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'.

Input: Consider Input: Paragraph: There is no mention of costs in the release, but overuse of medical technology such as MRI scanning is one major reason for soaring health care costs. According to personal finance website Nerdwallet.com, median prices of a brain MRI range from $525 in Atlanta to a whopping $3,310 in Milwaukee. The main contention of the news release is that "imaging findings can help spur beneficial lifestyle changes in patients to reduce risk for Alzheimer's disease." But there's no evidence presented to show that these images have any effect good or bad on patients' adoption of beneficial lifestyle changes. Does performing an MRI increase the likelihood that someone will lose weight, exercise, and stop smoking? The release also states, "institutions meld these approaches into novel ways to improve patient care," but the report doesn't detail what those "novel" therapies are. Experts in the report talk about pinpointing "volume loss in the brain" and characterizing imaging markers, but these are all surrogate endpoints. In other words, how do these translate to tangible health outcomes for patients? Bottom line: The idea that a brain MRI is going to help motivate people to adopt meaningful lifestyle changes and that those changes will, in turn, lead to an actual reduction in the number of Alzheimer's disease cases requires several leaps of logic that have very limited support from evidence. The release owed it to readers either to point out the preliminary nature of the hypothesis or provide some evidence to back it up. The release did neither. Procedures almost always carry risks, and MRI is no exception. Some physicians are concerned with "MRI abuse," pointing out that MRIs often pick up abnormal but harmless findings that muddy up the clinical picture. These so-called "incidentalomas" can lead to more tests and treatments that cause harm and add to costs. Unnecessary imaging is a major contributor to spiraling health care costs in the US, since a single scan on average in the US costs $2,611, according to Medicare data. Beyond stating that it exists, this news release provides no information about the journal article that is the subject of the release. Nor does it detail any of the studies that supposedly support the value of imaging for Alzheimer's disease prevention. We'd add that the journal article itself provides limited-quality evidence it doesn't detail the process for selecting articles that are included in the review (raising the possibility of "cherry-picked" studies) and includes little in the way of critical evaluation of the studies that are cited. Strangely, three physicians, who weren't listed as authors of the study, are quoted in the release and allowed to tout the benefits of quantitative MRI technology. They make sweeping statements, such as that this technology "will have a huge impact in the future" and that imaging "can have a powerful impact [on patients]" But the report fails to go into detail. One of these experts adds, "Patients seem to enjoy reviewing results of their imaging studies, more so than reading the results of their blood tests or other clinical evaluations." But one physician's anecdotal observation is not evidence of enhanced quality or effectiveness of care. Again, supporting data is needed. The news release does not engage in disease mongering and states that as many as three million cases of Alzheimer's dementia could be prevented with lifestyle changes. However, it does imply that there would be more cases prevented with the addition of brain imaging, a claim that is not supported by the release or the underlying review article. The release does not specify funding sources for the work, which included the National Institute of Biomedical Imaging and Bioengineering and the National Institutes of Health. Many of the authors are consultants for medical device and pharmaceutical companies, including Toshiba (cited as "related" or relevant in the original research report). The release does not disclose this. The main premise of the news release is that MRI imaging can help people lower their risks for cognitive decline by encouraging them to make lifestyle and behavioral changes. It states that risk factors include obesity, diet, sleep, hypertension, diabetes, depression and smoking. However, the release does not address any alternatives besides brain imaging that might help people make the desired changes. Behavioral change counseling, which is an established approach to reducing problematic behaviors, is not discussed. The release doesn't address the availability of quantitative MRIs of the brain. MRI in general has been used since the 1970s, and its availability is not in question. But since the issue is not specifically addressed by the release, we'll rate it Not Applicable. Using quantitative MRI technology to diagnose Alzheimer's disease in its early stages is not a new concept. There have been blog posts and numerous studies in the past 10 years devoted to this topic. We're not really sure what's new here. The news release refers to "novel ways to improve patient care," but does not specify what these new approaches are. The language of the release bordered on sensational, with neurologist Majid Fotuhi touting the benefits of quantitative MRI technology and claiming it will have a "huge impact in the future of diagnosis and treatment of Alzheimer's disease." The release never clarifies the how and why of this statement. Claim: Preventive neuroradiology: Brain imaging bolsters efforts to lower Alzheimer's risk

Output: 0

Input: Consider Input: Paragraph: IndyCar medical director Geoffrey Billows said Thursday a "very limited supply" of vaccines will be available at the medical building near the Indianapolis Motor Speedway museum. He says most insurance companies will cover the cost. Billows encourages concerned fans to get vaccinated before coming to a race expected to attract in excess of 275,000. Measles was once common in the U.S. but gradually became rare after vaccination campaigns that started in the 1960s. The nation is struggling with a high number of cases this year as some families choose not to get vaccinated despite the recommendations of public health experts. At least 20 confirmed cases of mumps also were reported at Indiana University in Bloomington, about 50 miles southwest of Indianapolis. ___ More AP auto racing: https://apnews.com/apf-AutoRacing and https://twitter.com/AP_Sports Claim: Indianapolis 500 officials to offer measles vaccine at race.

Output: 2

Input: Consider Input: Paragraph: Although Pfizer continues to test the drug, called dacomitinib, in another Phase III study, hopes for its success have now largely faded, according to ISI Group analyst Mark Schoenebaum. "We believe consensus expectations (for the drug) will be close to zero given today's readout" of unsuccessful trial results, Schoenebaum said in a research note. In one of the failed trials, called ARCHER 1009, patients given Pfizer's once-daily pill did not show improved survival without the cancer worsening, compared with Roche Holding AG's widely used Tarceva (erlotinib). Tarceva is the current standard of care in patients with mutated forms of a protein called Epidermal Growth Factor Receptor (EGFR). The protein plays a role in normal regulation of cell growth, but when mutated is believed to cause cells to proliferate and thereby help spur various types of cancer. Dacomitinib is designed to block several types of Epidermal Growth Factor receptors, while Tarceva and similar treatments for lung cancer target only one type of receptor. Cowen and Co had forecast annual sales of $500 million by 2020 for dacomitinib, if it were approved for lung cancer. That would make it a moderate-sized product for Pfizer, the largest U.S. drugmaker, which has annual revenue of $50 billion. Schoenebaum said there has been little investor interest in the drug and that Wall Street had expected it to generate annual sales of only $300 million by 2018. The second failed trial, named BR.26, involved patients that previously had failed to benefit from chemotherapy as well as from treatment with an EGFR inhibitor. Overall survival of patients taking the Pfizer drug was not prolonged in the study, compared with patients given a placebo. Pfizer said adverse events seen with dacomitinib were consistent with those seen in smaller earlier studies. In the meantime, Pfizer said dacomitinib is also being tested in a third late-stage trial, called ARCHER 1050, among patients with advanced non-small cell lung cancer who have not received prior treatment. The study will compare dacomitinib with Iressa (gefitinib), an EGFR inhibitor sold by AstraZeneca Plc. Results from that study are expected in 2015. Pfizer shares were little changed in morning trading on the New York Stock Exchange. Claim: Pfizer lung cancer drug fails in two large studies.
Output: 2