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.

[EX Q]: Paragraph: Employees of Novartis Pharma K.K. (NPKK) transferred some data from research centers to a Tokyo hospital when that data should have been sent directly without first passing through Novartis hands, according to a report by Japanese broadcaster NHK that was picked up by the Wall Street Journal. "NPKK is currently investigating the allegations," Novartis said in a statement. The data was from a not yet fully enrolled 55-patient trial testing the Novartis cancer drug Tasigna, the company said. "Novartis Pharma K.K. is aware of the media report regarding a small investigator-initiated clinical study ... conducted to assess side effects in patients with chronic myelocytic leukemia," Novartis said in a statement. "NPKK has conducted employee trainings on proper protocol related to investigator-initiated clinical studies and believes that any involvement of our medical representatives in investigator-initiated clinical studies is inappropriate." The University of Tokyo Hospital said it was re-examining test results it had received but had uncovered no evidence that Novartis employees had manipulated any of the data during the transfers, according to the Wall Street Journal report. Claim: Novartis employees may have violated trial protocol in Japan.
[EX A]: Swiss drugmaker Novartis said on Friday it was looking into a report that employees of is Japanese unit may have violated clinical trial protocol by handling data from a small independent study of one of its cancer drugs.

[EX Q]: Paragraph: Costs are mentioned reasonablyearly in the story, and with specificity. This was goodto see. Benefits of these tests are touted, but not quantified. An officer of the National Ovarian Cancer Research Fund Alliance, an advocacy group, testifies that the outcomes of women who have surgery from a gynecologic oncologist"are much better." But we don't knowwhat that means. Is it longer survival? Later the story explainsthat combining the two blood tests with assessment by a clinician "better determined the patients who should be referred to a [gynecological oncologist], identifying well over 90 percent of the women who actually had cancer." (Note that this statistic reflects only referral to a gyn-onc, not patient survival.) But how does that compare to thestandard assessment tools? A 2016 study describedas publication "of the first clinical utility data" demonstrating that use of OVA1 resulted in referral of ovarian patients to gynecologic oncologists offers similar outcomes but is not mentioned in the story. We're told thatexperts fear that these tests could lead to unnecessary surgery or delayed diagnosis, and that's sufficient for a Satisfactory rating. The story could have delved into a bit more of the specifics: What is the evidencefor these concerns? What are the false positive and false negative rates? These details areusefulbecause the point of the story is that clinicians are not using these tests to try to improve outcomes of ovarian cancer patients. Are the possible debitsoruncertainties driven by lack of clinical datacontributing to these decisions? There isn't sufficient information on the evidence behindthese tests. The FDA has approved ROMA and OVA1 for use, but the studies that led to that decision are not discussed. Nor is there sufficient discussion of why the physician groups that write guidelines haven't endorsed the tests. Their concerns are raised, but the evidence is not presented or analyzed. A late diagnosis of ovarian cancer is way too common, and the outcome is grim. At the same time, the anecdotes seem to highlight the sad aspect of the disease without necessarily providing a relevant case in which the tests described would have helped (any more than a basic blood test would have). The companies responsible for developing and marketing these two tests are front and center in this story, with scientists affiliated with the companies clearly identified. At least two sources in the storyone of them a scientist affiliated with the National Comprehensive Cancer Networkappear to be independent of the companies. The story makes it clear that no effective early detection screening test exists. Existing strategiesthe CA125 blood test and vaginal ultrasoundare mentioned and then discounted, in part via a personal narrative of a young woman who received a late diagnosis of cancer. While data-driven specifics aren't included on why standard methods aren't sufficient, this is enough to rate Satisfactory. Adirect comparison ofsurvival stemming from existing diagnostic tests relative to survival stemming from ROMA and OVA1 would have strengthened the story. If those numbers aren't available, that should have been pointed out. The story makes it clear that the two blood tests have been available since 2009. The storymentions that the tests are combinations of existing tests with a "proprietary" formula (essentially a risk prediction tool) to translate the results to likelihood of cancer. But, the article should havetalked about whether the tests, other than CA-125, have been used before. This appears to be an enterprise story, and does not rely on a news release. Claim: Ovarian cancer blood tests: Available, not widely used
[EX A]: This is a story about the apparent underuse of two blood testsROMA and OVA1that are FDA approved to help clinicians decide whether surgery toinvestigateabnormal growthsshould be performed by a gynecologic oncologist ("gyn-onc") trained to remove malignant ovarian cancer, rather than an obstetrician-gynecologist or a general surgeon. The gist of the story is that the tests have not been widely adopted in the ensuing years, "largely because they haven't been recommended by the physician groups that write the care guidelines." The story hit on a lot of important notesit told readers the cost of these tests, and it included comments from independent sources. What is not clear is the extent to which clinical evidence supports the increased use of the two tests. We're told they accurately picked up about 90 percent of cancer cases. But we're not told how that compares to standard methods of detection. As the story notes, surviving ovarian cancer is an uphill battleit is often a deadly disease caught too late. Any procedure that increases the probability of survival is worth careful consideration.

[EX Q]: Paragraph: Trump said his order was aimed at "making life better and longer for millions" by increasing the supply of donated kidneys, making it easier for patients to have dialysis in the comfort of their own homes and prioritizing the development of an artificial kidney. The changes won't happen overnight because some initiatives will require new government regulations. Because a severe organ shortage complicates the call for more transplants, the Trump administration will try to ease the financial hardships for living donors by reimbursing them for expenses such as lost wages and child care. "Those people, I have to say, have never gotten enough credit," Trump said. "What they do is so incredible." Another key change: steps to help the groups that collect deceased donations do a better job. Trump said it may be possible to find 17,000 more kidneys and 11,000 other organs from deceased donors for transplant every year. For families like those of 1-year-old Hudson Nash, the lack of organs is frightening. Hudson was born with damaged kidneys, and his parents hope he will be big enough for a transplant in another year. Until then, "to keep him going, he takes numerous medicines, receives multiple shots, blood draws and more doctors' visits than I can count," said his mother, Jamie Nash of Santa Barbara, California. Today's system favors expensive, time-consuming dialysis in large centers what Trump called so onerous "it's like a full-time job" over easier-to-tolerate at-home care or transplants that help patients live longer. More than 30 million American adults have chronic kidney disease, costing Medicare a staggering $113 billion. Careful treatment including control of diabetes and high blood pressure, the two main culprits can help prevent further kidney deterioration. But more than 700,000 people have end-stage renal disease, meaning their kidneys have failed, and require either a transplant or dialysis to survive. Only about one-third received specialized kidney care before they got so sick. "My health care providers failed me at the beginning of the dialysis continuum," said transplant recipient Tunisia Bullock of Rocky Mount, North Carolina. Her kidney failure struck while she was being treated for another disease, and she woke up in the hospital attached to a dialysis machine. She told Trump that she hoped the new initiatives help other patients find care "with less confusion and more ease." More than 94,000 of the 113,000 people on the national organ waiting list need a kidney. Last year, there were 21,167 kidney transplants. Of those, 6,442 were from living donors, according to the United Network for Organ Sharing, which oversees the nation's transplant system. "The longer you're on dialysis, the outcomes are worse," said Dr. Amit Tevar, a transplant surgeon at the University of Pittsburgh Medical Center, who praised the administration's initiatives. Too often, transplant centers don't see a kidney patient until he or she has been on dialysis for years, Tevar said. While any transplant is preferable, one from a living donor is best because those organs "work better, longer and faster," Tevar said. Among the initiatives that take effect first: Medicare payment changes that would provide a financial incentive for doctors and clinics to help kidney patients stave off end-stage disease. The goal is to lower the number of new kidney failure cases by 25% by 2030. a bonus to kidney specialists who help prepare patients for early transplant, with steps that can begin even before they need dialysis. additional Medicare changes so that dialysis providers can earn as much by helping patients get dialysis at home as in the large centers that predominate today. Patients typically must spend hours three or four times a week hooked to machines that filter waste out of their blood. Home options include portable blood-cleansing machines, or what's called peritoneal dialysis that works through an abdominal tube, usually while patients are sleeping. Today, about 11% of patients in kidney failure get at-home dialysis and an additional 3 percent get an early transplant. By 2025, the goal is to have 80% of people with newly diagnosed kidney failure getting one of those options, officials said. These changes are being put in place through Medicare's innovation center, created under the Obama-era Affordable Care Act and empowered to seek savings and improved quality. The administration is relying on the innovation center even as it argues in federal court that the law that created it is unconstitutional and should be struck down entirely. Other initiatives will require new regulations, expected to be proposed later this year. Among them: allowing reimbursement of lost wages and other expenses for living donors, who can give one of their kidneys or a piece of their liver. The transplant recipient's insurance pays the donor's medical bills. But donors are out of work for weeks recuperating, and one study found more than one-third of living kidney donors reported lost wages, a median of $2,712, in the year following donation. Details about who pays and who qualifies still have to be worked out. clearer ways to measure how well the nation's 58 organ procurement organizations, or OPOs, collect donations from deceased donors. Some do a better job than others, but today's performance standards are self-reported, varying around the country and making it difficult for government regulators or the OPOs themselves to take steps to improve. "Some OPOs are very aggressive and move forward with getting organs allocated and donors consented, and there are those that are a little more lackadaisical about it," said Pittsburgh's Tevar. Unlike the medical advances in transplantation, "we haven't really made big dents and progress and moves in increasing cadaveric organs or increasing live donor options." ___ Associated Press writer Ricardo Alonso-Zaldivar contributed to this report. Claim: Trump directs government to revamp care for kidney disease.
[EX A]:
President Donald Trump signed an executive order Wednesday revamping care for kidney disease so more people whose kidneys fail can have a chance at early transplants and home dialysis, and others don't get that sick in the first place.