Proposals are due March 15 for embedded pragmatic clinical trials that address pain management and the opioid crisis. The NIH will support one to two pragmatic trials that evaluate acupuncture treatment in older adults with chronic low back pain. The request for applications is part of the  NIH Heal (Helping to End Addiction Long-term) Initiative, which was created in April 2018 in an effort to speed scientific solutions for addressing the national opioid public health crisis .
NIH Collaboratory's Biostatistics and Study Design Core Contributes New Sections to the Living Textbook : Sections o n identification bias, alternative cluster randomized designs, and a case study of the STOP CRC Trial, offer insights into emerging issues in embedded pragmatic clinical trials and lessons learned from the NIH Collaboratory’s first round of Demonstration Projects .

Proposed Rule to Implement Provisions of the 21st Century Cures Act : The Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services announced a proposed rule intended to advance interoperability and support the access, exchange, and use of electronic health information. Notably, the rule would require that patients have the ability to electronically access their health information at no cost.
Trial Spotlight
HiLo: Due to an insufficient organ supply, patients diagnosed with end-stage renal disease (ESRD) often resort to dialysis for treatment. However, poor outcomes, primarily driven by increased risk of cardiovascular disease (CVD), are common. Because interventions that improve outcomes by targeting traditional CVD risk factors have mostly failed in patients with ESRD, the nephrology community has embraced targeting of kidney-specific risk factors, including hyperphosphatemia, in an effort to improve clinical outcomes. Although current clinical practice guidelines advocate aggressive treatment of hyperphosphatemia, the benefits of this approach are unproven, the optimal serum phosphate target remains unknown, and potential harms of aggressive treatment have not been definitively identified. HiLo will address these questions by comparing the effects of liberalizing the serum phosphate target (“Hi”) versus maintaining aggressive phosphate control (“Lo”) for patients receiving treatment with maintenance hemodialysis. Watch a video interview about the study with co-principal investigator Dr. Myles Wolf and read more about HiLo.
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Featured in the Living Textbook
By embedding pragmatic clinical trials in health systems, investigators enable partnerships between researchers and health system leaders from the beginning. Health system leaders are often eager to see results as soon as possible, especially if the results are important to system priorities, operations, and cost savings. A growing number of repositories for disseminating results to health system leaders are available, including collections for evidence-based practices, systematic reviews, and community and clinical guidelines. Learn more in the Dissemination Approaches for Different Stakeholders chapter of the Living Textbook .