Expected Organizational Costs for Inserting Prevalence Information Into Lumbar Spine Imaging Reports

Brian W. Bresnahan, Jeffrey G. Jarvik, Eric N. Meier, Kathryn T. James, Laura S. Gold, Sean D. Rundell, Judith A. Turner, Pradeep Suri, Patrick H. Luetmer, Janna L. Friedly, Karen J. Sherman, Patrick J. Heagerty, David F. Kallmes, Andrew L. Avins, Brent D. Griffith, Larry G. Kessler

Research output: Contribution to journalArticlepeer-review


Background: Modifying physician behavior to more closely align with guideline-based care can be challenging. Few effective strategies resulting in appropriate spine-related health care have been reported. The Lumbar Imaging With Reporting of Epidemiology (LIRE) intervention did not result in reductions in spine care but did in opioid prescriptions written. Objectives: To estimate organizational resource needs and costs associated with implementing a pragmatic, decision support-type intervention that inserted age- and modality-matched prevalence information for common lumbar spine imaging findings, using site-based resource use data from the LIRE trial. Research design: Time and cost estimation associated with implementing the LIRE intervention in a health organization. Subjects: Providers and patients assessed in the LIRE trial. Measures: Expected personnel costs required to implement the LIRE intervention. Results: Annual salaries were converted to daily average per person costs, ranging from $400 to $2,200 per day (base case) for personnel (range: $300-$2,600). Estimated total average cost for implementing LIRE was $5,009 (range: $2,651-$12,020), including conducting pilot testing with providers. Costs associated with a small amount of time for a radiologist (6-12 hours) and imaging-ordering providers (1-8 hours each) account for approximately 75% of the estimated total cost. Conclusions: The process of implementing an intervention for lumbar spine imaging reports containing age- and modality-appropriate epidemiological benchmarks for common imaging findings required radiologists, imaging-ordering providers, information technology specialists, and limited testing and monitoring. The LIRE intervention seems to be a relatively low-cost, evidence-based, complementary tool that can be easily integrated into the reporting of spine imaging.

Original languageEnglish (US)
Pages (from-to)1415-1422
Number of pages8
JournalJournal of the American College of Radiology
Issue number10
StatePublished - Oct 2021


  • Costs
  • imaging
  • implementation
  • opioids
  • spine

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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