UH3 Project: Lumbar Imaging with Reporting of Epidemiology (LIRE)

UH3 Project: Lumbar Imaging with Reporting of Epidemiology (LIRE)

 

Principal Investigator: Jeffrey Jarvik, MD, MPH

Sponsoring Institution: University of Washington

Collaborators:

  • Kaiser Permanente, Northern California

  • Kaiser Permanente Washington Health Research Institute

  • Mayo Clinic Health System

  • Henry Ford Health System

  • Oregon Health and Science University

NIH Institutes Providing Oversight:

Program Official: Chuck Washabaugh (NIAMS)

Project Scientist: Robin Boineau (NCCIH)

ClinicalTrials.gov Identifier: NCT02015455

Study Locations: Clinics in California, Michigan, Minnesota, Wisconsin, and Washington

Trial Status: Ongoing, but not recruiting participants

Low back pain is an Institute of Medicine priority condition for comparative effectiveness research and is of major public health importance. It is one of the most common reasons for physician visits and an important cause of functional limitation and disability. Imaging is frequently performed as part of the diagnostic evaluation and is an important contributor to the cost of back pain care.

LIRE is a large pragmatic, cluster-randomized controlled trial testing the effectiveness of a simple and inexpensive intervention: inserting epidemiologic benchmarks into lumbar spine imaging reports. The goal of the trial is to reduce subsequent tests and treatments, including cross-sectional imaging (such as magnetic resonance and computed tomography), opioid prescriptions, spinal injections, or surgery. The LIRE trial has the potential to demonstrate the feasibility of randomly assigning clinics within large health systems to receive a clinical decision support-type intervention as well as the feasibility of passively collecting outcomes data up to 2 years after enrollment using the robust electronic medical record systems available at each health system.

NIH Project Information

Presentations

5/23/2017: LIRE: Top Barriers/Challenges and Recent Generalizable Lessons Learned (PDF)

11/18/16: Grand Rounds Presentation: Lumbar Imaging with Reporting of Epidemiology (LIRE): The Beginning of the End (or The End of the Beginning?) (Video; Slides)

5/9/2016: LIRE: Data Governance and Data Sharing Presentation at Steering Committee Meeting

5/9/2016: LIRE: Generalizable Lessons Learned Presentation at Steering Committee Meeting

11/6/2015: Grand Rounds Presentation: Lumbar Imaging with Reporting of Epidemiology (LIRE): Lessons Learned (Video; Slides)

4/21/2015: Update on Demonstration Project at Steering Committee Meeting

10/10/2014: Grand Rounds Presentation: The Lumbar Imaging with Reporting of Epidemiology (LIRE) UH3 Update (Video; Slides)

7/19/2013: Grand Rounds Presentation: Back Pain Outcomes Using Longitudinal Data (BOLD)—Lessons for LIRE and Other Pragmatic Trials (Video; Slides)

1/25/2013: Grand Rounds Presentation: Lumbar Imaging with Reporting of Epidemiology (LIRE) (Video; Slides)

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Citation:

UH3 Project: Lumbar Imaging with Reporting of Epidemiology (LIRE): UH3 Project: Lumbar Imaging with Reporting of Epidemiology (LIRE). In: Rethinking Clinical Trials: A Living Textbook of Pragmatic Clinical Trials. Bethesda, MD: NIH Health Care Systems Research Collaboratory. Available at: http://www.rethinkingclinicaltrials.org/uh3-project-lumbar-imaging-with-reporting-of-epidemiology-lire/. Updated October 13, 2017.