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.
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Question: This is a tricky one. The story does not explicitly address cost, except to call text messaging "a scalable and affordable approach." For many (or most) patients, the cost of receiving four text messages a week would likely be negligible covered by an individual's phone plan or by nominal text rates. However, not everyone owns a mobile phone, a fact that makes access (and cost) a more significant issue. However, the story does deliver on this point. The story discusses both the number of U.S. adults who own mobile phones (90 percent) and the fact that text messages are more accessible than other forms of mobile health communication (such as apps, which require patients to own smartphones or other smart devices). So, while we'd prefer a more in-depth discussion here, we'll awarda Satisfactory rating for the story's nod in this direction. The story addresses the range of benefits reported in the study, such as reduced cholesterol and blood pressure, but doesn't quantify that information or offer readers any context. For example, while the story says "patients who had received the text messages had reduced their cholesterol," the JAMA paper reports that patients who received the text messages had a "mean difference [of] 5 mg/dL" in "LDL-C." In other words, the information in the paper, while quantified, probably isn't very useful to many readers outside the health industry. Is "a mean difference of5 mg/dL in LDL-C" good? Bad? Irrelevant? This is where reporters have an opportunity to shine. If a news story can take those numbers and translate them into language that is accessible to non-experts, it provides a very real service. It would have been great to see that here. As long as people aren't driving and checking their cell phones, there don't appear to be any harms associated with receiving well-meaning text messages four times a week, so we'll mark this one "not applicable." This is a strong suit. The story not only offers a concise, but good, summary of the study but it also goes out of its way to address the study's limitations. For example, the study notes that the study "can't tell us whether text messaging could eventually lead to fewer subsequent heart attacks among the patients receiving those messages or whether the positive health outcomes would continue past the six-month study window." Good points, and we're glad the story includes them. No disease mongering here. The story includes input from an outside expert who was not involved with the research. The story clearly meets our bar here, although it would have been stronger if it had reached out to at least one more independent source preferably one who hadn't written an editorial that ran in conjunction with the paper in JAMA. Yes, the editorial was independent and provides some insightful commentary. But it also means we already knew where this source stood on the issue. Finding another reputable expert, who hadn't already weighed in publicly on the work, would have been great. The focus of the story is not so much on how the text message intervention directly reduced heart disease risk, but on the extent to which it resulted in patients taking steps to reduce their own risk such as by exercising more, smoking less, making dietary changes, or taking prescription drugs on a regular basis. The story does discuss other "mobile health interventions," such as smartphone apps but notes that there don't appear to be many mobile health projects that rely simply on text messages. The story also looks at how the text messages helped patients pursue lifestyle changes like exercising more and smoking less that reduced their risk. It was fairly clear from the story that this was a clinical trial, and that this particular service doesn't seem to be available to offer customized, encouraging text messages for heart disease patients. From the start, the story frames this research in the context of the much larger "mobile health" field. For example, the story notes that "While there are more than 100,000 health-related apps on the market, the evidence to date is lacking as to whether many of those apps are safe or effective." Since the story includes quotes from an interview, we can be fairly certain it went beyond the related JAMA news release.

Answer: Text Reminders Help People Lower Cholesterol, Blood Pressure

Question: The question of cost is cited in the final line of the story, which suggests that the scoring system can "address escalating health care cost issues." But we didn't think that was specific enough to warrant a Satisfactory score. The story doesn't clue readers in to the fact that the financial burden can be measured in billions of dollars a single screening test recommended for millions of Americans can cost thousands of dollars apiece. The other cost issue specific to this test is that it takes valuable time for providers to retrieve a reputable risk calculator when sitting with a patient and enter in the specific data points, including in this case waist circumference, which clinicians often do not measure as a 'vital sign' per se. The story cites a study that credits colonoscopy with reducing the risk of death from colon cancer by about 50 percent, by removing polyps. It would have been helpful for the story to explain what that relative reduction in risk means in absolute terms (e.g. did the rate of cancer death go from 50% to 25% or from 2% to around 1%?) The story also notes that the study found that patients with a low to intermediate risk score "still have a risk between of between 1.9 percent to 9.9 percent of harboring a polyp that can develop into cancer." We'll give credit here for the story's provision of these key statistics, which do give a sense as how well the test accurately identifies truly low-risk individuals. However, we'd note that the benefit here should ideally refer to theability of the algorithm to classify people at all risk levels (including high-risk), and therefore target the highest-risk patients for colonoscopy. The story doesn't really get into discussion of the predictive power of the test, referred to as a likelihood ratio, which is in the study manuscript. However, this is a difficult concept for most health care providers and patients, and we think it's understandable that the story did not include a full discussion of this topic. The harm of a screening test such as this really is "getting it wrong" in terms of predicting someone to be at low risk and finding them to have a higher risk polyp or malignancy. As noted above, the story cautions that "low- to intermediate-risk patients still have a risk between of between 1.9 percent to 9.9 percent of harboring a polyp that can develop into cancer." This story accurately explains that the research was about predictive modeling, and explains the components of the risk score as well as the study design. There are some cautionary notes in the text, including a statement from outside expert that "the data from this study is not strong enough to spur any changes in current screening recommendations," an opinion shared by an editorialist on the study. We think this is sufficient for a Satisfactory rating. The story does not hype the incidence or seriousness of the disease. The prevalence statistics cited are consistent with these National Cancer Institute figures. The story contains two independent voices. The perspective they provide is a particular strengthof the article. We wish that more stories would reach out to experts not affiliated with the studies being reported on for context. The story notes that a variety of screening tests exist, but the relevant alternative here is actually other risk calculators, which the authors of the studydescribe and cite but are not routinely used. The story doesn't mention these other calculators and why they are seldom used context that would have deepened reader understanding of the issue. Although availability isn't explicitly addressed, this risk calculator is now available (implicitly) by virtue of publication of the paper. It is a simple scoring system that can be implemented based on the information in the paper, and the story makes this clear. We'll rate this Satisfactory. The story makes it sound as if this is a first-of-its-kind tool. However, risk calculation tools for colon cancer have been in circulation for many years. We could not find a news release related to this study. But in any case, the comments from two independent experts assure us that the story wasn't based on a news release.

Answer: 'Scoring System' May Spot Those in Greatest Need of Colonoscopy; But one expert cautions that even 'low risk' patients can still develop suspicious polyps

Question: He's not sure when the second-year starter will be healthy enough to be cleared to play. Allen was placed in the NFL's concussion protocol after taking a helmet-to-helmet hit by Patriots defensive back Jonathan Jones in the opening minute of the fourth quarter of a 16-10 loss to New England on Sunday. Putting aside the three interceptions Allen threw, McDermott's biggest question was why Jones wasn't ejected. "There's no room in football for that," McDermott said. "I thought he should have been thrown out. But other than that, I'm not going to get into that. That's for the league to get into." The hit occurred when Allen scrambled out of the pocket and burst through a hole up the middle while facing third-and-8 at the New England 45. He gained 7 yards before Jones closed in on him, lowered his helmet and struck the quarterback in the crown of his helmet. Jones was flagged for a personal foul for unnecessary roughness. Allen lay on the field for several minutes before hopping up on his own. He was briefly evaluated on the sideline before being escorted up the tunnel. Allen was spotted in the locker room chatting with teammates following the game. NFL officiating chief Al Riveron told a pool reporter the decision to not eject Jones came because the hit did not rise to the level of the league standard for disqualification. "There was a foul called and obviously the penalty stood, but we did not feel this contact rose to that level," Riveron said, who also noted Jones was turning his head just before hitting Allen. Bills safety Micah Hyde questioned the official's judgment saying he or any of his teammates would have been ejected for a similar hit on New England's Tom Brady. "That's our quarterback. We ride or die with him," Hyde said. "To see that happen, Josh didn't slide, but at the end of the day it doesn't matter if you're a running back, you can't head to the head." Jones defended the hit saying it was never his intent to hurt Allen. "No malice or intent. Just a part of football," Jones said. "We're just running around playing football. I hope he's OK. I'm going to check on him." Allen finished going 13 of 28 for 153 yards, and scored on a 1-yard touchdown dive. Allen's uncertain status leaves Buffalo with veteran backup Matt Barkley the only quarterback on the active roster in preparing to play at Tennessee next weekend. Buffalo then enters its bye week. The loss prevented Buffalo (3-1) from getting off to its first 4-0 start since 2008. Though the Bills defense held Brady in check, their offense was busy coughing up the ball at critical moments for the third time in four games. Allen threw three interceptions, two of which translated into a touchdown and a field goal. Punter Corey Bojorquez also had a punt blocked by J.C. Jackson, which led to Matthew Slater returning it 11 yards for a touchdown to put the Patriots up 13-0 in the first quarter. McDermott was unhappy with Allen's continuing string of committing turnovers. He's now thrown six interceptions and lost two fumbles in four starts this season. "He's a young quarterback and sometimes they have to learn those lessons. Those are hard lessons and we have to continue to coach it up," McDermott said. The game was decided on Buffalo's fourth turnover with 1:27 left. Facing third-and-9 on the New England 39, Barkley was pressured by linebacker Kyle Van Noy, who got his hand on the quarterback's chest. That forced Barkley to throw the ball up into the air, and have it easily picked off by Jamie Collins. The loss spoiled a stout effort by a Bills defense which limited the Patriots to just 11 first downs and 224 yards. Brady finished 18 of 39 for 150 yards and an interception. He was picked off by Hyde in the end zone on third-and-goal from the 2 in the second quarter. Brady's 45.9 passer rating was the sixth lowest of his career and lowest since finishing with a 34 rating in a 27-20 loss to Indianapolis on Nov. 5, 2006. Barkley lamented how the Bills let the Patriots off the hook. "Especially with the way our defense played and where we had the ball at the end of the game, it's tough," Barkley said. "This is a tough one." ___ More AP NFL: https://apnews.com/NFL and https://twitter.com/AP_NFL

Answer:
Bills fall to Pats, and lose QB Josh Allen to head injury.