The Spine Phenome Project: Enhancing Patient Diversity

项目总结/摘要 慢性腰痛（cLBP）是一种使人衰弱的疾病，影响着全球数百万人。尽管 随着干预措施的使用增加和医疗费用的上升，cLBP患病率继续增加。这 由于cLBP是复杂的、异质的，并且目前的诊断和治疗主要依赖于 主观指标，并不针对所有的多维生物心理社会机制， cLBP。为了解决这个问题，我们有一个NIH背痛联盟（BACPAC）拨款进行一项 纵向研究，以确定独特的cLBP表型，并告知个性化药物，以改善 患者结局。此外，我们还在一个多地点的NIH BACPAC BEST（生物标志物， 评估脊柱治疗）试验，以告知治疗cLBP患者的精确医学方法。一 预计在这两项研究之间的3年期间总共招募480名cLBP患者。 然而，为了确保我们的研究结果是普遍的和有意义的所有个人， cLBP，我们的患者群体需要多样化，包容性和代表性。有据可查， 少数群体在临床研究中的代表性普遍不足。因此，至关重要的是， 在我们的努力中加强患者的多样性和包容性，特别是在社会决定因素 已知对cLBP结果的影响不同。此外，提高患者多样性并不是 这不仅是科学上的当务之急，也是道德上的当务之急，因为这将有助于减少健康差距，改善健康状况。 公平对待我们社会中的cLBP。总的来说，拟议的努力有助于确保我们的发现 来自多样化和代表性的数据集，并有可能改变临床实践 范例，改善病人的结果，提高护理效率，并降低成本。

Project Summary/Abstract Chronic Low Back Pain (cLBP) is a debilitating condition that affects millions of people globally. Despite increased utilization of interventions and rising medical costs, cLBP prevalence has continued to increase. This problem arises because cLBP is complex, heterogeneous and current diagnostics and treatments rely primarily on subjective metrics and do not target all the multidimensional biopsychosocial mechanisms associated with cLBP. To address this problem, we have a NIH Back Pain Consortium (BACPAC) grant to conduct a longitudinal research study to identify unique cLBP phenotypes and inform personalized medicine to improve patient outcomes. In addition, we are also collaborating in a multi-site NIH BACPAC BEST (Biomarkers for Evaluating Spine Treatments) Trial to inform precision medicine approach for the treatment of cLBP patients. A total of 480 cLBP patients are anticipated to be enrolled over a 3-year period between these two studies. However, in order to ensure that our study findings are generalizable and meaningful to all individuals with cLBP, our patient population needs to be diverse, inclusive and representative. It is well documented that minority groups in general are underrepresented in clinical studies. It is therefore critical and important to enhance patient diversity and inclusion in our efforts particularly in relation to the fact that social determinants to health are known to differentially impact cLBP outcomes. Furthermore, enhancing patient diversity is not only a scientific imperative but also a moral one, as it will help reduce health disparities and improve health equity for the treatment of cLBP in our society. Collectively, the proposed effort helps ensure that our findings are derived from a diverse and representative data sets and has the potential to shift clinical practice paradigms, improve patient outcomes, enhance care efficiency, and reduce costs.