Given a paragraph and a claim, classify it this way: If the claim contradicts the evidence present in the paragraph, classify the claim as '0'. If the claim has multiple supporting *AND* contradicting evidences, classify the claim as '1'. If the claim has supporting evidence and the paragraph is in overall favor of the claim, then classify the claim as '2'.
One example is below.
Q: Paragraph: While the financial costs of screening mammography&!1-positive recalls&biopsies were not included in the study,readers would benefit from being reminded that recall mammography&biopsies increase patient financial costs.This article leads with valuable information for all women over age 40 by stating "Getting screening mammograms every two years instead of annually reduces the chance of a!1 alarm,a new study shows." Unfortunately the writer doesn't quantify or elaborate adequately on that reduction.Instead,the writer later focuses on how women undergoing screening mammography shouldn't be anxious if they experience a recall because over half of women who have screening mammograms for 10 years will be recalled.Readers would have been better served if the writer had emphasized the significant reduction in both recall mammograms&!1-positive biopsies in women who are screened every two years rather than annually.Part of the continuing controversy over screening mammography focuses on annual versus biennial screening.Because this study showed a significant reduction in the percentage of those recalled&needing biopsies among women who are screened every other year,with no statistically significant increase in late-stage diagnosis of breast cancer,the article should have emphasized those important findings.The piece states that the researchers noted that "!1 positive recalls may cause inconvenience&anxiety and biopsies can cause pain and scarring." This article fails to include several important facts about the study.1)This is a prospective cohort study of women screened between 1994-2006.2)Most of the mammograms were film rather than digital.3)Few women underwent screening for the entire 10 year period.4)Screening mammography recall rates are influenced by the skill of the radiologists who read the mammograms.There was no disease mongering.No independent experts were quoted.The story did an adequate job comparing at a very high level annual screening versus biennial screening.Screening mammography is widely available throughout the United States.The study did not examine a new procedure.There's no evidence that the story relied solely on a news release.
Claim: Annual Mammograms May Have More False-Positives
A: 1
Rationale: This article reports on the results of a study of nearly 170,0 women who had screening mammograms beginning between age 40-59.The study found that over ten years of screening mammograms,over half of the women will experience a!1-positive recall for additional mammography.In addition,7%-9%of the women will have a biopsy for a suspicious lump which is not cancerous.Both of those percentages decrease if the woman is screened every other year rather than every year.Even with biennial mammography,41%of women will experience a recall over 10 years of mammography.The study's Principal Investigator emphasized that "in most cases,a recall doesn't mean you have cancer." She hoped this knowledge would reduce the anxiety of women who are recalled.The story never explained the size of the decrease in the number of!1 positives between annual(61.3%) and biennial screening(41.6%).Our first two reviewers were a researcher who specializes in health decisions and a breast cancer survivor trained in evidence by the Natiional Breast Cancer Coalition's Project LEAD.This study is valuable because it helps to quantify and compare the harms of annual and biennial screening,specifically the number of!1 positives and the number of unnecessary biopsies.Prior to this study,estimates of!1 positive screening mammography rates varied widely.The critical question is whether you can do less frequent screening,subject women to fewer harms and get similar results in terms of detection of "early stage" cancer.This study's data seems to suggest that answer is yes.
Q: Paragraph: We won't require a discussion of costs in this story because the use of zoledronic acid for early stage breast cancer is still up in the air. However, since the drug is already being sold for other indications, the story would have been better if it had told readers something about the costs of using the drug for approved indications. The story headline and lead muddled the main conclusion of the AZURE trial: that there was no survival benefit to adding zoledronic acid to standard therapy for women with early stage breast cancer. In contrast to the headline of this story saying that any benefit to younger women is "in question," the other story we reviewed included a quote from the lead author of the study article saying that not only did younger patients get no benefit, "If anything, they are doing a little bit worse." The story did accurately report that there may be some benefit to postmenopausal women, but the story should have been more cautious in presenting the results of the sub-group analysis. Overall, the thrust of the story didn't appear to match the negative results that researchers reported. The article did not mention any adverse effects associated with zoledronic acid. The story should have at least discussed the incidence of osteonecrosis of the jaw bonea serious complication affecting more than one percent of study subjects. The article never mentioned that roughly one percent of women taking zoledronic acid in this trial developed a serious side effect: confirmed osteonecrosis of the jawbone. And another half a percent of subjects may have developed this bone-destroying problem. Women weighing the pros and cons of zoledronic acid for early breast canceror for other indications such as metastatic breast cancerwould certainly want to take this potentially devastating side-effect into account in their decision-making. And it deserved mention in the article. The article provided an adequate description of the randomized trial. In addition, it offered readers background on an earlier trial, highlighting some possible reasons that trial produced different results. However, it appeared to overstate the power of a subgroup analysis to produce conclusive results; in this case that the drug may extend the lives of women with established menopause. To produce strong take-home messages, the results of subgroup analyses have to be tested in further clinical trials. The story did offer a statement from an independent expert to this effect further down the pagebut never explicitly stated that subgroup analyses have inherent limitations. There was no hint of disease mongering in this article. The article used an independent source. Howeever, it failed to tell readers about the support provided by the pharmaceutical company that markets this drug or about speaker fees paid to the lead researcher. The story did point out that the women in this trial did receive standard therapy, though it did not specifically say what that treatment entails. We will give the story a satisfactory rating since it is not clear that there is a proven alternative that would provide the type of recurrence and survival benefits seen in a previous study of zoledronic acid for early stage breast cancer. The article did not clarify the regulatory status of zoledronic acid. The FDA has approved zoledronic acid as a treatment for metastatic breast cancer but not for early stage breast cancer. The article made it clear that zoledronic acid is already being used in routine clinical care for other indications. The article did not appear to be overly reliant on a news release. Claim: Drug's benefit to younger breast cancer patients in question
A:
1