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.

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
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.

Paragraph: After nearly disappearing in the United States, the bloodsucking pests have made a comeback in recent years, quickly infesting apartment buildings and stubbornly resisting common insecticides. The city of New York alone spends as much as $40 million a year in bedbug control. A study of bedbug genetics presented on Tuesday at the American Society of Tropical Medicine and Hygiene meeting in Philadelphia now suggests why. A team of entomologists led by Coby Schal and Ed Vargo of North Carolina State University studied the genes of bedbugs infesting three multistory apartment buildings in North Carolina and New Jersey and found very low genetic diversity meaning most of them were very close relatives. They were so close in fact that the team suspects it may have taken just one or two founder insects to start an entire infestation. "We find that bedbug infestations basically start from a very small number of individuals," Schal said in a telephone interview. "A single mated female bedbug starts the infestation. She gives rise to offspring and those offspring mate with each other and with their mother," he said. "This is different from many animals," he said, mostly because close inbreeding can result in genetic deformities, adding, "In humans, it is taboo." But he said there are some animals that can withstand such close inbreeding without experiencing detrimental effects including cockroaches. Schal said this may be a trait of insects that have evolved an association with humans and rely on them to get from place to place. Typically this happens when humans bring infested furniture into their homes, and he warns people to inspect second-hand furniture carefully. "There is a myth out there that bedbugs get transported on people," Schal said. Unlike ticks, the wingless, reddish-brown insects stay attached to people for a blood meal for just 5 to 10 minutes, he said. "The chances that a person is carrying bedbugs on them is quite low." According to the U.S. Centers for Disease Control and Prevention, bedbugs do not carry disease, but their bites can cause severe itching and a whole lot of anxiety. Schal said his findings are not likely to lead to new insecticides for bedbugs, but they do underscore the need to move fast once bedbugs are detected. "If you don't deal with them early they can spread thorough a building very quickly," he said. Claim: All in the family: Inbreeding key to bedbug spread.
Inbreeding may be the secret to the bedbug's success, U.S. researchers said on Tuesday.

Paragraph: The Office of Inspector General on Friday released two reports that look into the longstanding challenges of the 28 hospitals directly operated by the federal Indian Health Service. The OIG, which acknowledged that reports of inadequate health care services for Native Americans have been of concern to the federal government for almost a century, criticized the agency's limited oversight regarding compliance with federal regulations and quality of care, detailing how the agency's regional administrators have few sources of information to assess the services provided at the facilities. The Indian Health Service, commonly referred to as IHS, is responsible for providing health care services to enrolled tribal members as part of the government's treaty obligations to Native American tribes. But the agency has faced challenges for decades, and within the past year it has been under increased scrutiny from Congress after inspections of hospitals in the Great Plains uncovered severe deficiencies. The OIG says IHS's eight regional offices conduct activities to monitor the quality of the facilities, but those efforts are minimal in some areas. One of the reports states that the primary source of information that the regional offices use to detect quality problems is a small number of complaints and patient harm reports. "However, according to hospital administrators, most patient complaints relate to customer service and wait times, rather than medical care," according to the report. "Further, most hospitals (20 of 28) receive fewer than 100 complaints per year for inpatient and outpatient visits combined, averaging about 1 complaint per 1,000 patient visits. ... Considering the quantity and subject matter of complaints and patient harm reports, they are unlikely to provide hospital staff with the breadth of information needed to identify and diagnose systemic quality or compliance breakdowns." The OIG, which gathered the information for the reports between April and October 2014, also said that only half of the regional offices conducted mock inspection surveys that could provide insight regarding the facilities' quality practices. The watchdog also faulted the IHS for staggering findings of outdated facilities and the weekslong process that job applicants must follow, even when the physician vacancy rate was 33 percent at the time the information for the reports was gathered. According to the report, in 15 of the 28 hospitals, administrators reported that aging or inadequate physical environments affected their ability to give quality care. Corroded pipes in one hospital caused sewage to leak into the operating room. The IHS has now been under scrutiny for more than a year after inspectors from the Centers for Medicare and Medicaid Services, known as CMS, found several quality-of-care deficiencies at hospitals in South Dakota and Nebraska. At one facility, the alarming conditions of its emergency room led officials to close it for seven months. The OIG on Friday recommended that CMS inspectors survey IHS facilities more frequently. The IHS in a statement Friday concurred with recommendations made by the OIG, including the need for more training for staffers and new ways to monitor hospital quality. The IHS also said it began a mock survey initiative at 26 hospitals in May 2016 to assess compliance with the standards that facilities must meet to be able to participate in the Medicare program. The IHS's statement also highlighted a team that was formed in February 2016 "to ensure that dependable, quality care is delivered consistently across IHS facilities." ___ Follow Regina Garcia Cano on Twitter at https://twitter.com/reginagarciakNO ___ Associated Press writer James Nord contributed to this report from Pierre, South Dakota. Claim: Watchdog: Staff issues affect care at reservation hospitals.
The internal watchdog of the U.S. Department of Health and Human Services says the often-substandard quality of care at hospitals serving Native Americans is the result of outdated equipment and technology, lack of resources and difficulty attracting and keeping skilled staff.