Summaries of Independent Scientist (K) Awards

Birkmeyer, Nancy

Institution: University of Michigan, Ann Arbor
Grant Title: Assess and Improve the Quality of Care for Low Back Pain
Grant Number:  K02 HS11288
Duration: 5 years (2000-2005)
Total Award: $417,000

Project Description: The overall purpose of this project was to evaluate and improve the quality of care for low back pain through a comparative study of the structure, process, and outcomes of care at medical centers participating in Spine Patient Outcomes Research Trials (SPORT), a National Institutes of Health (NIH)/National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)-sponsored clinical trial designed to address the relative efficacy of surgical and non-surgical treatment for common lumbar spine conditions.  The project had three goals:

1. To characterize clinical practices.
2. To assess outcomes of care.
3. To link clinical practices and outcomes. 

Career Goals: Dr. Birkmeyer is an Associate Professor in the Department of Surgery at the University of Michigan Medical School.   She completed her planned coursework during the first year of the award.  She had two main career goals:

1. To evaluate the quality of surgical and non-surgical treatment for low back pain.
2. Reduce variation in treatment practices and improve the outcomes of treatment for these conditions.

Progress to Date: Dr. Birkmeyer completed her K award in 2006.  Until recently, all of the data relating to the outcomes of SPORT had been embargoed by the SPORT Data and Safety monitoring Board following completion of enrollment and follow-up of patients into the randomized components of SPORT and publication of the results.  Results only for the lumbar disc herniation diagnostic category are now published.

Highlights and Specific Accomplishments:

• Member of Heart Value Surgery Workgroup, Northern New England Cardiovascular Disease Research Group.
• Member of Committee on Clinical Quality, University of Michigan Health System.
• Associate Director for Michigan Surgical Collaboration for Outcomes Research and Evaluation.
• Associate Editorial Board Spine.
• Referee for several professional journals.
• Member of the American Association for the Advancement of Science.
• Member of the Society for Epidemiologic Research.

K-Generated Publications:

Birkmeyer NJO, Weinstein JN, Tosteston TD, Skinner JS, Lurie JD, Deyo RA, Wennberg JE. Design of the spine patient outcomes research trial (SPORT).  Spine 2002. 27(12):1361-72.

Birkmeyer NJO, Weinstein JN. Medical versus surgical treatment for low back pain: Evidence and clinical practice. Effective Clinical Practice 199:2(5):218-27.

Fanuele JC, Birkmeyer NJO, Abdu WA, Weinstein JN. The impact of spinal problems on the health status of patients: Have we underestimated the effect? Spine 200;25(12):1509-14.

Birkmeyer NJO. Point of View Commentary: Liberman et al. Initial outcome and efficacy of "kyphoplasty" in the treatment of painful osteoporotic vertebral compression fractures.  Spine 2001. 26(14):1637.

Lurie JD, Birkmeyer NJO, Weinstein JN. Rate of advanced spinal imaging and spine surgery.  Spine 2003. 28(6):616-20.

Cummins J, Lurie JD, Tosteson T. Hanscom B, Adu WA, Birkmeyer NJO, et al. Descriptive epidemiology and prior healthcare utilization of patients in the spine patient outcomes research trial (SPORT).  Spine 2006. 31(7):806-14.

Arega A, Birkmeyer NJO, Lurie JDN, Tosteson T, Gibson J, Taylor B, Weinstein JN. Racial variation in treatment preferences and willingness to be randomized in the spine patients outcomes research trial (SPORT).  Spine 2006. 31(19):2263-69.

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