instruction:
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.
question:
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.
answer:
Silicon Valley Startup Grail Sees Hope for Cancer Blood Test


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Dorian has the potential to put millions of people at risk, along with holiday attractions such as Walt Disney World, the NASA launchpads along the Space Coast, and even President Trump’s Mar-a-Lago resort in Palm Beach. The Miami-based National Hurricane Center said Dorian was packing maximum sustained winds of 140 mph (225 kph) as it churned an unpredictable path toward Florida. “Although fluctuations in intensity are possible early next week, Dorian is expected to remain a powerful hurricane during the next few days,” the NHC said in a statement on Friday. On Florida’s east coast, where Dorian’s winds are expected to quickly gather speed on Monday morning, residents snapped up bottled water, plywood and other supplies as fast as they could be restocked. Some gas stations had run out of fuel. “They’re buying everything and anything that applies to a hurricane, flashlights, batteries, generators,” said Amber Hunter, 30, assistant manager at Cape Canaveral’s ACE Handiman hardware store. In the Bahamas, evacuations were already underway, two days before Dorian is expected to bring a life-threatening storm surge forecast at up to 10 to 15 feet (3 to 4.5 meters) to the northwest of the islands. NHC Director Ken Graham saw a worrying, unpredictable situation for Florida, with the hurricane set to hit land somewhere up its east coast and potentially linger over the state, spinning slowly. “Slow is not our friend, the longer you keep this around the more rain we get,” Graham said in a Facebook Live video. It was unclear where the hurricane would hit land, but the results were expected to be devastating: “Big-time impacts, catastrophic events, for some areas 140 mph winds, not a good situation,” said Graham. Mindful of that warning, Cocoa Beach Mayor Ben Malik was putting up storm shutters on his Florida home on Friday afternoon and worrying about the flooding Dorian could unleash on his barrier island town. “It’s slowed down, we’re looking at a multiple-day event, we were hoping it would just barrel through and leave,” Malik said of forecasts that Dorian could sit over Florida for up to two days, dumping up to 18 inches (46 cm) of water. “I’m really worried about the amount of rain we’ll be getting.”  Florida Governor Ron DeSantis urged residents to have in reserve at least a week’s worth of food, water and medicine. President Donald Trump told reporters before leaving for Camp David for the weekend: “We’re thinking about Florida evacuations, but it’s a little bit too soon. We’ll probably make that determination on Sunday.”  But Fort Pierce Mayor Linda Hudson urged its 46,000 residents who planned to evacuate not to delay. “It’s decision time now. Don’t wait until I-95 north and I-75 north and the turnpike are parking lots,” said Hudson, who experienced two devastating hurricanes in 2004. Dorian’s course remains unpredictable. One of Florida’s last major hurricanes, 2017’s Irma, swept up the peninsula, instead of hitting the east coast. Florida residents like Jamison Weeks, general manager at Conchy Joe’s Seafood in Port St. Lucie, planned on staying put. “I’m planning on boarding up my house this evening,” said  Weeks. “The mood is a little tense, everybody’s a little nervous and just trying to prepare as best as possible.”  In the Bahamas, Freeport’s international airport was set to close on Friday night and not reopen until Sept. 3, amid worries that Dorian will slam tourist hotspots on the archipelago. Dorian began on Friday over the Atlantic as a Category 2 hurricane on the five-step Saffir-Simpson Wind Scale. By Friday night it was moving at nearly 10 mph (16 kph), giving it time to intensify before making landfall. Two thousand National Guard troops will have been mobilized for the hurricane by the end of Friday, with 2,000 more joining them on Saturday. Florida officials also were making sure all nursing homes and assisted living facilities had generators. Only one in five Florida nursing homes plans to rely on deliveries of temporary generators to keep their air conditioners running if Dorian knocks out power, a state agency said on Friday, short of the standard set by a law passed after a dozen people died in a sweltering nursing home after 2017’s Hurricane Irma. North of Cape Canaveral, the Kennedy Space Center’s 400-foot (122-m) launch tower was dragged inside a towering vehicle assembly building to shelter it from Dorian, a video posted by the National Aeronautics and Space Administration (NASA)-owned space launch center showed.
answer:
Hurricane Dorian swirls toward anxious Florida, packing 140-mph winds.


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The move comes three days after Reuters reported that the CDC published key dosing information involving the two antimalarial drugs based on unattributed anecdotes rather than peer-reviewed science. Reuters also reported that the original guidance was crafted by the CDC after President Trump personally pressed federal regulatory and health officials to make the malaria drugs more widely available to treat the novel coronavirus, though the drugs in question had been untested for COVID-19. Initially, the CDC webpage, titled Information for Clinicians on Therapeutic Options for Patients with COVID-19, had said: “Although optimal dosing and duration of hydroxychloroquine for treatment of COVID-19 are unknown, some U.S. clinicians have reported anecdotally” on several ways to prescribe the medication of COVID-19. Medical specialists had told Reuters they were surprised by that language. “Why would CDC be publishing anecdotes?” asked Dr. Lynn Goldman, dean of the Milken Institute School of Public Health at George Washington University. “That doesn’t make sense. This is very unusual.”  Doctors and other health experts had further criticized the guidance as suggesting that doctors might prescribe the medications when it isn’t established whether or not they are effective or harmful. Now the CDC website no longer includes that information. Instead, its first sentence says: “There are no drugs or other therapeutics approved by the US Food and Drug Administration to prevent or treat COVID-19.”  The updated, and shortened, guidance adds that “Hydroxychloroquine and chloroquine are under investigation in clinical trials” for use on coronavirus patients. To read the new CDC guidance, click here  The CDC did not immediately respond to questions about the removal of the original guidance. In a statement, it had originally told Reuters it had crafted the guidance for doctors at the request of a coronavirus task force, which urged prompt action. Jeffrey Flier, a former dean of Harvard Medical School who had criticized the original guidance, applauded the updated version, calling it “substantially improved.”  “It states the facts without in effect recommending that physicians prescribe the drugs despite a lack of adequate evidence,” Flier said. The hydroxychloroquine debate has heated up and become more political as President Trump this weekend said he might want to take the drug himself.
answer:

CDC removes unusual guidance to doctors about drug favored by Trump.