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: "Ed Stafford of Leicestershire, England walks in between trees as he walks through the Amazon jungle in Brazil in this undated handout photo. Former British army captain Stafford became on Monday the first known person to walk from the origin of the Amazon river, the world's second-longest river, to its mouth, after withstanding ""50,000"" mosquito bites, scorpion attacks and skin disease in his 859 day odyssey. REUTERS/Handout Ed Stafford, a 34-year-old from Leicestershire, England, dived into the Atlantic Ocean after taking 859 days to walk the length of the world's second-longest river, starting at the peak of Mount Mismi in Peru in April 2008. "It's just phenomenal to be here at the end of the journey after 2-1/2 years slogging our way through the jungle," he told Reuters after arriving at the beach about 90 miles northeast of the Brazilian city of Belem. "It was really difficult to envisage how this was going to feel and I'm completely overwhelmed." Stafford briefly collapsed from exhaustion with only 52 miles of the 6,000-mile journey to go, passing out by the roadside after breaking out in a rash. "I feel slightly humbled that my system just decided to shut down so close to the finish," he wrote on his blog at www.walkingtheamazon.com. Stafford has aimed to use the walk to raise awareness about the threats to the Amazon rain forest and its people, using a portable satellite video to blog about his trek. He had planned to complete the walk in about a year, but the journey was prolonged by floods that forced him to walk a roundabout route that was 2,000 miles longer than the 4,000-mile (6,400-km) length of the Amazon, which is exceeded in length only by Africa's Nile river. He began the journey with fellow British adventurer Luke Collyer, but the pair had a falling out early in the trek and Stafford continued alone. He was joined in July 2008 by a Peruvian forestry worker, Gadiel Cho Sanchez Rivera, who pledged to walk with him for five days and has been with him on the walk ever since. A statement from Stafford's media team said that the Briton had been: "wrongly accused of murder on two separate occasions, been imprisoned, had concrete stuffed in his mouth by hostile tribes people, been chased by Ashaninka Indians with bows and arrows, been stung by hundreds of wasps and watched as his guide 'Cho' removed a botfly from Ed's head with superglue and a tree spine." It said he had endured "50,000" mosquito bites, lived on a diet of piranha fish, rice and beans, and dodged a variety of snakes, electric eels, scorpions, and ants, as well as contracting a skin-disfiguring disease. Famed British explorer Sir Ranulph Fiennes was quoted as saying in the statement that Stafford's feat was "truly extraordinary." "No one has ever done this before and the pundits considered the route impossible," he said."

SOLUTION: British man becomes first to walk Amazon length.

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

PROBLEM: As part of the shifting casting that often goes on in the lead-up to motion picture productions, the person first cast to play the Tin Woodman in MGM's 1939 film version of The Wizard of Oz was Ray Bolger. Buddy Ebsen (later to become familiar to generations of TV viewers as Jed clampett, the patriarch of The Beverly Hillbillies sitcom family), was originally intended for the role of the Scarecrow, but Ray Bolger eventually managed to convince MGM to allow him to swap parts with Ebsen (not, as is often claimed, because a clause in Bolger's contract stipulated that he could play the part of the Scarecrow if MGM ever made The Wizard of Oz). MGM initially had no idea exactly how to costume Ebsen for his role. They tried a variety of materials for his clothing (real tin, silver paper, cardboard covered with silver cloth) and makeup before finally settling on aluminum dust (applied over clown white) for the latter. When The Wizard of Oz began principal photography on 12 October 1938, Ebsen had finished all his costume and makeup tests, recorded his songs for the film soundtrack, and completed four weeks of rehearsal. Nine days later, he was rushed to the hospital and placed in an oxygen tent when his lungs failed. As Ebsen described the onset of symptoms in his autobiography: It was several days later when my cramps began. My first symptoms had been a noticeable shortness of breath. I would breathe and exhale and then get the panicky feeling I hadn't breathed at all. Then I would gasp for another quick breath with the same result. My fingers began to cramp, and then my toes. For a time I could control this unusual cramping by forcibly straightening out my fingers and toes. One night in bed I woke up screaming. My arms were cramping from my fingers upward and curling simultaneously so that I could not use one arm to uncurl the other. My wife tried to pull my arm straight with some success, just as my toes began to curl; then my feet and legs bent backward at the knees. I panicked. What was happening to me? Next came the worst. The cramps in my arms advanced into my chest to the muscles that controlled my breathing. If this continued, I wouldn't even be able to take a breath. I was sure I was dying. The aluminum dust used in Ebsen's makeup had caused an allergic reaction or infection in his lungs that left him scarcely able to breathe, and he ended up spending two weeks in the hospital and another month recuperating in San Diego. While Ebsen was recovering from his illness, producer Mervyn LeRoy hired Jack Haley to replace him. (The aluminum makeup was modified as well, changing from a powder that was brushed on to a paste that was painted on. Haley missed four days of filming when the new makeup caused an eye infection, but treatment was rendered in time to prevent any permanent damage.)

SOLUTION:
Buddy Ebsen was slated to play the Tin Woodman in the 1939 film version of The Wizard of Oz, but he had to be replaced after the aluminum makeup used with his costume made him gravely ill.