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: Officials in Cumberland County say the Department of Health was told Saturday that a person affiliated with the university was hospitalized with a "possible diagnosis of a bacterial meningitis infection." They did not say if the ill individual is a student. Officials say they are coordinating with the school and the state to provide antibiotics to anyone who had direct close contact with the individual. The university sent a campus-wide notification Saturday. Meningitis is an infection of the membranes surrounding the brain and spinal cord. The bacteria that cause the infection can spread through kissing, coughing and sharing beverages. Signs and symptoms of infection include high fever, headache, stiff neck and a rash.

SOLUTION: Officials investigate possible meningitis case at NC college.

PROBLEM: This release makes no mention of the costs of the drugs compared in this study, even though the drugs have been in use for years and are widely available. Since the study is a comparison of various treatments for this form of cancer, it seems relevant to offer a cost comparison as well as a comparison of efficacy. It appears that the high dose methotrexate is given over a 24-hour period, presumably in the hospital, while the standard methotrexate is given as a single dose. Also, the high dose methotrexate isfollowed by leucovorin administration while the standard dose is not. According to the site GoodRx, the cost for methotrexate in low-dose (2.5 mg) pill form averages out to about $50 for a month's supply. Newer, injectable variations of the drug cost upwards of $500 a month for the 25 mg dose. The release states that patients receiving high doses of the drug methotrexate "had a significantly better outcome, by 5 to 6 percent" than did patients receiving the current standard of care, which is gradually escalating doses of the drug. The release also explains that patients nine years old or younger who were also treated with a steroid called decadron (dexamethasone) forhalf as long as normal (14 versus 28 days) benefited from the treatment while patients 10 and older did not. We're not sure of the meaning behind these results as portrayed in the release. Which outcome was better by 5 or 6 percent? The study has several. Does that mean the relapse rate was reduced or is it the event free survival that was better? It would be more meaningful to readers if the release had included the actual relapse and event free survival rates for each group analyzed in terms most people can understand. For example: "relapse rates were 5 percent lower in Group X compared to Group Y." We'll give this category a satisfactory rating largely due to the release including information that patients 10 and older receiving dexamethasone "were at much higher risk for a debilitating bone condition called osteonecrosis," although we would have been happier if that greater risk would have been quantified. However, the published study explains that there were toxicity problems beyond that of dexamethasone and the release would have been stronger including that information as well. The release stated the study was randomized and controlled, and provides a broad overview of the study design, for which we give the release a borderline satisfactory under this criteria. However, these are thesuperficial results. On deeper delving into the study methodology, the statistical significances of the results were very close to notstatistically significant. This is due to their planned interim stopping of the treatment and the fact that they were looking at multiple outcomes in multiple groups. This release doesn't demonstrate disease-mongering. While the release does say that this clinical trial was run by the Children's Oncology Group, which is funded by the National Cancer Institute and the National Institutes of Health, it makes no mention of possible conflicts of interest. Compounding that is the fact that the published study says, "Disclosures provided by the authors are available with this article at www.jco.org," but that information is behind the journal's paywall for most readers, so it's unknown if there is, or is not, a conflict. It appears as though five of the authors (out of a total of about 20) have some conflicts of interest, mostly from several types of drug company payments. The release is comparing the efficacy of treatment regimens using different drugs so alternative treatmentsfor B-acute lymphoblastic leukemia are noted. The release makes clear at the end that the treatment of this disease is improving thanks to refinement of the use of existing drug treatments, meaning that they are readily available for patient use. The release suggests the study findings could change the way childhood leukemia is treated. Modifying existing treatments to enhance a patient's survival is certainly novel enough to warrant a release. There is no use of unjustifiable language in this release. However, the tone may be a bit overly optimistic given the study findings.

SOLUTION: Relapses of childhood leukemia improve with high doses of common chemo drug

PROBLEM: "One of the arguments Health and Human Services secretary Tom Price made about why substantial changes in federal health care law were needed was that the Affordable Care Act, sometimes called Obamacare, had failed in one of its goals -- to cut down on emergency room use. Because emergency rooms by law cannot turn patients away, they can become a health care provider of last resort, even for more minor conditions that could be handled just as well -- and more inexpensively -- in a doctor's office. ""One of the things that the previous administration said was that they were going to be able to drive folks away from one of the most expensive areas for the provision of health care, and that is the emergency rooms,"" Price said at a White House briefing on March 7, 2017. ""In fact, they did just the opposite."" Is Price correct that emergency room usage has gone up -- not down -- since passage of the law? Our research suggests that Price has a strong case. Did Obama say the law would lower emergency room use? He certainly expressed hope that it would. He mentioned it during an address on health care to a joint session of Congress, and during a nationally televised town hall on health care on June 24, 2009. During the town hall, Obama said this: ""One of the areas where we can potentially see some saving is -- a lot of those patients are being seen in the emergency room anyway, and if we are increasing prevention, if we are increasing wellness programs, we're reducing the amount of emergency room care, then that frees up doctors and resources to provide the kind of primary care that will keep people healthier, but also allow them to see more patients and hopefully give more time to patients, as well."" Has emergency room use gone up since the law has gone into effect? Different pieces of data vary somewhat, but all in all, there's strong evidence that emergency room usage hasn't declined much, if at all, since the law largely took effect in 2013. There's also evidence that it has increased. Here are some examples of studies that looked at this question. May 2015: A survey of more than 2,000 emergency-room physicians by the American College of Emergency Physicians asked whether the volume of patients in their emergency room had dropped or risen after the law took effect. The results: 28 percent said it had ""increased greatly"" and 47 percent said it had ""increased slightly."" Combined, that means three-quarters of emergency room doctors saw an increase. February 2016: A study by the Centers for Disease Control and Prevention looked at the change in emergency room use between 2013 (which was largely before the law) and 2014 (which was largely after the law took effect). ""ER use overall has not changed significantly after the first full year of ACA implementation,"" the report concludes. August 2016: A study in the journal Annals of Emergency Medicine looked at emergency room use in Illinois by adults between 2011 and 2015, separating out patterns of visits before and after the law took effect. The study found that emergency room visits in the state ""increased after ACA health insurance expansion. ... A large post-ACA increase in Medicaid visits and a modest increase in privately insured visits outpaced a large reduction in (emergency room) visits by uninsured patients."" So the studies pointed toward a modest increase in ER use. Two other recent studies looked at state-based scenarios that mirrored the types of expansions of coverage in Obama's law. Both of them -- a March 2014 study of Massachusetts and an October 2016 study of Illinois -- found increased emergency room use after coverage was expanded. Why isn't emergency room use going down? Experts cite a mix of reasons. Medicaid reimbursement rates are lower than those for private insurance, so appointments at doctors' offices may be hard to obtain for those who received Medicaid coverage under the Affordable Care Act. In addition, ""two-thirds of emergency visits occur on weekends and when doctors' offices are closed,"" said Laura Gore, a spokeswoman for the American College of Emergency Physicians. Demographics may play a role, too. Senior citizens are growing as a percentage of the population, and older Americans are likelier to have chronic health problems that require an emergency room visit, Gore said. In fact, the trend of growing emergency room use predates the enactment of the Affordable Care Act. ""Emergency department use has been rising since they were popularized after World War II,"" said Scott M. Dresden, a physician and assistant professor at Northwestern University who co-wrote the Illinois study. ""Research on health services use since the 1970s has shown that providing patients with assistance for health care costs, such as insurance, leads to increased health services use. So it's not particularly surprising that providing patients with insurance didn't decrease emergency department use."" But the biggest factor may be force of habit. ""Old habits are hard to break,"" said Gail Wilensky, who headed Medicare and Medicaid under President George H.W. Bush. ""People who were used to seeking care in ERs may continue to go there for a while. When Kaiser first started taking Medicaid patients, many continued their use of the ER for routine care like they had always done. It took a while to wean them away."" Katherine Baicker, a professor of health economics at Harvard University's T.H. Chan School of Public Health and co-author of the Oregon study, agreed. ""Expanding health insurance coverage leads to greater use of care across many settings, including the doctor's office, the pharmacy, the hospital, and the emergency room,"" she said. ""This is what one might expect from the basic economics: Medicaid took health care that was expensive and made it free, so people used more of it."" Our ruling Price said the Obama administration said ""they were going to be able to drive folks away from one of the most expensive areas for the provision of health care, and that is the emergency rooms. In fact, they did just the opposite."" While the data varies a bit from study to study, the findings generally fail to provide any evidence that emergency room use has decreased after the law took effect. Indeed, several studies found increases in emergency room use, though modestly. Price overstated the case slightly, but he's basically correct."

SOLUTION:
The Obama administration said "they were going to be able to drive folks away from one of the most expensive areas for the provision of health care, and that is the emergency rooms. In fact, they did just the opposite.