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'.
One example is below.
Q: Paragraph: While the financial costs of screening mammography&!1-positive recalls&biopsies were not included in the study,readers would benefit from being reminded that recall mammography&biopsies increase patient financial costs.This article leads with valuable information for all women over age 40 by stating “Getting screening mammograms every two years instead of annually reduces the chance of a!1 alarm,a new study shows.” Unfortunately the writer doesn’t quantify or elaborate adequately on that reduction.Instead,the writer later focuses on how women undergoing screening mammography shouldn’t be anxious if they experience a recall because over half of women who have screening mammograms for 10 years will be recalled.Readers would have been better served if the writer had emphasized the significant reduction in both recall mammograms&!1-positive biopsies in women who are screened every two years rather than annually.Part of the continuing controversy over screening mammography focuses on annual versus biennial screening.Because this study showed a significant reduction in the percentage of those recalled&needing biopsies among women who are screened every other year,with no statistically significant increase in late-stage diagnosis of breast cancer,the article should have emphasized those important findings.The piece states that the researchers noted that “…!1 positive recalls may cause inconvenience&anxiety and biopsies can cause pain and scarring.” This article fails to include several important facts about the study.1)This is a prospective cohort study of women screened between 1994-2006.2)Most of the mammograms were film rather than digital.3)Few women underwent screening for the entire 10 year period.4)Screening mammography recall rates are influenced by the skill of the radiologists who read the mammograms.There was no disease mongering.No independent experts were quoted.The story did an adequate job comparing – at a very high level – annual screening versus biennial screening.Screening mammography is widely available throughout the United States.The study did not examine a new procedure.There’s no evidence that the story relied solely on a news release. 
Claim: Annual Mammograms May Have More False-Positives
A: 1
Rationale: This article reports on the results of a study of nearly 170,0 women who had screening mammograms beginning between age 40-59.The study found that over ten years of screening mammograms,over half of the women will experience a!1-positive recall for additional mammography.In addition,7%-9%of the women will have a biopsy for a suspicious lump which is not cancerous.Both of those percentages decrease if the woman is screened every other year rather than every year.Even with biennial mammography,41%of women will experience a recall over 10 years of mammography.The study’s Principal Investigator emphasized that “in most cases,a recall doesn’t mean you have cancer.” She hoped this knowledge would reduce the anxiety of women who are recalled.The story never explained the size of the decrease in the number of!1 positives between annual(61.3%) and biennial screening(41.6%).Our first two reviewers were a researcher who specializes in health decisions and a breast cancer survivor trained in evidence by the Natiional Breast Cancer Coalition’s Project LEAD.This study is valuable because it helps to quantify and compare the harms of annual and biennial screening,specifically the number of!1 positives and the number of unnecessary biopsies.Prior to this study,estimates of!1 positive screening mammography rates varied widely.The critical question is whether you can do less frequent screening,subject women to fewer harms and get similar results in terms of detection of “early stage” cancer.This study’s data seems to suggest that answer is yes.
Q: Paragraph: “It’s because my body has been suppressed for so long, it can’t fight it (cancer),” the Wisconsin resident said. Patty, who has worked at her father’s restaurant for 27 years, now struggles to handle full-time duties. “I’m trying to get disability, but I’ve been denied once already. I don’t plan on quitting working. I just need help. I need help because I can’t do a full-time job,” Patty said. In March 2017, a friend who lives in New Mexico, where medical marijuana is legal, mailed her Buddha Tears, a cannabis oil product containing cannabidiol (CBD), and THC, the psychotropic component of cannabis. After consuming a tiny amount of the oil each day — as well as smoking marijuana — Patty said she saw a massive improvement in her condition. “Unfortunately, I have to smoke everyday, because if I don’t, I will be in the bathroom all the time,” said Patty, who asked that her last name not be published because she is using an illegal substance. But these days, Patty is again struggling with the symptoms. “My connection (for CBD and marijuana) got cut off,” she said. “I’m very angry.” While Patty and others have found success treating their medical ailments with cannabis, the drug remains illegal in Wisconsin. And because of its status as a Schedule I drug — the most restrictive classification — there has been limited research in the United States about its effectiveness as medicine. The U.S. Food and Drug Administration has authorized one component of cannabis to treat serious and rare seizure disorders, as well as three drugs with synthetic cannabis substances; no other uses have been approved. ___ The nonprofit news outlet Wisconsin Watch provided this article to The Associated Press through a collaboration with Institute for Nonprofit News. ___ Although it remains illegal federally, 33 states and the District of Columbia have authorized medical use of cannabis. A bipartisan group of lawmakers has proposed legalizing it for medical use in Wisconsin, and another group of Democratic lawmakers introduced a bill in October to decriminalize possession of less than 28 grams. But Senate Majority Leader Scott Fitzgerald, R-Juneau, remains opposed. An April poll conducted by the Marquette Law School Poll showed that 83% of registered voters polled support the use of marijuana for medical purposes with a doctor’s prescription. “When issues receive more than 70% support from registered voters in Wisconsin, the Legislature needs to listen and act,” said Rep. David Bowen, D-Milwaukee. According to Dr. Angela Janis, director of psychiatry for University of Wisconsin-Madison’s University Health Services, Schedule I drugs, including marijuana, are considered to have no currently accepted medical use and a high potential for abuse, whereas for Schedule II drugs, there is less potential for abuse, and there is some therapeutic benefit. Janis is intimately familiar with this distinction. In addition to her university job, Janis is chief medical officer at LeafLine Labs, a Minnesota-based medical marijuana company. “To put this in perspective: methamphetamine is Schedule II because it’s approved for obesity. Cocaine is Schedule II because it’s approved for nasal surgery since it can constrict your blood vessels as they do surgery in your nose. So that’s the bar for what ‘medical benefit’ means,” Janis said. According to Janis, cannabis has less abuse potential than any of those substances. “Cannabis is not appropriately scheduled. And that’s one of the barriers, but not the only barrier, to research,” Janis said. Janis recommends rescheduling the drug so researchers can further study its properties. Even Smart Approaches to Marijuana (SAM), which opposes marijuana legalization, is “fully supportive” of drugs containing cannabis that have been approved by the FDA, said Colton Grace, a spokesman for the group. According to the National Institute on Drug Abuse, cannabinoids are substances within the cannabis plant that act on specific receptors in the human brain and body. They are the main active ingredients in the medical products derived from cannabis. These receptors affect many essential functions, including one’s memory, thinking, concentration and coordination. Interfering with it can have profound effects — both positive and negative. Two of the most extensively studied cannabinoids are delta-9-tetrahydrocannabinol (THC) and CBD. However, there are dozens of cannabinoids that may also have medical uses. “Many strains of the cannabis plant can have 60, 70, 80 cannabinoids in them that all interact in different ways,” Janis said. The National Institutes of Health reported spending $191 million on researching cannabinoids for medicinal use in 2017-18. Some effects are already known. For example, THC can affect the central nervous system, producing benefits such as decreased vomiting and nausea, increased appetite, reduced pain and anti-inflammatory effects. CBD also acts as an anti-inflammatory, increasing immune function, reducing pain and keeping certain cells from proliferating. Cannabinoid receptors are not in areas that control breathing, which is why there are no fatal overdoses with marijuana, Janis said. CBD actually blocks the psychotropic effects of THC, Janis said. In addition to all those cannabinoids, the cannabis sativa plant has a lot of other chemicals. For instance, terpenes, which give each strain its particular smell, such as lemon or pine, “are thought to have a lot of effects, but we just don’t know what they actually do in the body,” Janis said. In 2017, the National Academies of Sciences, Engineering and Medicine came out with one of the most comprehensive reviews of scientific research on what is known about the health effects of cannabis and cannabis-derived products. The committee considered more than 10,000 scientific abstracts. It reached nearly 100 conclusions, finding substantial evidence for just a few indications — the biggest one being pain. The report found there is substantial evidence that cannabis is an effective treatment for chronic pain in adults, specifically nerve pain, Janis said. The group also found conclusive evidence for cannabis treating chemotherapy-associated nausea and vomiting and MS-associated muscle spasms. The report also showed moderate evidence that cannabis or cannabinoids are effective for improving sleep in individuals with sleep apnea, fibromyalgia, chronic pain and multiple sclerosis. It also found limited evidence for cannabis as effective for increasing appetite and decreasing weight loss associated with HIV/AIDS, relaxing muscle tightness and pain from MS, symptoms of Tourette syndrome, anxiety and post-traumatic stress disorder (PTSD). Anecdotal evidence has also proven the effectiveness of cannabinoids for treating Rett syndrome. Norah Lowe, 10, started feeling relief from the rare neurological disorder one year ago when she began using CBD to treat her symptoms. Rett syndrome impacts nearly every part of a child’s life, including the ability to speak, walk, eat and breathe. A distinct feature of the condition is repetitive, almost constant hand movements. At a news conference arranged by state Rep. Melissa Sargent, D-Madison, to introduce her latest bill to legalize medical and recreational marijuana, Norah’s father, Josh Lowe, said he is frustrated that state law prohibits her from trying medical marijuana, which has helped others with her condition. Norah, who uses a wheelchair, has experienced “increased flexibility, decreased pain and muscle cramping, increased communication, cognitive ability, reduction in seizures, better mood control, and the list goes on and on,” Lowe said. A 2017 study published in the Cochrane Database of Systematic Reviews analyzed several studies, concluding that cannabis-based medicines were better than placebos for pain relief — and that these medications also improved sleep and psychological distress — it concluded that any potential benefits might be outweighed by their potential harms. According to the Marijuana Policy Project, the most common conditions accepted by states that allow medicinal cannabis relate to the relief of the symptoms of cancer, glaucoma, HIV/AIDS and MS. Some other common indicators include Alzheimer’s disease, inflammatory bowel disease, Crohn’s, Parkinson’s disease and PTSD, according to the group, which advocates for marijuana legalization. Additionally, the University of Michigan published a study in the February issue of Health Affairs to understand the reasons why people are using cannabis for medical purposes, and whether those purposes are evidence-based. The authors found that 85.5% t of uses of medical cannabis were for conditions for which there was substantial or conclusive evidence of their therapeutic effectiveness. Even more, they found that chronic pain is currently the most common qualifying condition reported by medical cannabis patients, used by 64.9% of such patients in 2016. “That’s a good sign,” Janis said. “Even though a physician can write it (a cannabis prescription) for a variety of things, it seems to be being used for what it’s intended for.” Since cannabis is a Schedule I drug, it is “very difficult to study at any institutional level” because, in order to do so, researchers need sign-offs from the U.S. Drug Enforcement Agency, which has “historically been unwilling to provide them,” said David Abernathy, vice president of data and government affairs for the Arcview Group, a firm that advises investors in the cannabis industry. Because of this, “Things like double-blind placebo-controlled clinical trials weren’t happening in the U.S.,” Abernathy said. But there has been a lot of research in the past decade in other countries including Israel, Canada, China and Italy, and “now we’re starting to see more research in the U.S.,” he said. The 2017 National Academies review of cannabis research agreed that the drug’s status as a Schedule I substance made it hard to study. “Researchers also often find it difficult to gain access to the quantity, quality, and type of cannabis product necessary to address specific research questions,” the review found. Patty, the Crohn’s patient, believes that her cannabis treatment not only alleviated her Crohn’s symptoms, but she credits it with keeping her aggressive skin cancer at bay. According to a 2018 article published in Biochemical Pharmacology, studies have shown the potential of cannabinoids to reduce of skin cancer progression. However, there is a significant lack of clinical studies promising enough to make any conclusive statements at this time. “I haven’t had the cannabis oil since March of 2018, and once I couldn’t get it anymore, I mean I just finished my 12th surgery (for cancer),” Patty said. “So, you tell me, what do you think?” Claim: Wisconsin residents using medical cannabis amid restrictions.
A:
2