September 8, 2020: LIRE Trial Finds No Change in Healthcare Utilization, Small Drop in Opioid Prescriptions

Photo of Jeffrey Jarvik
Dr. Jerry Jarvik, principal investigator of LIRE

Inserting benchmark prevalence information about common imaging findings into spine image reports did not reduce spine-related healthcare utilization but did slightly reduce subsequent opioid prescriptions. These were the main findings of the Lumbar Imaging With Reporting of Epidemiology (LIRE) trial, an NIH Collaboratory Trial.

The report was published this month in JAMA Network Open.

Spine imaging often has incidental findings that can lead to unnecessary tests and treatments. Prior observational research suggested that placing information about the prevalence of common findings in spine imaging reports may help reassure physicians and patients about such findings and reduce subsequent, unnecessary healthcare interventions.

LIRE was a stepped-wedge, cluster randomized trial of an intervention that placed age- and modality-appropriate epidemiological benchmark information about common imaging findings in lumbar spine imaging reports. The intervention did not reduce spine-related healthcare utilization overall.

In prespecified secondary analyses, the intervention slightly reduced subsequent opioid prescriptions, and patients for whom computed tomography was the imaging modality had lower spine-related healthcare utilization.

LIRE was supported within the NIH Collaboratory by a cooperative agreement from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Read more about the LIRE trial.