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.

Project Narrative Chronic low back pain is the leading cause of disability globally. Current diagnostics and outcomes are subjective and fail to provide actionable information to improve patient outcomes. This supplementary grant aims to enhance patient diversity for our parent grant to facilitate deep patient phenotyping and ensure that results are generalizable and beneficial to all individuals with chronic low back pain.