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: The release does not include any cost information. The summary gives an absolute risk reduction percentage of 0.27% for patients who received radiation compared to those who did not. It also includes the number needed to treat (370) to save one patient. This is good detail, but we would also have liked more context on the controversies of DCIS treatment. A HealthNewsReview.org podcast provides a deeper look here. The release briefly discusses harms. The release says patients who received radiation and lumpectomy had more “local” recurrences of the cancer, but their overall survival was modestly better than patients who did not have radiation (a 0.27% reduction over 15 years). The release should have given some mention to the harms of radiation treatment, particularly since the potential benefit of radiotherapy was very small. The release provides details on the association study, which reviewed records from thousands of patients. The release also includes limitations of the study. There is no disease mongering. The release provides context on the prevalence of DCIS in the U.S. The style of this news release was to punt the question of funders and “conflicts” into a web link where the reader has to chase it down. It would better serve readers to have funders and any conflicts of interest spelled out in the release. Here is what the release states: Editor’s Note: The article contains conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. The study notes that researchers received funding from Canadian government agencies. The release let readers down in providing the broader context about controversies over appropriate treatment — if any — for women diagnosed with DCIS. It’s common knowledge that radiation and surgery are widely available treatments. There was no claim of novelty. The release stated that results are based on an association study of a national database containing more than 140,000 patient records. It’s unclear if similar studies have been completed. We found no unjustifiable language. Claim: Association of radiation therapy plus lumpectomy in reduced risk of dying in women with DCIS

Output: 1


Input: Consider Input: Paragraph: The state Department of Environmental Conservation says an investigation determined the geese died of the fungal disease Aspergillosis, caused by eating moldy grain or bread. Three dozen Canada geese were found dead in a pond at the Malone Recreation Park in Franklin County near the Canadian border. State wildlife staff in Albany tested the dead birds. The state agency is asking the public not to feed waterfowl to help prevent the fungal disease or cause poor nutrition, delayed migration and other problems. Officials are also asking farmers to dispose of moldy grain and silage by burying it rather than spreading it over fields. Claim: Moldy bread or grain blamed for Canada geese deaths.

Output: 2


Input: Consider Input: Paragraph: The story attempted to discuss cost by citing the difference in price between shoulder surgery ($13,000) and the PRP treatment ($1,000, in this case for two injections). This is sufficient enough for a Satisfactory rating, but barely. While this does give readers some idea of the possible cost difference in treatments, there is no assurance that the charges in the author’s case are typical for those for the general public. It is simply one single data point which is fairly useless to the public. And, since there is no evidence of benefit or how many shots one might require, cost could be all over the place. The story gives no information on quantified benefits measured in PRP research, and instead focuses only on the author’s experience. The only mention of potential harms in the story comes in this statement:  “The American Academy of Orthopedic Surgeons — which says PRP ‘holds great promise’ — describes the risk as minimal.”  That’s not acceptable given that there is no explanation of what those risks might be. Readers are left clueless when it comes to questions of potential harms. Simply put, the discussion on the quality of evidence here is at best minimal, just the experience of one patient who happens to be a writer for the Washington Post. The story does cite a “recent pilot study” from a Canadian clinic of just seven rotator cuff injury patients who underwent PRP therapy. It said the study “showed tissue healing in five of seven patients . . . as well as improvements in their pain and function.”  But the story offers no information on how much healing or what degree of pain reduction or function, information readers need to consider a new therapeutic approach. There is no discussion of the growing body of evidence that has yet to show PRP actually improves clinical results. High-quality research, including a Cochrane systematic review, shows no benefit from injecting PRP. As Cochrane’s review noted: “The quality of the evidence is very low, partly because most trials used flawed methods that mean their results may not be reliable….In terms of individual conditions, we were able to pool results from six studies and found no differences in long-term function between those who received PRT during rotator cuff surgery and those who did not.” When it comes to shoulder injuries like rotator cuff tears, the story does not disease monger. However, the author’s claim that a vaccination injection resulted in the shoulder tear was an unusual claim, and one that we’re dubious of. Along with quotes from the author’s physician (who has already posted the story on his website) there are quotes from a researcher who was involved in one small clinical trial on PRP. The inclusion of the researcher just barely squeaks by as sufficient to earn a Satisfactory rating here. However, the story would have been much stronger had the author interviewed an expert who disagrees with these two sources, which wouldn’t be hard to find given the Cochrane review and other systematic reviews that cast a less rosy glow on PRP. The story is basically touting a possible new therapy as an alternative to traditional rotator cuff surgery, but it does a poor job of comparing them in an evidence-based manner. The story explains that platelets are removed from a patient’s blood using a centrifuge, equipment readily available in most practices. It makes the point of advising readers to seek out practitioners who do the procedure frequently. The story suggests that the PRP procedure is becoming more available. The story does not make it clear that PRP is not a new treatment, and that has been studied for many years now, including in rotator cuff tears. This story does not rely on a news release. Claim: I’ll never go through shoulder surgery again, so here’s what I did


Output: 1


