Evidence map›Paper›PMID 33595635›Full record

Trial reportPain medicine (Malden, Mass.)2021

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.

Pradeep Suri, Eric N Meier, Laura S Gold, Zachary A Marcum, Sandra K Johnston, Kathryn T James, Brian W Bresnahan, Michael O'Reilly, Judith A Turner, David F Kallmes and 9 more

Abstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Pain medicine (Malden, Mass.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Pradeep SuriClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.ORCID 0000-0002-9449-4165
Eric N MeierClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.
Laura S GoldClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.
Zachary A MarcumDepartment of Pharmacy, School of Pharmacy, University of Washington, Seattle, Washington, USA.
Sandra K JohnstonClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.
Kathryn T JamesClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.
Brian W BresnahanDepartment of Radiology, School of Medicine, University of Washington, Seattle, Washington, USA.
Michael O'ReillyClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.
Judith A TurnerClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.
David F KallmesDepartment of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Karen J ShermanKaiser Permanente Washington, Seattle, Washington, USA.
Richard A DeyoDepartments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, Oregon, USA.
Patrick H LuetmerDepartment of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Andrew L AvinsDivision of Research (ALA), Kaiser Permanente Northern California, Oakland, California, USA.
Brent GriffithDepartment of Radiology, Henry Ford Hospital, Detroit, Michigan, USA.
Patrick J HeagertyClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.
Sean D RundellClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.
Jeffrey G JarvikClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.
Janna L FriedlyClinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA.

Funding

NIH Health Care Systems Research Collaboratory-Coordinating Center (U24)U24AT009676 · NCCIH · DUKE UNIVERSITY · PI LESLEY H CURTIS, Adrian Hernandez · 2017 to 2026
$21.5M
UW Core Center for Clinical Research of Musculoskeletal ConditionsP30AR072572 · NIAMS · UNIVERSITY OF WASHINGTON · PI JEFFREY G JARVIK, Pradeep Suri · 2017 to 2026
$8.3M
A Pragmatic Trial of Lumbar Image Reporting with Epidemiology (LIRE)UH3AR066795 · NIAMS · UNIVERSITY OF WASHINGTON · PI JARVIK, JEFFREY G · 2014 to 2017
$6.0M
A Pragmatic Trial of Lumbar Image Reporting with Epidemiology (LIRE)UH2AT007766 · NCCIH · UNIVERSITY OF WASHINGTON · PI JARVIK, JEFFREY G · 2012 to 2012
$838k
NCCIH NIH HHS U24 AT009676NCCIH NIH HHS UH2 AT007766NIAMS NIH HHS P30 AR072572NIAMS NIH HHS UH3 AR066795
6 · The paper itself

Abstract

objectiveTo evaluate the effect of inserting epidemiological information into lumbar spine imaging reports on subsequent nonsurgical and surgical procedures involving the thoracolumbosacral spine and sacroiliac joints.

designAnalysis of secondary outcomes from the Lumbar Imaging with Reporting of Epidemiology (LIRE) pragmatic stepped-wedge randomized trial.

settingPrimary care clinics within four integrated health care systems in the United States. SUBJECTS: 238,886 patients ≥18 years of age who received lumbar diagnostic imaging between 2013 and 2016.

methodsClinics were randomized to receive text containing age- and modality-specific epidemiological benchmarks indicating the prevalence of common spine imaging findings in people without low back pain, inserted into lumbar spine imaging reports (the "LIRE intervention"). The study outcomes were receiving 1) any nonsurgical lumbosacral or sacroiliac spine procedure (lumbosacral epidural steroid injection, facet joint injection, or facet joint radiofrequency ablation; or sacroiliac joint injection) or 2) any surgical procedure involving the lumbar, sacral, or thoracic spine (decompression surgery or spinal fusion or other spine surgery).

resultsThe LIRE intervention was not significantly associated with subsequent utilization of nonsurgical lumbosacral or sacroiliac spine procedures (odds ratio [OR] = 1.01, 95% confidence interval [CI] 0.93-1.09; P = 0.79) or any surgical procedure (OR = 0.99, 95 CI 0.91-1.07; P = 0.74) involving the lumbar, sacral, or thoracic spine. The intervention was also not significantly associated with any individual spine procedure.

conclusionsInserting epidemiological text into spine imaging reports had no effect on nonsurgical or surgical procedure utilization among patients receiving lumbar diagnostic imaging.

Indexed as

Low Back PainSpinal DiseasesZygapophyseal JointHumansLumbar VertebraeLumbosacral RegionUnited StatesEpidural InjectionsInjectionInjectionsLumbarRadiofrequency AblationRadiologySpineZygapophyseal Joint

Identifiers

PMID33595635
PMCPMC8185556

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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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.