TASK DEFINITION: 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.
PROBLEM: Paragraph: The jury in a Philadelphia court awarded the $8 billion to a man who previously won $680,000 over his claims that it failed to warn that young men using Risperdal could grow breasts. J&J called the sum “grossly disproportionate with the initial compensatory award” and said it was confident it would be overturned. Legal experts agreed that the penalty was likely to be slashed. But the verdict, which helped drive J&J’s shares down 2% on Wednesday, is an example of how public outrage at the pharmaceutical industry for high drug prices has contributed to harsher verdicts against drugmakers accused of wrongdoing in recent years, legal experts said. Outsized penalties awarded by some juries highlight risks in a longstanding strategy by drugmakers such as J&J of taking their chances at trial rather then settle product liability lawsuits brought by patients. “Every pharmaceutical company needs to seriously consider if they want to litigate to verdict in the present environment, but with the settlement demands so incredibly high it’s not always clear what their alternative is,” said Barry Thompson, a partner at Baker McKenzie law firm who was not involved in the case. Drugmakers often prefer to litigate rather than settle in hopes of protecting their brands and discouraging future patient lawsuits, Thompson said. Companies also may use a series of early trial verdicts to gauge the size of any settlement it might eventually offer, as Merck & Co (MRK.N) did with its withdrawn Vioxx arthritis pain drug when facing thousands of lawsuits by patients who claimed harm from the drug. A 2003 U.S. Supreme Court decision suggests that the upper limit of a fair punitive penalty in the Risperdal case would be about $6 million based on the earlier compensatory award. J&J could still get a favorable ruling on appeal that would give the company leverage in dealing with the remaining cases, said Benjamin McMichael, a professor at the Alabama School of Law who has researched punitive damage awards. “With such a large punitive damages award at issue, appellate courts may be more willing to come down hard on the plaintiffs,” McMichael said. J&J faces more than 13,000 lawsuits tied to Risperdal alleging that it caused a condition called gynecomastia in boys, in which breast tissue becomes enlarged. The company is also facing lawsuits involving its baby powder, opioids, medical devices and other products. “We’re operating within a very litigious environment, and we must at times be willing to go to trial when the science, facts and law are on our side,” J&J spokesman Ernie Knewitz said in an email. “We also have to remain open to resolving cases through settlement when and where that’s appropriate to do. We have a proven track record of being able to successfully and appropriately manage this balance,” Knewitz added. The company has had its share of legal wins, losses and settlements. An Oklahoma judge in August ordered J&J to pay $572.1 million to that state for its part in fueling the opioid crisis by deceptively marketing addictive painkillers, although the sum was substantially less than investors had expected. Johnson & Johnson has said it plans to appeal the ruling. Earlier this month, the company agreed to pay $20.4 million to settle claims by two Ohio counties, avoiding a federal opioid trial. In 2013, J&J paid more than $2.2 billion to resolve civil and criminal investigations by the U.S. Department of Justice into its marketing of Risperdal and other drugs. Claim: Massive jury award against J&J highlights risks of its legal strategy.

SOLUTION: A jury award that hit Johnson & Johnson (JNJ.N) with $8 billion in punitive damages for a case involving its anti-psychotic drug Risperdal highlights the risks of the drugmaker’s all-or-nothing legal strategy, several legal experts told Reuters on Wednesday.

PROBLEM: Paragraph: It’s too bad this story didn’t mention costs. Considering that the trial found only small differences in the effectiveness of the treatments, it seems that cost might be a key deciding factor for many people with neck pain. It’s notable that two educational sessions about home exercise were as effective as 15 chiropractic sessions. The story includes both some of the specific results reported by researchers as well as more conversational descriptions of the overall experiences of people in this trial. Readers get the message that people with neck pain tend to feel better as time passes no matter which treatment option they used and that none of the treatments is clearly superior or can deliver sure-fire pain relief. This rating is a close call. The story does warn readers that spinal manipulation can pose “rare, but serious risks.” Also, none of the trial participants reported a serious adverse event. But the story could have been more specific and reported that, as the editorial accompanying the research article pointed out, “neck manipulation has a rare but potentially catastrophic risk for vertebral artery stroke.” Also, the story should have at least briefly mentioned some of the harms that can be caused by the pain medications (including acetaminophen, narcotics and muscle relaxants) that were prescribed to some participants. This story gives readers the important highlights of the study design and how the researchers measured effectiveness. It also includes a comment from an independent source that the trial would have been better if it had included a no-treatment group (in order to look for improvements that were due simply to the passage of time or a placebo effect). The story could have pointed out that unlike major drug trials that use placebo pills there was no way to prevent patients from knowing which treatment they received, which means the researchers can’t be sure that the reports from patients weren’t partially influenced by their beliefs about how effective a treatment might be. For instance, it could be that people who got spinal manipulation from a professional (and paid for it) might tend to believe that the treatment was more effective than a set of exercises that they did themselves at home. The story accurately reports that neck pain is common. It also includes cautionary statements about the uncertainty that exists about what sort of treatment works best, thus helping readers keep expectations in line with reality. The story includes quotes from multiple independent sources. It reports that funding for this trial was provided by “U.S. National Center for Complementary and Alternative Medicine.” It might have been helpful to point out that the center is part of the National Institutes of Health, so that it would be clear to readers that it is a public institution. Although the story does not report on any potential conflicts of interest on the part of the researchers, the article authors did not disclose any conflicts in their journal article. The trial was set up as a direct comparison of popular treatments for neck pain, and that is just how the story presents it. It even includes a comment from an independent source that this sort of neck pain tends to improve on its own. As mentioned above, the story could have provided more details about the potential harms of the various treatment options. It is clear that all of the treatments included in this trial are widely available. The story points out that this trial was designed to address the lack of solid evidence comparing common treatments for back pain, while also noting that this trial doesn’t answer all of the questions. The story does not appear to rely on a news release. Claim: Spinal Manipulation, Home Exercise May Ease Neck Pain

SOLUTION: When researchers randomized 272 neck pain patients to receive either spinal manipulation, medication, or instructions on home exercises, they found some differences that were statistically significant. But the big picture is that all the patients tended to get better and those who got manipulation or home exercise instructions fared about the same. And that the bottom line message that readers get from the news story. The story didn’t mention costs and it could have provided more details about potential harms, but overall it gives readers a fair overview of the research and the broader background of neck pain treatment. News reports should always distinguish between study results that really mean something to people dealing with illnesses and those that are merely statistically significant, but clinically underwhelming. This story reports key findings about measured differences, but also helps readers to see the main message; that those differences didn’t make a dramatic difference to how patients felt… and that important questions remain. The study raises some interesting questions. It’s difficult to know if similar results would be seen for patients coming for care in usual practice settings, rather than in response to newspaper and radio ads recruiting subjects. It’s also worth looking at effective care versus efficient care. If two group instructional sessions are as good as 15 individual chiropractic sessions on average, one could surmise that home exercise might provide more bank for the buck. The story could have done a better job driving this point home. AS

PROBLEM: Paragraph: "Sen. Jeff Merkley appeared at the new Children’s Center in Clackamas County to raise awareness about an increase in child abuse and, according to his news release, to highlight ""the correlation to the economic downturn."" ""Even one case of child abuse or neglect is too many, and with the ongoing economic downturn, the numbers of Oregon children suffering from abuse is on the rise,"" said Merkley. ""We must do everything in our power to reduce the number of children being abused and help provide sanctuary to those in need."" The Children’s Center received some federal money last year. And the visit was a good photo op for a freshman senator during a congressional break. But at Politifact Oregon, we wondered if child abuse really is on the rise and if there is actually a cause-and-effect connection between child abuse and dismal economic times. Merkley is correct about the increase: More Oregon children are suffering abuse and neglect. The Oregon Department of Human Services reports that 11,090 children were victims of abuse or neglect last year, a 6.4 percent increase from 2008. Population growth isn’t the only culprit behind the higher numbers. The state reports that the rate of abuse increased from 11.8 victims per 1,000 children to 12.5 per 1,000. A check with the agency’s number-crunchers indicates the trend holds this year, with abuse reports up between 6 percent and 7 percent between July 2009 and July 2010. Though reports don’t always turn out to be confirmed cases, officials say they expect the number of child victims will rise again for 2010. But is the increase because of high unemployment? Merkley’s spokeswoman, Courtney Warner Crowell, said she hadn’t seen any research linking a rise in abuse to an economic downturn. But she said several people she’d talked to blamed the increase in child abuse on the economy. But there isn’t any statistical evidence drawing a direct link between increased child abuse and a bad economy. ""We can’t say that factually and we can’t prove it,"" says Katharine Cahn, executive director of the Child Welfare Partnership at Portland State University. The number of child abuse victims can rise, even in good times, Cahn says, simply because more people are reporting the abuse. State stats do show alcohol and drug abuse, domestic violence and parental run-ins with police among the common stress factors that contribute to child abuse. Cahn concedes that people do feel stressed and depressed when the economy goes bust and may drink or use drugs in an attempt to cope. And that, she says, may be the indirect tie to Oregon’s rising numbers. So, it appears that while Oregon’s junior senator was right about the numbers of kids abused, the sour economy may not be deserve all the blame." Claim: Jeff Merkley Says with the ongoing economic downturn, child abuse is on the rise.

SOLUTION:
Jeff Merkley says with the economic downturn Oregon is seeing more child abuse