids any sensationalized verbiage, a feat to be lauded in cases like this when an inference of a simple activity — like eating nuts — might lead a reader to jump to wrong conclusions.

New Harvard research finds walnuts may help slow colon cancer growth A walnut-enriched diet may cause beneficial genetic changes in animal cancer cells, affecting inflammation, blood supply and growth of tumors