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.

[EX Q]: 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.
[EX A]: Silicon Valley Startup Grail Sees Hope for Cancer Blood Test

[EX Q]: The story does include a discussion of price, reporting that a fluoride varnish treatment can cost $23 to $55, while a filling can cost $86 to $606. That's enough to be rated Satisfactory. However, the story also should have stated that those numbers aren't a head-to-head comparison, since the varnish treatment must be repeated many times over many yearswhich would add up. In fact,a cost-effectiveness analysis done by one of the quoted experts concluded the "Caries Management System" he advocates costs almost $1,800 for every cavity or lost tooth prevented. While the story includes links to some studies that report specific results, the only number reported in the story is a reduction in adult tooth fillings of 30 to 50 percent. But without any absolute numbers, this number isn't useful. Is it a cavity a year? A cavity a decade? The story refers to people at "high risk" for cavities, but does not define what that term means. Without some anchoring in absolute numbers, all readers are left with is a vague sense that preventive treatment is "better" for some people, without pinning down how much better or for whom. Fluoride for dental health has been extensively studied for decades and is considered safe, so we'll file this rating as not applicable to the story. But, as some dentists might point out, there is an argument to be made for discussing one knownthough minorrisk: Some people living in areas with naturally high levels of fluoride in their water may experience tooth discoloration or other issues if they are given additional fluoride treatment. The story portrays the evidence for fluoridetreatments as clear and convincing, when there are actually just a few studies, and a lot of expert opinion. That's not to say the experts quoted in the story are wrong, but the story elevates beliefs to the level of evidence-based conclusions. Cavities in adults can cause serious health problems if left untreated, and any new effective treatment or trends in this area is worthy of press coverage. However, the studiesdiscussedin the story focused on a relatively small group of people with unusually high risk of tooth decayand so these results may not apply to the adult population at large, which this piece implies. The story quotes a number of sources discussing this trend in dentistry, instead of just relying on one dentist. But the piece would be more balanced had it included at least one source pointing out that some of the techniques advocated in the story could be overkill or wasteful for many people who are at just average risk for tooth decay. As the piece was written, all the sources are very rosy about more aggressive preventive dental care. We also found via an internet search that sourceJohn Featherstonehas accepted consultation fees from dental companies that make products for these purposes. However, since he wasn't specifically endorsing one of these productsin this story,we'llgive this a pass. The story does not quantify the benefits of these new preventive treatments, or similar approaches, so it fails to give readers a useful comparison with standard dental care or advice for most adultssuch asfluoride toothpastes, community water fluoridation, flossing, and mouthwashes. It is clear that the treatments mentioned in the story are widely available, and we were pleased to see the story went a step further and let us know how insurance impacts availability. The story reports that the concepts are not new, and that fluoride varnishes have normally been the purview of pediatric dentistry, but are now catching on among adult dentists. However, it never really explains why practice would be changing nowdid research spur this change? There is a reference to "more effective preventive techniques," but it's not clear what that means, and how a reader might act on that. This piece doesn't appear to rely on a news release; the reporter interviewed a number of experts and referred to several publications.
[EX A]: No-Drill Dentistry: Fluoride Treatments Can Prevent Cavities In Adults

[EX Q]: The story notes that the extensively hydrolyzed formula is more expensive than standard formula; however, the authors should have indicated how much more expensive hydrolyzed formula is compared to regular formula. Monthly cost comparison of two formulas would have been appropriate as this may be a deciding factor for many families who choose not to breastfeed, or who are weaning. We've already penalized the story in "evidence"above for not giving the absolute risk reduction, so we won't do it again here. The story reports on a study which showed about 50% fewer diabetes antibodies in at-risk children who were fed special hydrogized infant formula. But 50% of what? This may or may not translate into fewer cases of childhood diabetes. If there are other side effects or harms associated with using hydrolyzed versus standard formula, they are not described. There are no real "harms" with using formula, either cow's milk formula or extensively hydrolyzed formula. It appears the latter may be a better choice because there are fewer proteins broken down for digestion. What is missing here for the reader is a clear estimate of the absolute increase in risk of developing these antibodies. For example, if the risk for infants exposed to hydrolyzed is 1% and the risk for standard formula is 2% this may not be worth the cost. Whereas if the risk for those exposed to hydrolyzed is 5% and for those exposed to standard formula is 10% this may be worth it. Both of these represent a 50% increase in risk, but the absolute differences would have substantially different clinical implications The story does not engage in disease mongering. The story carefully explains the results of the study and is conservative about the role a formula may play in the prevention of Type 1 diabetes in susceptible children. it would have been helpful to indicate the prevalence of type 1 diabetes and how much the risk is increased if you have a first degree relative with type 1, which would have provided some perspective on the meaning of the relative increased risk for developing these auto-antibodies if an infant is exposed to standard formula. The story quotes several clinical experts who provide explanation of the results and put these into context with current formula recommendations. Study authors are cited as well as clinical experts who feel the research is noteworthy, but should not change recommendations for a hydrolyzed formula to prevent Type 1 diabetes. Affliations of all sources are listed in the story postscript. There are many options when weaning an infant from breast milk. The story discusses the NEJM study which compared extensively hydrolyzed formula with regular infant formula. While the more expensive hydrolyzed forumula was associated with fewer cases of Type 1 diabetes antibodies in at-risk children, the story notes that there is not definitive evidence that cow's milk formula will increase the risk of Type 1 Diabetes compared to other types of formular or breast feeding. Various infant formulas are available when weaning infants from breast milk, or when breastfeeding is not an option. The story discusses research that compared regular infant formula with a type of extensively hydrolyzed formula that helps break down proteins during digestion. This formula may not be available to some parents due to greater expense. It is known that breast feeding is preferable to formula, and that it may offer some protection against the development of Type 1 diabetes. Formula is an option, particularly when breast milk is not available, and using formula will not harm an infant. However, formula may somehow trigger the development of autoantibodies as these proteins are broken down for digestion. More research is needed, but this new information from a well-designed double-blinded RCT trial may guide recommendations and parents decisions in choosing a specialized infant formula that does not require breakdown of so many proteins during digestion. There is some thoughtful independent reporting and the story does not appear to rely on a news release.
[EX A]:
Special Infant Formula Might Help Shield Babies from Type 1 Diabetes