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.

[Q]: Paragraph: 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 is followed 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) for half 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 the superficial results. On deeper delving into the study methodology, the statistical significances of the results were very close to not statistically 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 treatments for 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. Claim: Relapses of childhood leukemia improve with high doses of common chemo drug
[A]: This release reports the findings of a large clinical trial testing whether alternative dosing regimens of standard chemotherapeutic drugs can improve the treatment of B-acute lymphoblastic leukemia. The study showed that using high doses of the drug methotrexate, rather than the standard regimen of gradually increasing doses, improved the outcomes for patients with the disease. The study also showed that using the steroid dexamethasone increased a debilitating bone condition in patients 10 and older but not in patients nine or younger. While the study results are promising, they are by no means clear-cut in the release. The release needed some qualifiers in order to give a clear picture of the benefits. The release also neglected to discuss costs and potential conflicts of interest among the investigators. This form of cancer — B-acute lymphoblastic leukemia — is the most common cancer in children and a major cause of cancer death in patients under 40 years old. And while the majority of patients survive with appropriate treatment, anywhere from one-fifth to one-quarter of patients do not. This study showed that refining the dosing of standard cancer drugs may improve the outcome for some high-risk patients.


[Q]: Paragraph: Researchers from the University of Glasgow reported the results in the New England Journal of Medicine on Monday. They compared the causes of death of 7,676 Scottish men who played soccer with 23,000 similar men from the general population born between 1900 and 1976. Over a median of 18 years of study, 1,180 players and 3,807 of the others died. The players had a lower risk of death from any cause until age 70. However, they had a 3.5 times higher rate of death from neurodegenerative diseases such as Alzheimer’s or Parkinson’s. In absolute terms, that risk remained relatively small — 1.7% among former players and 0.5% for the comparison group. Former players also were more likely to be prescribed dementia medicines than the others were. The results “should not engender undue fear and panic,” Dr. Robert Stern, a Boston University scientist who has studied sports-related brain trauma, wrote in a commentary published in the journal. The findings in professional players may not apply to recreational, college or amateur-level play, or to women, Stern noted. “Parents of children who headed the ball in youth or high-school soccer should not fear that their children are destined to have cognitive decline and dementia later in life. Rather, they should focus on the substantial health benefits from exercise and participation in a sport that their children enjoy,” while also being aware of the risks of head-balling, Stern wrote. English Football Association chairman Greg Clark said “the whole game must recognize that this is only the start of our understanding and there are many questions that still need to be answered. It is important that the global football family now unites to find the answers and provide a greater understanding of this complex issue.” The association and players’ union sponsored the study. “We need to kick on now and understand what it means, because that’s all an awful lot we don’t know,” English FA chief executive Mark Bullingham said. “We don’t know if concussion was the cause or whether it was heading or whatever or whether it’s the old heavy ball or something entirely different.” But the association’s medical advisory group has not deemed it necessary to issue to change how the game is played, even reducing heading among younger age groups. “In youth football, you might want to reduce the likelihood of aerial challenges,” Bullingham said. “But our research shows this has already been reduced significantly over the years as we change to small size of pitches, move to possession-based football and now rolling substitutes.” Referees across all levels can stop games for three minutes to fully assess head injuries, but some experts believe that is not long enough. The English FA also is pushing soccer’s global lawmaking body for the introduction of concussion substitutes, with an additional player switch or as a temporary replacement. Campaigning to discover more about the long-term impact of head injuries in soccer has been led in England by the family of former England striker Jeff Astle, whose death at age 59 in 2002 was attributed to repeatedly heading heavy, leather balls. In 2017, a British study of brains of a small number of retired players who developed dementia highlighted the degenerative damage possibly caused by repeated blows to the head. ___ AP Chief Medical Writer Marilynn Marchione in Milwaukee contributed to this report. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. ___ More AP soccer: https://apnews.com/Soccer and https://twitter.com/AP_Sports Claim: Study raises fresh dementia concerns from playing pro soccer.
[A]: A study of former professional soccer players in Scotland finds that they were less likely to die of common causes such as heart disease and cancer compared with the general population but more likely to die from dementia. The results raise fresh concerns about head-related risks from playing the sport — at least for men at the pro level.


[Q]: Paragraph: "The story includes the cost of this test $1,625 and mentions that insurance companies currently don’t cover the cost of the new genetic test for breast cancer. The test manufacturer CEO’s speculation that insurance companies will eventually cover the test because it’s easy to perform and ""any doctor can order the test"" is an inappropriate rationale for any screening, especially when such screening may place a woman at risk for unnecessary surgery or other treatments. It is not clear how this test improves on these current practice as there was no evidence presented about it. The story appropriately expresses caution when presenting the value of this new test to predict a woman’s lifetime risk of developing cancer. There is a wide range of experts interviewed, all of whom express concern about the current available evidence for the predictive value of this test. Most experts advise against women taking this test, and the American Cancer Society does not promote the test. The story provides appropriate caveats for women who are considering this test. Namely, a lower than average score might suggest a woman could forgo screening. Women with a higher than average risk score could experience unnecessary anxiety and possibly choose treatments they do not need (such as prophylactic mastectomy). The story does not provide any evidence about the test itself (despite alluding to it). The story does mention that this test has not been validated in an external review, so any evidence would be from company-sponsored studies. Additionally, peer-reviewed studies need to be done to determine the best course of prevention if a woman chooses to take the test and discovers she is at higher risk of developing breast cancer. Because the story raised appropriate questions about the quality of the evidence, we give this a satisfactory score. The story lists the annual incidence of new breast cancers and mortality rate. The story is tempered in reporting about a new genetic test which may or may not be another option for women looking to assess their risk. The story mentions that knowing individual risk may inform a woman’s decision whether to increase surveillance and/or take chemoprevention medication, such as tamoxifen. Several leading breast cancer researchers, a member of the American Cancer Society and a spokesperson for the FDA are interviewed for this story. These interviewees do not have a vested interest in this test–unlike Decode’s chief executive, who is also interviewed, mainly promoting his company’s product. Researchers help educate the reader about a new test may have many more cons than pros. The story does note, via a patient advocate, that some women may still go ahead with the test if they feel it may help guide them in future breast cancer prevention efforts. The story mentions current prevention guidelines for women who are considered at higher than average risk of developing breast cancer. This includes additional surveillance with MRI and mammography, chemoprevention and adopting a healthier lifestyle, namely reducing alcohol consumption and lowering body fat. However, the evidence of survival benefit for lifestyle and screening is fairly limited. Most of recent decrease in breast cancer  mortality is attributed to advances in treatment not necessarily screening. Currently, breast cancer risk for women who do not carry the BRAC1/2 genes is determined via population-based calculators such as the Gail Risk Model. This tool provides an estimated 5-year risk and is only validated for Caucasian women, so a well-validated, individualized predictive test would, in theory, be useful for some women. The test discussed in this story has not been studied long enough, nor have results of company studies been subjected to an external review. The focus of the story is a new, widely available genetic test. The story says that any doctor can order this test to assess a woman’s risk of developing of developing one of the more common forms of breast cancer. The story notes that the FDA does not regulate this or similar types of predictive genetic tests, and there are questions about the validity of tests that have not been subjected to external review. The story notes that there are other genetic tests, but this is one of the first for breast cancer for women who do not carry the BRCA1/2 gene. The story does not mention that there are several other risk calculators to estimate a women’s risk. The story does not rely on the Decode Genetics press release. There is independent reporting and a balanced review of this new genetic test." Claim: Firm says test judges risk for common breast cancers
[A]:
"The focus of the story is a newly available genetic test to assess a woman’s risk of developing of developing one of the more common forms of breast cancer. The story does not provide any evidence about the test itself (despite alluding to it). The story does mention that this test has not been validated in an external review, so any evidence would be from company-sponsored studies. The story notes that the FDA does not regulate this or similar types of predictive genetic tests, and there is concern about the validity of such tests that have not been subjected to external review. The test manufacturer CEO’s speculation that insurance companies will eventually cover the test because it’s easy to perform and ""any doctor can order the test"" is an inappropriate rationale for any screening, especially when such screening may place a woman at risk for unnecessary surgery or other treatments. The story mentions current prevention guidelines for women who are considered higher than average risk of developing breast cancer. This includes additional surveillance with MRI and mammography, chemoprevention and adopting a healthier lifestyle, namely reducing alcohol consumption and lowering body fat. However,the evidence of survival benefit for lifestyle and screening is fairly limited. Most of recent decrease in breast cancer mortality is attributed to advances in treatment not necessarily screening. Currently, breast cancer risk for women who do not carry the BRAC1/2 genes is determined via population-based calculators such as the Gail Risk Model. This tool provides an estimated 5-year risk and is only validated for Caucasian women, so a well-validated, individualized predictive test would, in theory, be useful for some women. It is not clear how the new genetic test improves on this current practice, as there was no evidence presented. Researchers and clinicians interviewed help educate the reader about a new test may have many more cons than pros. The story does note, via a patient advocate, that some women may still go ahead with the test if they feel it may help guide them in future breast cancer prevention efforts."


