{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T23:18:51Z","timestamp":1756682331044,"version":"3.37.3"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Care Systems Research Collaboratory"},{"DOI":"10.13039\/100015326","name":"NIH Common Fund","doi-asserted-by":"publisher","award":["U24AT009676"],"award-info":[{"award-number":["U24AT009676"]}],"id":[{"id":"10.13039\/100015326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006086","name":"Office of Strategic Coordination","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006086","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIH Director","award":["UH2AT007766","UH3AR066795"],"award-info":[{"award-number":["UH2AT007766","UH3AR066795"]}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UW Clinical Learning, Evidence and Research"},{"name":"Center for Musculoskeletal Disorders funded"},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"NIAMS","doi-asserted-by":"publisher","award":["P30AR072572"],"award-info":[{"award-number":["P30AR072572"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"name":"VA Puget Sound Health Care System"},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"name":"U.S. Government"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Analysis of secondary outcomes from the Lumbar Imaging with Reporting of Epidemiology (LIRE) pragmatic stepped-wedge randomized trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Primary care clinics within four integrated health care systems in the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Subjects<\/jats:title>\n                  <jats:p>238,886 patients \u226518\u2009years of age who received lumbar diagnostic imaging between 2013 and 2016.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Clinics 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 \u201cLIRE intervention\u201d). 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).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The LIRE intervention was not significantly associated with subsequent utilization of nonsurgical lumbosacral or sacroiliac spine procedures (odds ratio [OR]\u2009=\u20091.01, 95% confidence interval [CI] 0.93\u20131.09; P\u2009=\u20090.79) or any surgical procedure (OR\u2009=\u20090.99, 95 CI 0.91\u20131.07; P\u2009=\u20090.74) involving the lumbar, sacral, or thoracic spine. The intervention was also not significantly associated with any individual spine procedure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Inserting epidemiological text into spine imaging reports had no effect on nonsurgical or surgical procedure utilization among patients receiving lumbar diagnostic imaging.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnab065","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T20:36:48Z","timestamp":1613162208000},"page":"1272-1280","source":"Crossref","is-referenced-by-count":6,"title":["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"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9449-4165","authenticated-orcid":false,"given":"Pradeep","family":"Suri","sequence":"first","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA"},{"name":"Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA"},{"name":"Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric N","family":"Meier","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Biostatistics, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura S","family":"Gold","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Radiology, School of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary A","family":"Marcum","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra K","family":"Johnston","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Radiology, School of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn T","family":"James","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Radiology, School of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian W","family":"Bresnahan","sequence":"additional","affiliation":[{"name":"Department of Radiology, School of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"O\u2019Reilly","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Radiology, School of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith A","family":"Turner","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA"},{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David F","family":"Kallmes","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen J","family":"Sherman","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard A","family":"Deyo","sequence":"additional","affiliation":[{"name":"Departments of Family Medicine and Internal Medicine, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick H","family":"Luetmer","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew L","family":"Avins","sequence":"additional","affiliation":[{"name":"Division of Research (ALA), Kaiser Permanente Northern California, Oakland, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent","family":"Griffith","sequence":"additional","affiliation":[{"name":"Department of Radiology, Henry Ford Hospital, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick J","family":"Heagerty","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Biostatistics, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean D","family":"Rundell","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey G","family":"Jarvik","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Radiology, School of Medicine, University of Washington, Seattle, Washington, USA"},{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janna L","family":"Friedly","sequence":"additional","affiliation":[{"name":"Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington, USA"},{"name":"Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"issue":"14","key":"2022021701033862400_pnab065-B1","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1001\/jama.2018.0158","article-title":"The State of US Health, 1990-2016: Burden of diseases, injuries, and risk factors among US States","volume":"319","author":"Mokdad","year":"2018","journal-title":"JAMA"},{"issue":"24","key":"2022021701033862400_pnab065-B2","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1001\/jama.2016.16885","article-title":"US spending on personal health care and public health, 1996\u20132013","volume":"316","author":"Dieleman","year":"2016","journal-title":"JAMA"},{"issue":"6","key":"2022021701033862400_pnab065-B3","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1001\/jama.299.6.656","article-title":"Expenditures and health status among adults with back and neck problems","volume":"299","author":"Martin","year":"2008","journal-title":"JAMA"},{"issue":"1","key":"2022021701033862400_pnab065-B4","doi-asserted-by":"crossref","first-page":"62","DOI":"10.3122\/jabfm.2009.01.080102","article-title":"Overtreating chronic back pain: Time to back off?","volume":"22","author":"Deyo","year":"2009","journal-title":"J Am Board Fam Med"},{"issue":"10","key":"2022021701033862400_pnab065-B5","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1097\/BRS.0b013e3181a1390d","article-title":"Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: An evidence-based clinical practice guideline from the American Pain Society","volume":"34","author":"Chou","year":"2009","journal-title":"Spine (Phila Pa 1976)"},{"issue":"3","key":"2022021701033862400_pnab065-B6","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1177\/2192568217694151","article-title":"Impact of the economic downturn on elective lumbar spine surgery in the United States: A national trend analysis, 2003 to 2013","volume":"7","author":"Bernstein","year":"2017","journal-title":"Global Spine J"},{"issue":"5","key":"2022021701033862400_pnab065-B7","doi-asserted-by":"crossref","first-page":"e193676","DOI":"10.1001\/jamanetworkopen.2019.3676","article-title":"Expenditures and health care utilization among adults with newly diagnosed low back and lower extremity pain","volume":"2","author":"Kim","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"6","key":"2022021701033862400_pnab065-B8","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.spinee.2019.01.001","article-title":"Trends in lumbar radiofrequency ablation utilization from 2007 to 2016","volume":"19","author":"Starr","year":"2019","journal-title":"Spine J"},{"issue":"3","key":"2022021701033862400_pnab065-B9","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.spinee.2019.10.005","article-title":"Repeat procedures and prescription opioid use after lumbar medial branch nerve radiofrequency ablation in commercially insured patients","volume":"20","author":"Starr","year":"2020","journal-title":"Spine J"},{"issue":"1","key":"2022021701033862400_pnab065-B10","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.spinee.2011.10.005","article-title":"Utilization characteristics of spinal interventions","volume":"12","author":"Abbott","year":"2012","journal-title":"Spine J"},{"issue":"8","key":"2022021701033862400_pnab065-B11","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.2106\/JBJS.G.00858","article-title":"Geographic variation in epidural steroid injection use in medicare patients","volume":"90","author":"Friedly","year":"2008","journal-title":"J Bone Joint Surg Am"},{"issue":"16","key":"2022021701033862400_pnab065-B12","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1097\/BRS.0b013e3180b9f96e","article-title":"Increases in lumbosacral injections in the Medicare population: 1994 to 2001","volume":"32","author":"Friedly","year":"2007","journal-title":"Spine"},{"issue":"4","key":"2022021701033862400_pnab065-B13","doi-asserted-by":"crossref","first-page":"811","DOI":"10.3174\/ajnr.A4173","article-title":"Systematic literature review of imaging features of spinal degeneration in asymptomatic populations","volume":"36","author":"Brinjikji","year":"2015","journal-title":"AJNR Am J Neuroradiol"},{"issue":"2","key":"2022021701033862400_pnab065-B14","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/BRS.0b013e3181cd9adb","article-title":"Potential of magnetic resonance imaging findings to refine case definition for mechanical low back pain in epidemiological studies: A systematic review","volume":"36","author":"Endean","year":"2011","journal-title":"Spine (Phila Pa 1976)"},{"issue":"1","key":"2022021701033862400_pnab065-B15","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1186\/1471-2474-15-152","article-title":"Longitudinal associations between incident lumbar spine MRI findings and chronic low back pain or radicular symptoms: Retrospective analysis of data from the longitudinal assessment of imaging and disability of the back (LAIDBACK)","volume":"15","author":"Suri","year":"2014","journal-title":"BMC Musculoskel Disord"},{"issue":"10","key":"2022021701033862400_pnab065-B16","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1097\/00007632-200105150-00014","article-title":"The Longitudinal Assessment of Imaging and Disability of the Back (LAIDBack) study: Baseline data","volume":"26","author":"Jarvik","year":"2001","journal-title":"Spine"},{"issue":"8","key":"2022021701033862400_pnab065-B17","doi-asserted-by":"crossref","first-page":"e0200677","DOI":"10.1371\/journal.pone.0200677","article-title":"Modic changes\u2014their associations with low back pain and activity limitation: A systematic literature review and meta-analysis","volume":"13","author":"Herlin","year":"2018","journal-title":"PLoS One"},{"issue":"9123","key":"2022021701033862400_pnab065-B18","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/S0140-6736(97)11499-4","article-title":"Should radiologists change the way they report plain radiography of the spine?","volume":"352","author":"Roland","year":"1998","journal-title":"Lancet"},{"issue":"9","key":"2022021701033862400_pnab065-B19","doi-asserted-by":"crossref","first-page":"e2015713","DOI":"10.1001\/jamanetworkopen.2020.15713","article-title":"The effect of including benchmark prevalence data of common imaging findings in spine image reports: A stepped-wedge, pragmatic randomized trial","volume":"3","author":"Jarvik","year":"2020","journal-title":"JAMA Network Open"},{"issue":"9","key":"2022021701033862400_pnab065-B20","doi-asserted-by":"crossref","first-page":"e2015713","DOI":"10.1001\/jamanetworkopen.2020.15713","article-title":"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","volume":"3","author":"Jarvik","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"Pt B","key":"2022021701033862400_pnab065-B21","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.cct.2015.10.003","article-title":"Lumbar Imaging with Reporting of Epidemiology (LIRE)\u2014Protocol for a pragmatic cluster randomized trial","volume":"45","author":"Jarvik","year":"2015","journal-title":"Contempor Clin Trials"},{"issue":"5","key":"2022021701033862400_pnab065-B22","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"issue":"11","key":"2022021701033862400_pnab065-B23","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/0895-4356(94)90129-5","article-title":"Validation of a combined comorbidity index","volume":"47","author":"Charlson","year":"1994","journal-title":"J Clin Epidemiol"},{"issue":"6","key":"2022021701033862400_pnab065-B24","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/aje\/kwq433","article-title":"Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries","volume":"173","author":"Quan","year":"2011","journal-title":"Am J Epidemiol"},{"issue":"2","key":"2022021701033862400_pnab065-B25","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/BRS.0000000000000682","article-title":"Validation of an administrative coding algorithm for classifying surgical indication and operative features of spine surgery","volume":"40","author":"Kazberouk","year":"2015","journal-title":"Spine (Phila Pa 1976)"}],"container-title":["Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/painmedicine\/advance-article-pdf\/doi\/10.1093\/pm\/pnab065\/37214897\/pnab065.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/painmedicine\/article-pdf\/22\/6\/1272\/38490832\/pnab065.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/painmedicine\/article-pdf\/22\/6\/1272\/38490832\/pnab065.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T01:04:18Z","timestamp":1645059858000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/painmedicine\/article\/22\/6\/1272\/6141027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,17]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,2,17]]},"published-print":{"date-parts":[[2021,6,4]]}},"URL":"https:\/\/doi.org\/10.1093\/pm\/pnab065","relation":{},"ISSN":["1526-2375","1526-4637"],"issn-type":[{"type":"print","value":"1526-2375"},{"type":"electronic","value":"1526-4637"}],"subject":[],"published-other":{"date-parts":[[2021,6,1]]},"published":{"date-parts":[[2021,2,17]]}}}