TASK DEFINITION: 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.
PROBLEM: We were surprised to see that a story that covered as much ground as this one did somehow missed costs. The competing story by NBC spelled out the costs. The story nicely explained that while one of the new studies showed, as expected, that following the updated statin guidelines did increase the number of people who would be treated with statins, following the guidelines would apparently not have saved a significant number of people from dying or having a heart attackor stroke. The story said, "Among the people eligible for statins under the old guidelines, 6.9 percent had a heart attack orstrokeor died from coronary disease over the ensuing nine years. Among those eligible for statins under the new guidelines, the figure was 6.3 percent, almost as high. That suggests that the new guidelines do not lead to treatment of many more people who do not need statins." At the same time, the story noted that the new guidelines "over all did a better job in discriminating between those who should and should not get statins." It said that "only 1 percent of participants deemed ineligible for statins under the new guidelines had a heart attack or stroke over nine years, compared with 2.4 percent of those ineligible under the old guidelines." While an NBC story also used absolute numbers in talking about the potential benefits in terms of heart attacks, we liked the greater level of context provided in the Times piece. Nevertheless, we think it would have been useful for the Times to include the Number Needed to Treat in its discussion of benefits this is an easy-to-understand metric that was reported in the study. In addition, we question the Times's contention that the new criteria "do not lead to treatment of many more people who do not need statins." According to the study, approximately 94% of both guideline groups did not have a cardiovascular event, and yet the new criteria now extend the use of statins to much larger number of people. In light of such findings, it's unclear that the new criteria don't lead to unnecessary treatment for more people as the Time states. We wish the story had explored this result more thoroughly. We thought that NBC did a better job detailing some of the potential harms from statin use, but we give the Times credit here for framing the story as a discussion of risks vs. benefits and making it clear that experts critical of the new guidelines believe that they "would lead millions of additional people to take statins, exposing them to potential side effects such asmuscle painor damage with little to gain." Covering two studies in little more than 1,000 words is already a feat. Doing so while bringing in enough context to explain the caveats to the study is an order of magnitude greater. Compared to the NBCpiece, the Times did a superior job showing that, despite the enthusiasm in some quarters of the scientific community, the two studies did not settle the debate over whether statins should be more widely prescribed. The story did not engage in disease mongering. The story sought out and made good use of independent sources. It mentions that the guidelines were widely criticized and links to some printed criticisms made at the time. It quotes a variety of supportive and critical researchers regarding their opinions on the new research. The storydid not make any reference to dietary changes, lifestyle changes, or exercise. The story made it clear that statins are widely prescribed. One in four Americans take them by some estimates. The story established that the findings of the studies were not novel but rather were in keeping with earlier findings about statins. Because it contains comments from independent experts, we can be sure the story did not rely excessively on any news release.

SOLUTION: 2 Studies Back Guidelines for Wider Use of Statins

PROBLEM: In a study in the British Journal of Psychiatry, researchers analyzed comedians from Australia, Britain and the United States and found they scored significantly higher on four types of psychotic characteristics compared to a control group of people who had non-creative jobs. The traits included a tendency towards impulsive or anti-social behavior, and a tendency to avoid intimacy. "The creative elements needed to produce humor are strikingly similar to those characterizing the cognitive style of people with psychosis - both schizophrenia and bipolar disorder," said Gordon Claridge of the University of Oxford's department of experimental psychology, who led the study. Although the traits in question are known as "psychotic", Claridge said, they can also represent healthy equivalents of features such as moodiness, social introversion and the tendency to lateral thinking. "Although schizophrenic psychosis itself can be detrimental to humor, in its lesser form it can increase people's ability to associate odd or unusual things or to think 'outside the box'," he said. "Equally, manic thinking - which is common in people with bipolar disorder - may help people combine ideas to form new, original and humorous connections." The researchers recruited 523 comedians - 404 men and 119 women - and asked them to complete an online questionnaire designed to measure psychotic traits in healthy people. The traits scored were "unusual experiences", such as belief in telepathy and paranormal events, "cognitive disorganization" such as difficulty in focusing thoughts, "introvertive anhedonia" - reduced ability to feel social and physical pleasure, and "impulsive non-conformity", or tendency towards impulsive, antisocial behavior. The same questionnaire was also completed by 364 actors - who are also used to performing in front of an audience - as a control group, and the comedians' and actors' results were compared to each other as well as a general group of 831 people who had non-creative jobs. The researchers found that comedians scored significantly higher on all four types of psychotic personality traits compared to the general group. Most striking were their high scores for impulsive non-conformity and introverted personality traits, the researchers said. The actors scored higher than the general group on three types - but did not display high levels of introverted personality traits.

SOLUTION: Comedians have psychotic personality traits, study finds.

PROBLEM: 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.

SOLUTION:
Silicon Valley Startup Grail Sees Hope for Cancer Blood Test