Trial reportContemporary clinical trials2015
Lumbar Imaging With Reporting Of Epidemiology (LIRE)--Protocol for a pragmatic cluster randomized trial.
Trial report in Contemporary clinical trials, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02015455 (Lumbar Imaging With Reporting of Epidemiology), which is not on this map. Cited by 31 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Lumbar Imaging With Reporting of Epidemiology: A Pragmatic Cluster Randomized Trial
Who cites it
31 citing papers in PubMed, 44 citations in OpenAlex.
- Providing Epidemiological Data in Lumbar Spine Imaging Reports Did Not Affect Subsequent Utilization of Spine Procedures: Secondary Outcomes from a Stepped-Wedge Randomized Controlled Trial.Pain medicine (Malden, Mass.) · 2021Trial
- The Effect of Including Benchmark Prevalence Data of Common Imaging Findings in Spine Image Reports on Health Care Utilization Among Adults Undergoing Spine Imaging: A Stepped-Wedge Randomized Clinical Trial.JAMA network open · 2020Trial
- Patient, Provider, and Clinic Characteristics Associated with Opioid and Non-Opioid Pain Prescriptions for Patients Receiving Low Back Imaging in Primary Care.Journal of the American Board of Family Medicine : JABFMTrial
- Causal Inference for Intervention Spillover in a Stepped Wedge Cluster-randomized Trial: Lessons from a Physician Network.Social networks · 2026Article
- A tutorial on conducting sample size and power calculations for detecting treatment effect heterogeneity in cluster randomized trials with linear mixed models.International journal of epidemiology · 2026Article
- Australian General Practitioners' Use of Diagnostic Lumbar Spine Imaging for Patients With Acute Low Back Pain: A Qualitative Study.Musculoskeletal care · 2025Article
- Monitoring in pragmatic trials lessons from the NIH pragmatic trials collaboratory.Contemporary clinical trials · 2025Article
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- Intervention delivery for embedded pragmatic clinical trials: Development of a tool to measure complexity.Contemporary clinical trials · 2023Review
- Predicting decompression surgery by applying multimodal deep learning to patients' structured and unstructured health data.BMC medical informatics and decision making · 2023Article
- Predictors of Lumbar Spine Degeneration and Low Back Pain in the Community: The Johnston County Osteoarthritis Project.Arthritis care & research · 2022Article
- Osteoporosis identification among previously undiagnosed individuals with vertebral fractures.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Ethical and epistemic issues in the design and conduct of pragmatic stepped-wedge cluster randomized clinical trials.Contemporary clinical trials · 2022Article
- A Comparison of Natural Language Processing Methods for the Classification of Lumbar Spine Imaging Findings Related to Lower Back Pain.Academic radiology · 2022Article
- Natural language processing in low back pain and spine diseases: A systematic review.Frontiers in surgery · 2022Review
- Enhancing the use of EHR systems for pragmatic embedded research: lessons from the NIH Health Care Systems Research Collaboratory.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Expected Organizational Costs for Inserting Prevalence Information Into Lumbar Spine Imaging Reports.Journal of the American College of Radiology : JACR · 2021Article
- Consumer understanding of terms used in imaging reports requested for low back pain: a cross-sectional survey.BMJ open · 2021Article
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Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundDiagnostic imaging is often the first step in evaluating patients with back pain and likely functions as a "gateway" to a subsequent cascade of interventions. However, lumbar spine imaging frequently reveals incidental findings among normal, pain-free individuals suggesting that treatment of these "abnormalities" may not be warranted. Our prior work suggested that inserting the prevalence of imaging findings in patients without back pain into spine imaging reports may reduce subsequent interventions. We are now conducting a pragmatic cluster randomized clinical trial to test the hypothesis that inserting this prevalence data into lumbar spine imaging reports for studies ordered by primary care providers will reduce subsequent spine-related interventions. METHODS/
designWe are using a stepped wedge design that sequentially randomizes 100 primary care clinics at four health systems to receive either standard lumbar spine imaging reports, or reports containing prevalence data for common imaging findings in patients without back pain. We capture all outcomes passively through the electronic medical record. Our primary outcome is spine-related intervention intensity based on Relative Value Units (RVUs) during the following year. Secondary outcomes include subsequent prescriptions for opioid analgesics and cross-sectional lumbar spine re-imaging. DISCUSSION: If our study shows that adding prevalence data to spine imaging reports decreases subsequent back-related RVUs, this intervention could be easily generalized and applied to other kinds of testing, as well as other conditions where incidental findings may be common. Our study also serves as a model for cluster randomized trials that are minimal risk and highly pragmatic.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.