Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
One example is below.
Q: Paragraph: "Although the story didn’t cite the cost of appendectomy – emergency or urgent surgery – and we wish it had, we nonetheless will give it a satisfactory score because it at least cited what the editorial writer wrote, ""A secondary benefit is the savings to the hospital generated by minimizing staff and anesthesiologist presence late in the evening and during the wee hours of the morning."" As with our harms score above, although the story didn’t give absolute numbers, in this case we think it was sufficient for it to report that ""The scientists found no significant difference among the groups in the patients’ condition 30 days after surgery or in the length of their operation or hospital stay."" Although the story didn’t give absolute numbers, in this case we think it was sufficient for it to report that ""The scientists found no significant difference among the groups in the patients’ condition 30 days after surgery or in the length of their operation or hospital stay."" Despite running less than 300 words, this story did an adequate job in explaining the quality of the evidence, including pointing out limitations. No disease-mongering here. The story meets the bare minimum requirement for this criterion in that it at least cited what an editorial stated. The focus of the story was on a study comparing emergency appendectomy with surgery done up to 12 hours later or beyond. This is the whole focus of the story – and one we applaud – when it begins:  ""Appendectomy is the most common emergency surgery in the world, but it doesn’t have to be."" There were no claims made about the novelty of this research, and we may have wished for a bit more context on this. Nonetheless, the potential for guiding future care decisions was made clear. Not applicable. Given that the story only pulled excerpts from the journal article and the accompanying editorial, and didn’t include any fresh quotes from interviews, we can’t be sure of the extent to which it may have been influenced by a news release.". Claim: Some appendicitis cases may not require ’emergency’ surgery
A: We really don’t understand why only a handful of mainstream news organizations reported this story. (At least in what we found.) The most common emergency surgery in the world. Rushing to emergency surgery may not carry any benefit. Waiting a few hours may be safer and less expensive. Why is that not a story? We applaud USA Today for finding time and space – and clearly it didn’t need to free up much space to do a good job telling the story. The story explains that as many as 300,0 appendectomies are done each year in the US. That figure alone explains why this is an important study to report.
Rationale: The output is an analysis of the claim while considering the paragraph as a reference. The output highlights the key features presented in the paragraph and explains the claim accordingly.
Q: Paragraph: The release does not mention cost. The FDA evaluates drugs without consideration of cost, so it’s understandable that they wouldn’t comment on it — and that’s why we’re rating this Not Applicable. But let’s be real here: The value of a new drug is a function not just of how well it works, but its cost-effectiveness. So we look forward to the day when any news release about a new drug — even one from the FDA — will include some mention of cost in its message. This release gives the preliminary results from a single study of 310 patients. Because the drug is experimental, long-term results haven’t been studied. Of the 310 patients enrolled in the lone trial upon which the approval is based, 14.8 percent showed some shrinkage of tumors during the assessment period lasting from 2.1 to about 13.8 months. For a subset of patients who were classified as having a positive response to PD-L1 expression, the response was 26 percent. As noted above, tumor shrinkage doesn’t always lead to improvements in survival or quality of life. It is a surrogate endpoint — a substitute — for the main outcome which is survival. Although this drug looks promising, to be fully transparent about its benefits as currently known, the release should have explained this. As noted in the “Summary,” another larger study is underway to assess the drug’s impact on extending life and improving quality of life. The release includes a description of side effects of this treatment. The most common ones included fatigue, decreased appetite, nausea, urinary tract infection, fever (pyrexia) and constipation. The release also mentions that patients taking the drug have an increased risk of infection and serious side effects that are “immune-mediated.” We would have liked a bit more context on what this term means for patients. The release outlines that this is the very first clinical trial of this compound for safety and efficacy, and under which regulatory paths the drug was assessed, including “breakthrough therapy designation, priority review status and accelerated approval.” We’re giving this release the benefit of the doubt and rating it Satisfactory for its bare bones description of the trial (and since we already addressed the lack of long-term survival data in the “Benefits” section.) As it stands, the results from the small trial were preliminary and short-term and did not reflect long-term survival. We would have liked to see a reference or link to the completed trial where one could look at the results to assess independently or learn more about the outcomes. We think the release should have provided more data on the patient demographics, the treatment regimen (dosing amount and schedule) as well as the range in tumor reduction. There is no disease mongering. This release describes the approval of a new drug by a regulatory agency, but we’d still like to know who sponsored the study that’s the basis for the approval. It’s not enough to state who markets the drug. The release does not give us very much information about alternatives. These patients had already received other therapy and their cancer had recurred, so it is implied that they had no other alternatives. But this isn’t stated very clearly. We can assume (and it seems evident) that the platinum-based therapy that the patients didn’t respond to initially is the usual treatment. The FDA’s approval of a drug clears the way for the drug sponsor to scale up production and begin marketing and selling the product. (The FDA doesn’t state this explicitly but it can be inferred.) A NYT article said the drug would be available in about two months. The release clearly states this product is first of its kind for this type of cancer. We found no unjustifiable language. Claim: FDA approves new, targeted treatment for bladder cancer
A:
The Food and Drug Administration approved a new immunotherapy drug that acts as a “checkpoint” inhibitor in patients whose bladder cancer (urothelial carcinoma) has not responded to other chemotherapy. The drug, atezolizumab (marketed as Tecentriq), showed effectiveness in about 14 percent of 310 patients in a very preliminary study. The release notes that the trial measured tumor shrinkage as the main outcome. It didn’t note, as a NYT article did, and important for this type of trial, that it is unknown whether the treatment makes a difference in survival. A larger study is being done to examine this. Whether it makes a difference in quality of life is also important and will presumably be examined in the larger trial. The National Cancer Institute (NCI) estimates 76,960 new cases of bladder cancer and 16,390 deaths from this disease in 2016. This approval of a new drug for treating bladder cancer is part of a wider area of research into immunotherapy, in which drugs target mechanisms of the human immune response. Patients with the PD-L1 protein highly expressed in their tumors appear to be responding best to the drug. This drug is an example of targeted chemotherapy which is becoming more important as treatments can be fine-tuned to the cancers of individual patients. In patients with intractable cancers, immunotherapy appears to offer some new hope while also bringing sobering questions about affordability and disparity of access by income. The drugs are typically very expensive — with some estimates putting the treatment cost for a single patient as high as $1 million. When the FDA gives a compound a “breakthrough” designation, some physicians and patients can misunderstand what that means. That’s a topic recently explored in this post.