{"pages":[{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-01","page":1,"lines":[{"cnt":[[243,249],[496,249],[496,299],[243,299]],"region":{"top_left_x":242,"top_left_y":249,"width":255,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"cc128ba8f427456b9312ce6a49b53a45","type":"section_header","conversion_output":false,"children_ids":["95944defe46c4953bfe22c446bb28db7"],"text":"","text_display":""},{"cnt":[[249,254],[492,254],[492,294],[249,294]],"region":{"top_left_x":249,"top_left_y":253,"width":243,"height":42},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"95944defe46c4953bfe22c446bb28db7","type":"text","conversion_output":true,"parent_id":"cc128ba8f427456b9312ce6a49b53a45","text":"PROTOCOL","text_display":"\\section*{PROTOCOL}","confidence":1,"confidence_rate":1},{"cnt":[[241,346],[1618,346],[1618,449],[241,449]],"region":{"top_left_x":240,"top_left_y":345,"width":1378,"height":105},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"aecf87b0f33f4773af1460f7f225c8f1","type":"section_header","conversion_output":false,"children_ids":["ab2dcb39dae94fe79ed920a57d5fb7f4","861a87f2f1494c189666e368f47af123"],"text":"","text_display":""},{"cnt":[[245,352],[1616,352],[1616,397],[245,397]],"region":{"top_left_x":244,"top_left_y":352,"width":1372,"height":46},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ab2dcb39dae94fe79ed920a57d5fb7f4","type":"text","conversion_output":true,"parent_id":"aecf87b0f33f4773af1460f7f225c8f1","text":"Study 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June 2015 & \\begin{tabular}{l}\nRevised opioid arm intervention approach \\\\\n- Decided to drop methadone from prescribing strategy (not prescribed to date) \\\\\n- Decided to keep fentanyl in prescribing strategy as third-line therapy; if prescribed, ensure potential excess risks are communicated to patient and patient agrees to not make any independent dose adjustments\n\\end{tabular} \\\\\n\\hline September 2015 & \\begin{tabular}{l}\nRevised prescribing procedures in response to strengthened FDA warning about cardiovascular risks of NSAIDs \\\\\n- Decided not to prescribe etodolac or diclofenac in patients with high cardiovascular risk \\\\\nClarified prescribing for female patients of child-bearing age who decline to use contraception \\\\\n- In non-opioid arm, decided to limit options to those safer in pregnancy \\\\\n- In opioid arm, decided to use lower dosages and instruct patient to contact study ASAP and not abruptly stop opioids if she becomes pregnant. 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PI Dr. Erin Krebs, previously of the Roudebush (Indianapolis) VA and colleagues have","confidence":1,"confidence_rate":1},{"cnt":[[180,1405],[1830,1405],[1830,1459],[180,1459]],"region":{"top_left_x":180,"top_left_y":1405,"width":1651,"height":54},"line":26,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"43ea8e9cbb4442bf85e2d8ef317c652d","type":"text","conversion_output":true,"text":"successfully used the TCM as the basis for two trials focused on management of pain symptoms,","text_display":" successfully used the TCM as the basis for two trials focused on management of pain symptoms,","confidence":1,"confidence_rate":1},{"cnt":[[180,1448],[1841,1448],[1841,1502],[180,1502]],"region":{"top_left_x":180,"top_left_y":1448,"width":1662,"height":54},"line":27,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ed28a998bdd744fba230f0719c5ff0ea","type":"text","conversion_output":true,"text":"INCPAD (an NCI-funded trial involving cancer patients with pain or depression) \\({ }^{12}\\) and SCOPE. By","text_display":" INCPAD (an NCI-funded trial involving cancer patients with pain or depression) \\({ }^{12}\\) and SCOPE. By","confidence":0.998046875,"confidence_rate":0.9999822271139778},{"cnt":[[180,1491],[1936,1491],[1936,1545],[180,1545]],"region":{"top_left_x":180,"top_left_y":1491,"width":1756,"height":54},"line":28,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"078ae541e6a2408799a4bee8a5e7f5be","type":"text","conversion_output":true,"text":"enhancing primary care and creating a bridge to specialty consultation, the TCM complements the VHA","text_display":" enhancing primary care and creating a bridge to specialty consultation, the TCM complements the VHA","confidence":1,"confidence_rate":1},{"cnt":[[180,1536],[1757,1536],[1757,1588],[180,1588]],"region":{"top_left_x":180,"top_left_y":1536,"width":1578,"height":52},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ee1884cd40b04736ad5054ba4a32fa68","type":"text","conversion_output":true,"text":"stepped care model of pain care described in the current VHA Pain Management Directive. \\({ }^{13}\\)","text_display":" stepped care model of pain care described in the current VHA Pain Management Directive. \\({ }^{13}\\)","confidence":1,"confidence_rate":1},{"cnt":[[180,1603],[1884,1603],[1884,1654],[180,1654]],"region":{"top_left_x":180,"top_left_y":1602,"width":1705,"height":53},"line":30,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2500817f63e94d6db0cec8c6a4349cc2","type":"text","conversion_output":true,"text":"The TCM is compatible with the Chronic Care Model, but is focused on the relationship among three","text_display":"\nThe TCM is compatible with the Chronic Care Model, but is focused on the relationship among three","confidence":1,"confidence_rate":1},{"cnt":[[180,1646],[1888,1646],[1888,1697],[180,1697]],"region":{"top_left_x":180,"top_left_y":1645,"width":1709,"height":53},"line":31,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b5001ceeb57048708ada674b2ec90394","type":"text","conversion_output":true,"text":"care providers collaborating through structured communication to optimize symptom care processes.","text_display":" care providers collaborating through structured communication to optimize symptom care processes.","confidence":0.99951171875,"confidence_rate":0.999995211771286},{"cnt":[[180,1689],[1815,1689],[1815,1742],[180,1742]],"region":{"top_left_x":180,"top_left_y":1688,"width":1636,"height":55},"line":32,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"11960e3e1fdc42578a0962f89ba83fa1","type":"text","conversion_output":true,"text":"The three components of the TCM are primary care, care management, and enhanced specialty","text_display":" The three components of the TCM are primary care, care management, and enhanced specialty","confidence":1,"confidence_rate":1},{"cnt":[[180,1732],[1934,1732],[1934,1785],[180,1785]],"region":{"top_left_x":180,"top_left_y":1731,"width":1754,"height":55},"line":33,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2a393eb94dce42329d60c57ab0b59036","type":"text","conversion_output":true,"text":"support. 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Study design overview","text_display":"\n\n\\section*{B. 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Rather than comparing simple uniform treatments, this study will compare two","text_display":" musculoskeletal pain. 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Inclusion criteria}","confidence":1,"confidence_rate":1},{"cnt":[[180,2307],[1919,2307],[1919,2357],[180,2357]],"region":{"top_left_x":180,"top_left_y":2307,"width":1739,"height":50},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ebc5ae9711204406aba61e6cda78029e","type":"text","conversion_output":true,"text":"Veterans will be eligible for participation if they have chronic back or lower extremity osteoarthritis pain","text_display":"\n\nVeterans will be eligible for participation if they have chronic back or lower extremity osteoarthritis pain","confidence":1,"confidence_rate":1},{"cnt":[[180,2350],[1837,2350],[1837,2400],[180,2400]],"region":{"top_left_x":180,"top_left_y":2350,"width":1657,"height":50},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7fb86b3edd974284a73624b4be9fea19","type":"text","conversion_output":true,"text":"with moderate-severe intensity and interference with function despite analgesic therapy. Inclusion","text_display":" with moderate-severe intensity and interference with function despite analgesic therapy. Inclusion","confidence":1,"confidence_rate":1},{"cnt":[[180,2396],[819,2396],[819,2443],[180,2443]],"region":{"top_left_x":180,"top_left_y":2395,"width":639,"height":48},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a4cde553fdbd446ea454befeb74c955b","type":"text","conversion_output":true,"text":"criteria are further defined as follows:","text_display":" criteria are further defined as follows:","confidence":1,"confidence_rate":1},{"cnt":[[183,2578],[1257,2578],[1257,2632],[183,2632]],"region":{"top_left_x":182,"top_left_y":2578,"width":1075,"height":54},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a7a483f24d8745f7984bc313fc890618","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1856,2625],[1886,2625],[1886,2662],[1856,2662]],"region":{"top_left_x":1856,"top_left_y":2625,"width":31,"height":37},"line":25,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"51d278a8b5e343c49712348e52332796","type":"page_info","conversion_output":false,"text":"6","text_display":"","confidence":0.99951171875,"confidence_rate":0.99951171875}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-07","page":7,"lines":[{"cnt":[[183,249],[1884,249],[1884,299],[183,299]],"region":{"top_left_x":182,"top_left_y":249,"width":1703,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"86e9e78475de4ea7bd21db0773e5ae5f","type":"text","conversion_output":true,"text":"(a) Chronic back or lower extremity osteoarthritis pain: For this study, we define chronic pain as pain","text_display":"\n(a) Chronic back or lower extremity osteoarthritis pain: For this study, we define chronic pain as pain","confidence":0.99951171875,"confidence_rate":0.9999954777833909},{"cnt":[[180,296],[1940,296],[1940,342],[180,342]],"region":{"top_left_x":180,"top_left_y":296,"width":1761,"height":46},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"25130a63bedf4fbea69f8068f6c5887c","type":"text","conversion_output":true,"text":"that is present nearly every day for at least 6 months. A standard definition of chronic pain is not agreed","text_display":" that is present nearly every day for at least 6 months. A standard definition of chronic pain is not agreed","confidence":0.99951171875,"confidence_rate":0.9999957530481652},{"cnt":[[183,339],[1897,339],[1897,387],[183,387]],"region":{"top_left_x":182,"top_left_y":339,"width":1716,"height":48},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3e1f3879c63a42ab94562c217d22c4c8","type":"text","conversion_output":true,"text":"upon, but most studies have used \\(3-6\\) months as the required duration. \\({ }^{14}\\) Patients with a primary pain","text_display":" upon, but most studies have used \\(3-6\\) months as the required duration. \\({ }^{14}\\) Patients with a primary pain","confidence":0.9970703125,"confidence_rate":0.999975344947346},{"cnt":[[183,382],[1919,382],[1919,432],[183,432]],"region":{"top_left_x":182,"top_left_y":382,"width":1737,"height":50},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3c1bc124a5b94792ae32dfe345a8ec26","type":"text","conversion_output":true,"text":"complaint of back pain or hip or knee arthritis pain are eligible. These two types of pain account for the","text_display":" complaint of back pain or hip or knee arthritis pain are eligible. These two types of pain account for the","confidence":1,"confidence_rate":1},{"cnt":[[183,425],[1886,425],[1886,475],[183,475]],"region":{"top_left_x":182,"top_left_y":425,"width":1705,"height":50},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bf6089ff01e24fa1bbfbb1e5b3bb1b59","type":"text","conversion_output":true,"text":"majority of pain complaints and long-term opioid therapy. \\({ }^{15}\\) Patients with additional pain locations will","text_display":" majority of pain complaints and long-term opioid therapy. \\({ }^{15}\\) Patients with additional pain locations will","confidence":1,"confidence_rate":1},{"cnt":[[180,471],[1888,471],[1888,518],[180,518]],"region":{"top_left_x":180,"top_left_y":470,"width":1709,"height":48},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b7d6284add5d49b183e219c1fe36fc57","type":"text","conversion_output":true,"text":"not be excluded unless they have a primary location other than back, hip, or knee or meet criteria for","text_display":" not be excluded unless they have a primary location other than back, hip, or knee or meet criteria for","confidence":1,"confidence_rate":1},{"cnt":[[180,516],[406,516],[406,561],[180,561]],"region":{"top_left_x":180,"top_left_y":515,"width":227,"height":46},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"757e8f4f89e64b53be748e83cbde831b","type":"text","conversion_output":true,"text":"fibromyalgia.","text_display":" fibromyalgia.","confidence":1,"confidence_rate":1},{"cnt":[[183,578],[1914,578],[1914,625],[183,625]],"region":{"top_left_x":182,"top_left_y":577,"width":1733,"height":49},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b6c7eb490fd048969c82d083e107f1ac","type":"text","conversion_output":true,"text":"(b) Moderate-severe intensity and interference with function: Eligible patients will have both moderate-","text_display":"\n(b) Moderate-severe intensity and interference with function: Eligible patients will have both moderate","confidence":1,"confidence_rate":1},{"cnt":[[183,623],[1854,623],[1854,672],[183,672]],"region":{"top_left_x":182,"top_left_y":623,"width":1673,"height":50},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"325f049ac1f642868c6c1263c2e0d4d4","type":"text","conversion_output":true,"text":"severe pain intensity nearly every day, defined using standard cutoffs as Brief Pain Inventory (BPI)","text_display":"severe pain intensity nearly every day, defined using standard cutoffs as Brief Pain Inventory (BPI)","confidence":0.9970703125,"confidence_rate":0.9999720576529205},{"cnt":[[183,666],[1940,666],[1940,715],[183,715]],"region":{"top_left_x":182,"top_left_y":666,"width":1759,"height":50},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"63e32d99b33d402b91e15e6e40d4f93c","type":"text","conversion_output":true,"text":"average pain item \\(\\geq 5\\) (on a scale of 0-10), and interference with function, as defined by BPI interference","text_display":" average pain item \\(\\geq 5\\) (on a scale of 0-10), and interference with function, as defined by BPI interference","confidence":0.984870433807373,"confidence_rate":0.999865095952193},{"cnt":[[180,709],[408,709],[408,754],[180,754]],"region":{"top_left_x":180,"top_left_y":708,"width":229,"height":47},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"dc8e1d42e84f417fb558a7cf277fb437","type":"text","conversion_output":true,"text":"score \\(\\geq 5 .^{16,17}\\)","text_display":" score \\(\\geq 5 .^{16,17}\\)","confidence":0.7772934660315514,"confidence_rate":0.9899731154330562},{"cnt":[[185,776],[1897,776],[1897,823],[185,823]],"region":{"top_left_x":184,"top_left_y":775,"width":1714,"height":48},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b7a08a637b4242f7bd93e0b330141cdf","type":"text","conversion_output":true,"text":"(c) Despite analgesic therapy: To ensure that potential participants are appropriate for opioid therapy,","text_display":"\n(c) Despite analgesic therapy: To ensure that potential participants are appropriate for opioid therapy,","confidence":0.99951171875,"confidence_rate":0.9999955192715237},{"cnt":[[183,821],[1888,821],[1888,866],[183,866]],"region":{"top_left_x":182,"top_left_y":820,"width":1707,"height":46},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7113697968b84b4e97aed8d2844626de","type":"text","conversion_output":true,"text":"we will require that their pain has persisted at a moderate-severe level despite analgesic use at least","text_display":" we will require that their pain has persisted at a moderate-severe level despite analgesic use at least","confidence":1,"confidence_rate":1},{"cnt":[[183,864],[1893,864],[1893,913],[183,913]],"region":{"top_left_x":182,"top_left_y":863,"width":1711,"height":51},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f5915deb216f4fd7a5354e230a4c7337","type":"text","conversion_output":true,"text":"nearly every day for the past 6 months. Veterans already receiving current chronic opioid therapy will","text_display":" nearly every day for the past 6 months. Veterans already receiving current chronic opioid therapy will","confidence":1,"confidence_rate":1},{"cnt":[[183,907],[672,907],[672,956],[183,956]],"region":{"top_left_x":182,"top_left_y":906,"width":491,"height":51},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4ced3404762d439c9188baf8c545f7bd","type":"text","conversion_output":true,"text":"be excluded (see C2 below).","text_display":" be excluded (see C2 below).","confidence":1,"confidence_rate":1},{"cnt":[[180,967],[587,967],[587,1021],[180,1021]],"region":{"top_left_x":180,"top_left_y":966,"width":407,"height":55},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a634bc450a0a471daca54d505b60609b","type":"section_header","conversion_output":false,"children_ids":["a26c5ec39ea942c883351c4977bab19b"],"text":"","text_display":""},{"cnt":[[185,971],[582,971],[582,1016],[185,1016]],"region":{"top_left_x":184,"top_left_y":971,"width":399,"height":46},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a26c5ec39ea942c883351c4977bab19b","type":"text","conversion_output":true,"parent_id":"a634bc450a0a471daca54d505b60609b","text":"C2. Exclusion criteria","text_display":"\n\n\\section*{C2. Exclusion criteria}","confidence":0.9990234375,"confidence_rate":0.9999638140011059},{"cnt":[[180,1016],[1888,1016],[1888,1063],[180,1063]],"region":{"top_left_x":180,"top_left_y":1016,"width":1709,"height":48},"line":18,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bad39d0e76734749a0a1741693576ba8","type":"text","conversion_output":true,"text":"As a pragmatic clinical trial, this study will enroll a generalizable sample of primary care patients who","text_display":"\n\nAs a pragmatic clinical trial, this study will enroll a generalizable sample of primary care patients who","confidence":1,"confidence_rate":1},{"cnt":[[180,1061],[1910,1061],[1910,1106],[180,1106]],"region":{"top_left_x":180,"top_left_y":1061,"width":1730,"height":46},"line":19,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"51ad23df0b304643b45a64d8acbb55f5","type":"text","conversion_output":true,"text":"would be considered eligible for either opioid or non-opioid analgesic therapy. We have therefore kept","text_display":" would be considered eligible for either opioid or non-opioid analgesic therapy. We have therefore kept","confidence":1,"confidence_rate":1},{"cnt":[[183,1104],[1936,1104],[1936,1152],[183,1152]],"region":{"top_left_x":182,"top_left_y":1104,"width":1754,"height":48},"line":20,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2fad8aa695fa423da92a7a74d0b6d856","type":"text","conversion_output":true,"text":"exclusion criteria to the minimum necessary to ensure both patient safety and internal validity. Veterans","text_display":" exclusion criteria to the minimum necessary to ensure both patient safety and internal validity. Veterans","confidence":1,"confidence_rate":1},{"cnt":[[183,1147],[1863,1147],[1863,1197],[183,1197]],"region":{"top_left_x":182,"top_left_y":1147,"width":1681,"height":50},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b8ecf1f7ede94f9287d1d5fd8007870f","type":"text","conversion_output":true,"text":"who meet any of the following exclusion criteria that may interfere with outcome assessment will be","text_display":" who meet any of the following exclusion criteria that may interfere with outcome assessment will be","confidence":0.99951171875,"confidence_rate":0.9999953038523913},{"cnt":[[183,1192],[1798,1192],[1798,1240],[183,1240]],"region":{"top_left_x":182,"top_left_y":1192,"width":1617,"height":48},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9913fd578027403b8f037a4062daa868","type":"text","conversion_output":true,"text":"ineligible: a) schizophrenia, bipolar disorder, or other psychosis; b) moderately severe cognitive","text_display":" ineligible: a) schizophrenia, bipolar disorder, or other psychosis; b) moderately severe cognitive","confidence":1,"confidence_rate":1},{"cnt":[[183,1233],[1820,1233],[1820,1283],[183,1283]],"region":{"top_left_x":182,"top_left_y":1233,"width":1638,"height":50},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"73ddb79236c4471d93d7ddbe5e9cf9a6","type":"text","conversion_output":true,"text":"impairment, defined as \\(\\geq 2\\) errors on a brief cognitive screener; \\({ }^{18} c\\) ) anticipated back, knee, or hip","text_display":" impairment, defined as \\(\\geq 2\\) errors on a brief cognitive screener; \\({ }^{18} c\\) ) anticipated back, knee, or hip","confidence":0.9776308536529541,"confidence_rate":0.999813049457165},{"cnt":[[183,1280],[1824,1280],[1824,1326],[183,1326]],"region":{"top_left_x":182,"top_left_y":1280,"width":1643,"height":46},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"41947693cc524722a0214d38e4a870ac","type":"text","conversion_output":true,"text":"surgery within 12 months; and d) anticipated life expectancy of less than 12 months. We will also","text_display":" surgery within 12 months; and d) anticipated life expectancy of less than 12 months. We will also","confidence":0.86865234375,"confidence_rate":0.9986970320222135},{"cnt":[[183,1323],[1897,1323],[1897,1371],[183,1371]],"region":{"top_left_x":182,"top_left_y":1323,"width":1716,"height":48},"line":25,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0f0e285ea0e74e1e9e3a45bdc92a895e","type":"text","conversion_output":true,"text":"exclude patients receiving current chronic opioid therapy and those with absolute contraindications to","text_display":" exclude patients receiving current chronic opioid therapy and those with absolute contraindications to","confidence":1,"confidence_rate":1},{"cnt":[[183,1366],[638,1366],[638,1416],[183,1416]],"region":{"top_left_x":182,"top_left_y":1366,"width":457,"height":50},"line":26,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"fdf7ecd7dd7247f58a4116210756523f","type":"text","conversion_output":true,"text":"either prescribing strategy.","text_display":" either prescribing strategy.","confidence":1,"confidence_rate":1},{"cnt":[[183,1431],[1803,1431],[1803,1480],[183,1480]],"region":{"top_left_x":182,"top_left_y":1430,"width":1621,"height":51},"line":27,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2d8b21ea4ade4da79dacf37191e020cb","type":"text","conversion_output":true,"text":"For exclusion purposes, we define current chronic opioid therapy as any long-acting opioid (i.e.,","text_display":"\nFor exclusion purposes, we define current chronic opioid therapy as any long-acting opioid (i.e.,","confidence":1,"confidence_rate":1},{"cnt":[[183,1474],[1901,1474],[1901,1523],[183,1523]],"region":{"top_left_x":182,"top_left_y":1473,"width":1720,"height":51},"line":28,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bf6245eb05cf4a569d6e482871cbaeac","type":"text","conversion_output":true,"text":"methadone, transdermal fentanyl, or any sustained-release opioid) dispensed in the past 3 months or","text_display":" methadone, transdermal fentanyl, or any sustained-release opioid) dispensed in the past 3 months or","confidence":1,"confidence_rate":1},{"cnt":[[183,1521],[1914,1521],[1914,1566],[183,1566]],"region":{"top_left_x":182,"top_left_y":1521,"width":1733,"height":46},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"61da7f82ab8741daa9e545a60f023dd8","type":"text","conversion_output":true,"text":"any prescription for \\(\\geq 60\\) tablets/capsules of short-acting schedule 2 or 3 opioids dispensed in the past","text_display":" any prescription for \\(\\geq 60\\) tablets/capsules of short-acting schedule 2 or 3 opioids dispensed in the past","confidence":0.99951171875,"confidence_rate":0.999995825645481},{"cnt":[[183,1564],[1824,1564],[1824,1611],[183,1611]],"region":{"top_left_x":182,"top_left_y":1564,"width":1643,"height":48},"line":30,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6b9f85cb7c7244c8b9c097f271d999b3","type":"text","conversion_output":true,"text":"3 months. Under this definition, patients who received a small number of short-acting opioids per","text_display":" 3 months. Under this definition, patients who received a small number of short-acting opioids per","confidence":1,"confidence_rate":1},{"cnt":[[183,1607],[1910,1607],[1910,1656],[183,1656]],"region":{"top_left_x":182,"top_left_y":1607,"width":1728,"height":50},"line":31,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3a08f2319a424083bbd0ea6371f2afeb","type":"text","conversion_output":true,"text":"month, but less than required to use them on a daily round-the-clock basis, would be eligible. Patients","text_display":" month, but less than required to use them on a daily round-the-clock basis, would be eligible. Patients","confidence":1,"confidence_rate":1},{"cnt":[[183,1652],[1800,1652],[1800,1699],[183,1699]],"region":{"top_left_x":182,"top_left_y":1652,"width":1619,"height":48},"line":32,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3f75ca6e04754abab1d2c78e5b628a4d","type":"text","conversion_output":true,"text":"receiving current chronic opioid therapy will be excluded for two main reasons. First, whether to","text_display":" receiving current chronic opioid therapy will be excluded for two main reasons. First, whether to","confidence":1,"confidence_rate":1},{"cnt":[[183,1695],[1893,1695],[1893,1742],[183,1742]],"region":{"top_left_x":182,"top_left_y":1695,"width":1711,"height":48},"line":33,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c6373b820d34470da92875c9e8fb9a14","type":"text","conversion_output":true,"text":"discontinue or rotate/escalate opioid therapy in patients without an adequate response to opioids is a","text_display":" discontinue or rotate/escalate opioid therapy in patients without an adequate response to opioids is a","confidence":1,"confidence_rate":1},{"cnt":[[183,1740],[1824,1740],[1824,1785],[183,1785]],"region":{"top_left_x":182,"top_left_y":1740,"width":1643,"height":46},"line":34,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f90061fed13243d8ad00901da050db86","type":"text","conversion_output":true,"text":"different research question from those addressed by this study. Second, insufficient \"washout\" of","text_display":" different research question from those addressed by this study. Second, insufficient \"washout\" of","confidence":1,"confidence_rate":1},{"cnt":[[183,1783],[1858,1783],[1858,1830],[183,1830]],"region":{"top_left_x":182,"top_left_y":1783,"width":1677,"height":48},"line":35,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9f34d57760b64d6481c6f4777f56f772","type":"text","conversion_output":true,"text":"preexisting opioid therapy could confound study results because chronic opioid therapy can induce","text_display":" preexisting opioid therapy could confound study results because chronic opioid therapy can induce","confidence":1,"confidence_rate":1},{"cnt":[[183,1826],[1927,1826],[1927,1876],[183,1876]],"region":{"top_left_x":182,"top_left_y":1826,"width":1746,"height":50},"line":36,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8000c71553f142088d269469b79e3938","type":"text","conversion_output":true,"text":"physical dependence and because discontinuation of opioids may lead to changes in pain sensitivity of","text_display":" physical dependence and because discontinuation of opioids may lead to changes in pain sensitivity of","confidence":1,"confidence_rate":1},{"cnt":[[183,1869],[507,1869],[507,1914],[183,1914]],"region":{"top_left_x":182,"top_left_y":1869,"width":326,"height":46},"line":37,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"fb9da9d1897949a298a7ce6beb9ccddc","type":"text","conversion_output":true,"text":"uncertain duration.","text_display":" uncertain duration.","confidence":1,"confidence_rate":1},{"cnt":[[185,1936],[1893,1936],[1893,1983],[185,1983]],"region":{"top_left_x":184,"top_left_y":1935,"width":1709,"height":49},"line":38,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"85a94e8c429948c9b18074d190dd65f7","type":"text","conversion_output":true,"text":"Finally, because participants should be considered eligible in clinical practice for either opioid or non-","text_display":"\n\nFinally, because participants should be considered eligible in clinical practice for either opioid or non","confidence":1,"confidence_rate":1},{"cnt":[[183,1981],[1888,1981],[1888,2026],[183,2026]],"region":{"top_left_x":182,"top_left_y":1980,"width":1707,"height":46},"line":39,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"fd38f9cf9b0f4ba895630c3820b0399f","type":"text","conversion_output":true,"text":"opioid analgesic therapy, patients with contraindications to all drugs in either arm will be excluded. In","text_display":"opioid analgesic therapy, patients with contraindications to all drugs in either arm will be excluded. In","confidence":1,"confidence_rate":1},{"cnt":[[180,2024],[1858,2024],[1858,2071],[180,2071]],"region":{"top_left_x":180,"top_left_y":2023,"width":1679,"height":49},"line":40,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"dc3bbf0ca0d949f28dd522e6125800c3","type":"text","conversion_output":true,"text":"general, contraindications for specific medications include known allergy, previous serious adverse","text_display":" general, contraindications for specific medications include known allergy, previous serious adverse","confidence":1,"confidence_rate":1},{"cnt":[[183,2067],[1921,2067],[1921,2116],[183,2116]],"region":{"top_left_x":182,"top_left_y":2066,"width":1739,"height":51},"line":41,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"cc43afe71ee146679f89bbfe04bd1f53","type":"text","conversion_output":true,"text":"effect, or failure of a previous adequate trial of that medication. Specifically, in the opioid-avoidant arm,","text_display":" effect, or failure of a previous adequate trial of that medication. Specifically, in the opioid-avoidant arm,","confidence":1,"confidence_rate":1},{"cnt":[[180,2110],[1815,2110],[1815,2159],[180,2159]],"region":{"top_left_x":180,"top_left_y":2109,"width":1636,"height":51},"line":42,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c7a1afac564149c09ebf6467cb00bf80","type":"text","conversion_output":true,"text":"a patient who previously failed adequate trials of all three drug class steps would meet exclusion","text_display":" a patient who previously failed adequate trials of all three drug class steps would meet exclusion","confidence":1,"confidence_rate":1},{"cnt":[[183,2157],[1910,2157],[1910,2202],[183,2202]],"region":{"top_left_x":182,"top_left_y":2157,"width":1728,"height":46},"line":43,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2f6c9855613946db81606b6df9d59e83","type":"text","conversion_output":true,"text":"criteria; in the opioid-intensive arm, a patient who previously failed high-dose sustained-release opioid","text_display":" criteria; in the opioid-intensive arm, a patient who previously failed high-dose sustained-release opioid","confidence":1,"confidence_rate":1},{"cnt":[[180,2200],[831,2200],[831,2245],[180,2245]],"region":{"top_left_x":180,"top_left_y":2200,"width":652,"height":46},"line":44,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5823a6cfebea423a8ed41a3956134a70","type":"text","conversion_output":true,"text":"therapy would meet exclusion criteria.","text_display":" therapy would meet exclusion criteria.","confidence":1,"confidence_rate":1},{"cnt":[[180,2264],[1768,2264],[1768,2312],[180,2312]],"region":{"top_left_x":180,"top_left_y":2264,"width":1589,"height":48},"line":45,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9308f9666c154379b0aef3a40ce2cc3f","type":"text","conversion_output":true,"text":"To determine adequacy of prior medication trials, the pharmacist care manager will conduct a","text_display":"\n\nTo determine adequacy of prior medication trials, the pharmacist care manager will conduct a","confidence":1,"confidence_rate":1},{"cnt":[[183,2307],[1833,2307],[1833,2357],[183,2357]],"region":{"top_left_x":182,"top_left_y":2307,"width":1651,"height":50},"line":46,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8c9d0cffd20d45738293846d584a6cf1","type":"text","conversion_output":true,"text":"medication history as described in Section E1. For each drug used, patients will be queried about","text_display":" medication history as described in Section E1. For each drug used, patients will be queried about","confidence":1,"confidence_rate":1},{"cnt":[[180,2350],[1906,2350],[1906,2400],[180,2400]],"region":{"top_left_x":180,"top_left_y":2350,"width":1726,"height":50},"line":47,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"13111d0ba5c64526bb6896d5d8770d33","type":"text","conversion_output":true,"text":"adverse effects, pain response, and dose/duration of use. We will consider a patient to have \"failed\" a","text_display":" adverse effects, pain response, and dose/duration of use. We will consider a patient to have \"failed\" a","confidence":1,"confidence_rate":1},{"cnt":[[180,2396],[1927,2396],[1927,2443],[180,2443]],"region":{"top_left_x":180,"top_left_y":2395,"width":1748,"height":48},"line":48,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"62d35ddd75f7477cae4bccf90abb0bc2","type":"text","conversion_output":true,"text":"drug if they did not tolerate it or did not respond to an adequate trial. Adequacy of a drug trial is defined","text_display":" drug if they did not tolerate it or did not respond to an adequate trial. Adequacy of a drug trial is defined","confidence":1,"confidence_rate":1},{"cnt":[[183,2441],[1914,2441],[1914,2488],[183,2488]],"region":{"top_left_x":182,"top_left_y":2440,"width":1733,"height":48},"line":49,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0f8553606dda43739220cb1d91f5ce86","type":"text","conversion_output":true,"text":"by both dose and duration of use. Figure 3 includes a flow chart for this assessment and a preliminary","text_display":" by both dose and duration of use. Figure 3 includes a flow chart for this assessment and a preliminary","confidence":1,"confidence_rate":1},{"cnt":[[180,2578],[1257,2578],[1257,2632],[180,2632]],"region":{"top_left_x":180,"top_left_y":2578,"width":1077,"height":54},"line":50,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5cb42dc4c88543bcb8f548990306714d","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1852,2625],[1886,2625],[1886,2662],[1852,2662]],"region":{"top_left_x":1851,"top_left_y":2625,"width":36,"height":37},"line":51,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"c1b185d61a0449599f447ba9b7ed4476","type":"page_info","conversion_output":false,"text":"7","text_display":"","confidence":1,"confidence_rate":1}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-08","page":8,"lines":[{"cnt":[[180,249],[1906,249],[1906,299],[180,299]],"region":{"top_left_x":180,"top_left_y":249,"width":1726,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7b41a366f06146f7bba73bf570c8b022","type":"text","conversion_output":true,"text":"table of dose/duration specifications for key drugs; these specifications will be expanded and finalized","text_display":"\ntable of dose/duration specifications for key drugs; these specifications will be expanded and finalized","confidence":0.9990236759185791,"confidence_rate":0.9999910385631244},{"cnt":[[180,296],[1115,296],[1115,342],[180,342]],"region":{"top_left_x":180,"top_left_y":296,"width":936,"height":46},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2074b258057f41079162cc0556a161d9","type":"text","conversion_output":true,"text":"by the study team during the start-up phase of the trial.","text_display":" by the study team during the start-up phase of the trial.","confidence":1,"confidence_rate":1},{"cnt":[[183,361],[1830,361],[1830,406],[183,406]],"region":{"top_left_x":182,"top_left_y":360,"width":1649,"height":47},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7545e440206a4ce68800b246d0739150","type":"text","conversion_output":true,"text":"For opioid therapy, additional contraindications include those outlined by VA/DoD clinical practice","text_display":"\n\nFor opioid therapy, additional contraindications include those outlined by VA/DoD clinical practice","confidence":1,"confidence_rate":1},{"cnt":[[183,404],[1755,404],[1755,449],[183,449]],"region":{"top_left_x":182,"top_left_y":403,"width":1574,"height":47},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6f43733aa4d340b68ffaad0472323b86","type":"text","conversion_output":true,"text":"guidelines, \\({ }^{6}\\) as follows: a) acute psychiatric instability, defined as current uncontrolled severe","text_display":" guidelines, \\({ }^{6}\\) as follows: a) acute psychiatric instability, defined as current uncontrolled severe","confidence":1,"confidence_rate":1},{"cnt":[[183,449],[1927,449],[1927,494],[183,494]],"region":{"top_left_x":182,"top_left_y":449,"width":1746,"height":46},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5aada7b520d94950a70c1b57ad6e48a6","type":"text","conversion_output":true,"text":"depression, severe PTSD, or suicidal ideation; b) substance use disorder not in remission or treatment;","text_display":" depression, severe PTSD, or suicidal ideation; b) substance use disorder not in remission or treatment;","confidence":1,"confidence_rate":1},{"cnt":[[183,494],[1343,494],[1343,537],[183,537]],"region":{"top_left_x":182,"top_left_y":494,"width":1161,"height":44},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"aea80fbfcf01406480b388ae134560b3","type":"text","conversion_output":true,"text":"and c) documented or suspected diversion of controlled substances.","text_display":" and c) documented or suspected diversion of controlled substances.","confidence":1,"confidence_rate":1},{"cnt":[[183,623],[1263,623],[1263,668],[183,668]],"region":{"top_left_x":182,"top_left_y":623,"width":1082,"height":46},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bebe838157d448baafe0af476ab1b6b3","type":"figure_label","conversion_output":false,"text":"Figure 3: Determination of an adequate analgesic drug trial","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[243,709],[971,709],[971,1489],[243,1489]],"region":{"top_left_x":242,"top_left_y":708,"width":730,"height":781},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"79e29fa263e2428b869473679ea2b5d9","type":"diagram","conversion_output":true,"selected_labels":["bebe838157d448baafe0af476ab1b6b3"],"text":"","text_display":"\n\n\\begin{figure}\n\\captionsetup{labelformat=empty}\n\\caption{Figure 3: Determination of an adequate analgesic drug trial}\n\\includegraphics[alt={},max width=\\textwidth]{https://cdn.mathpix.com/cropped/e4ef1058-bc42-42cb-89c4-03db8e1cab4d-08.jpg?height=781&width=730&top_left_y=708&top_left_x=242}\n\\end{figure}"},{"cnt":[[1040,761],[1704,761],[1704,806],[1040,806]],"region":{"top_left_x":1039,"top_left_y":760,"width":665,"height":46},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bf66984878634c7aa26cb4e41e99fd1e","type":"figure_label","conversion_output":false,"text":"Preliminary adequate trial specifications","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1018,808],[1989,808],[1989,1369],[1018,1369]],"region":{"top_left_x":1018,"top_left_y":807,"width":972,"height":562},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"79bbd96f70624ac2990753cf859248f6","type":"table","conversion_output":true,"selected_labels":["bf66984878634c7aa26cb4e41e99fd1e"],"text":"\\begin{tabular}{|l|l|l|}\n\\hline Prior medication & Daily dose & Duration \\\\\n\\hline Acetaminophen & 3000 mg & 2 weeks \\\\\n\\hline Naproxen & 1000 mg & 2 weeks \\\\\n\\hline Ibuprofen & 1800 mg & 2 weeks \\\\\n\\hline Tramadol & 300 mg & 2 weeks \\\\\n\\hline Gabapentin & 2700 mg & 4 weeks \\\\\n\\hline Amitriptyline & 75 mg & 4 weeks \\\\\n\\hline \"Low dose\" opioids & 4 tablets* & 2 weeks \\\\\n\\hline \"High dose\" opioids & 100 MEq mg & 2 weeks \\\\\n\\hline\n\\end{tabular}","text_display":"\n\n\\begin{table}\n\\captionsetup{labelformat=empty}\n\\caption{Preliminary adequate trial specifications}\n\\begin{tabular}{|l|l|l|}\n\\hline Prior medication & Daily dose & Duration \\\\\n\\hline Acetaminophen & 3000 mg & 2 weeks \\\\\n\\hline Naproxen & 1000 mg & 2 weeks \\\\\n\\hline Ibuprofen & 1800 mg & 2 weeks \\\\\n\\hline Tramadol & 300 mg & 2 weeks \\\\\n\\hline Gabapentin & 2700 mg & 4 weeks \\\\\n\\hline Amitriptyline & 75 mg & 4 weeks \\\\\n\\hline \"Low dose\" opioids & 4 tablets* & 2 weeks \\\\\n\\hline \"High dose\" opioids & 100 MEq mg & 2 weeks \\\\\n\\hline\n\\end{tabular}\n\\end{table}","confidence":0.5497086120089989,"confidence_rate":0.9987167748163713},{"cnt":[[1040,1366],[1888,1366],[1888,1412],[1040,1412]],"region":{"top_left_x":1039,"top_left_y":1366,"width":850,"height":46},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6ea9083f500b4b168b9ad36c640791e5","type":"text","conversion_output":true,"text":"*Combinations of a \"weak\" opioid with acetaminophen","text_display":"\n*Combinations of a \"weak\" opioid with acetaminophen","confidence":1,"confidence_rate":1},{"cnt":[[1040,1409],[1502,1409],[1502,1454],[1040,1454]],"region":{"top_left_x":1039,"top_left_y":1409,"width":463,"height":46},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bee45f5c63bb459dbddc98c609478f86","type":"text","conversion_output":true,"text":"(e.g., codeine/acetaminophen)","text_display":" (e.g., codeine/acetaminophen)","confidence":1,"confidence_rate":1},{"cnt":[[180,1530],[866,1530],[866,1583],[180,1583]],"region":{"top_left_x":180,"top_left_y":1529,"width":686,"height":55},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c0169507fd434316b56c7ec22b515db9","type":"section_header","conversion_output":false,"children_ids":["3406db4fa80b45f89c4dc30af7a3ee93"],"text":"","text_display":""},{"cnt":[[185,1534],[862,1534],[862,1579],[185,1579]],"region":{"top_left_x":184,"top_left_y":1533,"width":678,"height":47},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3406db4fa80b45f89c4dc30af7a3ee93","type":"text","conversion_output":true,"parent_id":"c0169507fd434316b56c7ec22b515db9","text":"C3. Identifying potential participants","text_display":"\n\n\\section*{C3. Identifying potential participants}","confidence":1,"confidence_rate":1},{"cnt":[[185,1577],[1867,1577],[1867,1622],[185,1622]],"region":{"top_left_x":184,"top_left_y":1576,"width":1683,"height":47},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8b24ebb8b25e4eb687493d75facbc3c2","type":"text","conversion_output":true,"text":"Primary care providers (PCPs) will be informed of the study and asked to provide written consent to","text_display":"\n\nPrimary care providers (PCPs) will be informed of the study and asked to provide written consent to","confidence":1,"confidence_rate":1},{"cnt":[[185,1622],[1893,1622],[1893,1665],[185,1665]],"region":{"top_left_x":184,"top_left_y":1622,"width":1709,"height":44},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5b0dce2d61f04a0291960fb69881b6a3","type":"text","conversion_output":true,"text":"approach their patients for participation. The Minneapolis VA has 47 full-time equivalent primary care","text_display":" approach their patients for participation. The Minneapolis VA has 47 full-time equivalent primary care","confidence":0.99951171875,"confidence_rate":0.9999955600053285},{"cnt":[[185,1667],[1940,1667],[1940,1710],[185,1710]],"region":{"top_left_x":184,"top_left_y":1667,"width":1757,"height":44},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"313f85eac9af4b29aba2bfb2f7d299fb","type":"text","conversion_output":true,"text":"physicians. We have an excellent track record of recruiting PCPs in this manner; in previous trials at the","text_display":" physicians. We have an excellent track record of recruiting PCPs in this manner; in previous trials at the","confidence":0.99951171875,"confidence_rate":0.9999956000051925},{"cnt":[[185,1710],[1008,1710],[1008,1751],[185,1751]],"region":{"top_left_x":184,"top_left_y":1710,"width":824,"height":41},"line":18,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"02f75913efbb49bc847ee6f3ef4db418","type":"text","conversion_output":true,"text":"Roudebush VA, \\(>90 \\%\\) of PCPs have consented.","text_display":" Roudebush VA, \\(>90 \\%\\) of PCPs have consented.","confidence":0.9882867336273193,"confidence_rate":0.9997643796205054},{"cnt":[[185,1775],[1923,1775],[1923,1818],[185,1818]],"region":{"top_left_x":184,"top_left_y":1774,"width":1739,"height":44},"line":19,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"408deec86df34ecdb7d732e7c33f6581","type":"text","conversion_output":true,"text":"The primary enrollment method will be a mail and phone strategy as used in our trials conducted at the","text_display":"\n\nThe primary enrollment method will be a mail and phone strategy as used in our trials conducted at the","confidence":0.97607421875,"confidence_rate":0.9997737017620295},{"cnt":[[185,1818],[1936,1818],[1936,1863],[185,1863]],"region":{"top_left_x":184,"top_left_y":1817,"width":1752,"height":46},"line":20,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"43ef0db059394bf19d6bd9c004c404bd","type":"text","conversion_output":true,"text":"Roudebush VA. \\({ }^{19}\\) Potentially eligible patients of participating PCPs will be identified through local VistA","text_display":" Roudebush VA. \\({ }^{19}\\) Potentially eligible patients of participating PCPs will be identified through local VistA","confidence":1,"confidence_rate":1},{"cnt":[[185,1861],[1867,1861],[1867,1906],[185,1906]],"region":{"top_left_x":184,"top_left_y":1860,"width":1683,"height":46},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d38c001effd84f21b6b981c24535ac9f","type":"text","conversion_output":true,"text":"searches, using the criteria in Table 1. Searches will be updated every month during the enrollment","text_display":" searches, using the criteria in Table 1. Searches will be updated every month during the enrollment","confidence":1,"confidence_rate":1},{"cnt":[[185,1904],[1846,1904],[1846,1949],[185,1949]],"region":{"top_left_x":184,"top_left_y":1903,"width":1662,"height":46},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9bdda6fbec1a44a0bd7c2dece8b046b9","type":"text","conversion_output":true,"text":"period. Potentially eligible Veterans will be mailed a recruitment letter describing the study and co-","text_display":" period. Potentially eligible Veterans will be mailed a recruitment letter describing the study and co","confidence":1,"confidence_rate":1},{"cnt":[[185,1951],[1841,1951],[1841,1994],[185,1994]],"region":{"top_left_x":184,"top_left_y":1950,"width":1658,"height":44},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"afd8e5efec2a492a881ca440acb542ad","type":"text","conversion_output":true,"text":"signed by study Principal Investigator Dr. Krebs and their PCP. Potential participants will then be","text_display":"signed by study Principal Investigator Dr. Krebs and their PCP. Potential participants will then be","confidence":1,"confidence_rate":1},{"cnt":[[185,1994],[1910,1994],[1910,2039],[185,2039]],"region":{"top_left_x":184,"top_left_y":1993,"width":1726,"height":46},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f3ed01e1a23b4258a0d48871070df773","type":"text","conversion_output":true,"text":"contacted by phone within a week after receipt of the letter to determine interest in participating and to","text_display":" contacted by phone within a week after receipt of the letter to determine interest in participating and to","confidence":1,"confidence_rate":1},{"cnt":[[185,2037],[1794,2037],[1794,2082],[185,2082]],"region":{"top_left_x":184,"top_left_y":2036,"width":1610,"height":46},"line":25,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"eb741c0ccde748248f0be6abf3508e85","type":"text","conversion_output":true,"text":"assess eligibility. If the Veteran is eligible and interested in participating, an appointment will be","text_display":" assess eligibility. If the Veteran is eligible and interested in participating, an appointment will be","confidence":1,"confidence_rate":1},{"cnt":[[185,2082],[1876,2082],[1876,2125],[185,2125]],"region":{"top_left_x":184,"top_left_y":2081,"width":1692,"height":44},"line":26,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"15f0be4fe40f44c0ba883be5955ca2b8","type":"text","conversion_output":true,"text":"scheduled for the informed consent process. After participants provide written informed consent and","text_display":" scheduled for the informed consent process. After participants provide written informed consent and","confidence":0.99951171875,"confidence_rate":0.9999953038523912},{"cnt":[[185,2125],[1111,2125],[1111,2168],[185,2168]],"region":{"top_left_x":184,"top_left_y":2124,"width":927,"height":44},"line":27,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d8bc034b4ca44e40919534210e345f7c","type":"text","conversion_output":true,"text":"authorization, the baseline interview will be conducted.","text_display":" authorization, the baseline interview will be conducted.","confidence":1,"confidence_rate":1},{"cnt":[[219,2187],[1377,2187],[1377,2237],[219,2237]],"region":{"top_left_x":219,"top_left_y":2187,"width":1159,"height":50},"line":28,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"dbb454bcc196434bbff157154e32c918","type":"figure_label","conversion_output":false,"text":"Table 1. Search Criteria to Identify Potential Study Participants","text_display":"","confidence":0.99951171875,"confidence_rate":0.9999930228743673},{"cnt":[[200,2252],[1940,2252],[1940,2460],[200,2460]],"region":{"top_left_x":199,"top_left_y":2251,"width":1742,"height":209},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"05d0a6ffd4a042848e7c8e01aedba9de","type":"table","conversion_output":true,"selected_labels":["dbb454bcc196434bbff157154e32c918"],"text":"\\begin{tabular}{|l|l|}\n\\hline Criterion & Search variable \\\\\n\\hline Pain & 1) \\(715 \\times x, 721 . x x, 722 . x x, 724 . x x\\) and \\\\\n& 2) pain score on most recent visit \\(\\geq 5\\) \\\\\n\\hline\n\\end{tabular}","text_display":"\n\n\\begin{table}\n\\captionsetup{labelformat=empty}\n\\caption{Table 1. Search Criteria to Identify Potential Study Participants}\n\\begin{tabular}{|l|l|}\n\\hline Criterion & Search variable \\\\\n\\hline Pain & 1) \\(715 \\times x, 721 . x x, 722 . x x, 724 . x x\\) and \\\\\n& 2) pain score on most recent visit \\(\\geq 5\\) \\\\\n\\hline\n\\end{tabular}\n\\end{table}","confidence":0.7223874217896905,"confidence_rate":0.9979308462756776},{"cnt":[[185,2580],[1257,2580],[1257,2628],[185,2628]],"region":{"top_left_x":184,"top_left_y":2580,"width":1073,"height":48},"line":30,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ecfe132fc98b4edda37d52e2767e8617","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved 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opioids","confidence":1,"confidence_rate":1},{"cnt":[[600,318],[1871,318],[1871,572],[600,572]],"region":{"top_left_x":599,"top_left_y":318,"width":1272,"height":255},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"cd52f664d37e4cde9af1378160e33e1f","type":"complex_cell","conversion_output":false,"parent_id":"5ff0cb9f87004b2587fdd6a082ab2442","children_ids":["95341503d0d54e6da4979dc434c71f81","d099e6ee8dfd4447a635eaef931e6470","8bb93c404a8f417ea0d6dc6f38adc230","9b9c35cb31754093a19b26461aa4da3c"],"text":"\\begin{tabular}{l}\nIn the past 3 months... \\\\\n1) No fentanyl patch, methadone, morphine SR, oxycodone SR dispensed and \\\\\n2) <60 short-acting opioid pills dispensed for 30 days\n\\end{tabular}","text_display":"\\begin{tabular}{l}\nIn the past 3 months... \\\\\n1) No fentanyl patch, methadone, morphine SR, oxycodone SR dispensed and \\\\\n2) <60 short-acting opioid pills dispensed for 30 days\n\\end{tabular}","cell_row":1,"cell_column":1,"cell_row_span":1,"cell_col_span":1,"confidence":0.7373046875,"confidence_rate":0.9985520821541409},{"cnt":[[608,321],[998,321],[998,365],[608,365]],"region":{"top_left_x":607,"top_left_y":321,"width":391,"height":44},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"95341503d0d54e6da4979dc434c71f81","type":"text","conversion_output":false,"parent_id":"cd52f664d37e4cde9af1378160e33e1f","text":"In the past 3 months...","text_display":"In the past 3 months...","confidence":0.9521484375,"confidence_rate":0.9984194975824492},{"cnt":[[608,384],[1865,384],[1865,433],[608,433]],"region":{"top_left_x":607,"top_left_y":383,"width":1259,"height":50},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d099e6ee8dfd4447a635eaef931e6470","type":"text","conversion_output":false,"parent_id":"cd52f664d37e4cde9af1378160e33e1f","text":"1) No fentanyl patch, methadone, morphine SR, oxycodone SR dispensed","text_display":"\n1) No fentanyl patch, methadone, morphine SR, oxycodone SR dispensed","confidence":0.7373046875,"confidence_rate":0.9958339889003814},{"cnt":[[608,455],[679,455],[679,498],[608,498]],"region":{"top_left_x":607,"top_left_y":454,"width":72,"height":45},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8bb93c404a8f417ea0d6dc6f38adc230","type":"text","conversion_output":false,"parent_id":"cd52f664d37e4cde9af1378160e33e1f","text":"and","text_display":" and","confidence":1,"confidence_rate":1},{"cnt":[[608,520],[1505,520],[1505,564],[608,564]],"region":{"top_left_x":607,"top_left_y":520,"width":899,"height":44},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9b9c35cb31754093a19b26461aa4da3c","type":"text","conversion_output":false,"parent_id":"cd52f664d37e4cde9af1378160e33e1f","text":"2) <60 short-acting opioid pills dispensed for 30 days","text_display":"\n2) <60 short-acting opioid pills dispensed for 30 days","confidence":0.9975600242614746,"confidence_rate":0.9999605982386839},{"cnt":[[183,604],[1850,604],[1850,655],[183,655]],"region":{"top_left_x":182,"top_left_y":603,"width":1668,"height":53},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"edcf3c58a68a474788e0bff57bf4d934","type":"text","conversion_output":true,"text":"If enrollment falls below targets, a second method of enrollment will be in-clinic contact of potential","text_display":"\n\nIf enrollment falls below targets, a second method of enrollment will be in-clinic contact of potential","confidence":1,"confidence_rate":1},{"cnt":[[180,649],[1841,649],[1841,698],[180,698]],"region":{"top_left_x":180,"top_left_y":648,"width":1662,"height":51},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d21134d492de40f692d2a7455e6dd489","type":"text","conversion_output":true,"text":"subjects by cross-referencing of the potentially eligible list with the appointment schedule for each","text_display":" subjects by cross-referencing of the potentially eligible list with the appointment schedule for each","confidence":1,"confidence_rate":1},{"cnt":[[183,696],[496,696],[496,741],[183,741]],"region":{"top_left_x":182,"top_left_y":696,"width":315,"height":46},"line":18,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"21bc730c70e2484fb094def665964697","type":"text","conversion_output":true,"text":"participating PCP.","text_display":" participating PCP.","confidence":1,"confidence_rate":1},{"cnt":[[176,750],[900,750],[900,810],[176,810]],"region":{"top_left_x":176,"top_left_y":749,"width":725,"height":61},"line":19,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d6800b2e1045453c8aa847280fc4ee41","type":"section_header","conversion_output":false,"children_ids":["920104404ee1452cb08818f63918b61c"],"text":"","text_display":""},{"cnt":[[185,758],[896,758],[896,804],[185,804]],"region":{"top_left_x":184,"top_left_y":758,"width":712,"height":46},"line":20,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"920104404ee1452cb08818f63918b61c","type":"text","conversion_output":true,"parent_id":"d6800b2e1045453c8aa847280fc4ee41","text":"C4. Inclusion of women and minorities","text_display":"\n\n\\section*{C4. Inclusion of women and minorities}","confidence":1,"confidence_rate":1},{"cnt":[[180,801],[1893,801],[1893,851],[180,851]],"region":{"top_left_x":180,"top_left_y":801,"width":1713,"height":50},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3cdd5f7bfc12440c969b654cffe8b703","type":"text","conversion_output":true,"text":"This study will be performed at the Minneapolis VAMC, where we expect approximately \\(7-10 \\%\\) of the","text_display":"\n\nThis study will be performed at the Minneapolis VAMC, where we expect approximately \\(7-10 \\%\\) of the","confidence":0.9980480668600649,"confidence_rate":0.9999812132472036},{"cnt":[[183,846],[1768,846],[1768,896],[183,896]],"region":{"top_left_x":182,"top_left_y":846,"width":1587,"height":50},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d24888512fe94e27b12fc8849451cd1e","type":"text","conversion_output":true,"text":"potentially eligible population to be women. Eligible women and racial/ethnic minorities will be","text_display":" potentially eligible population to be women. Eligible women and racial/ethnic minorities will be","confidence":1,"confidence_rate":1},{"cnt":[[183,889],[1863,889],[1863,939],[183,939]],"region":{"top_left_x":182,"top_left_y":889,"width":1681,"height":50},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a0cfd1c5f425437e8eba251b74a84316","type":"text","conversion_output":true,"text":"encouraged to enroll. This study will not be powered for subgroup analyses with women or minority","text_display":" encouraged to enroll. This study will not be powered for subgroup analyses with women or minority","confidence":1,"confidence_rate":1},{"cnt":[[180,935],[1923,935],[1923,982],[180,982]],"region":{"top_left_x":180,"top_left_y":934,"width":1743,"height":48},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"86b155521cec4583a7fa6addf1b26e07","type":"text","conversion_output":true,"text":"participants, but we will examine results for evidence of trends that can be prospectively evaluated in a","text_display":" participants, but we will examine results for evidence of trends that can be prospectively evaluated in a","confidence":1,"confidence_rate":1},{"cnt":[[180,980],[1772,980],[1772,1025],[180,1025]],"region":{"top_left_x":180,"top_left_y":979,"width":1593,"height":46},"line":25,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6d7448a5d60f44f5905f4965452ec786","type":"text","conversion_output":true,"text":"future multisite trial. Gender and race/ethnicity will be considered in all multivariable analyses.","text_display":" future multisite trial. Gender and race/ethnicity will be considered in all multivariable analyses.","confidence":1,"confidence_rate":1},{"cnt":[[180,1023],[1919,1023],[1919,1072],[180,1072]],"region":{"top_left_x":180,"top_left_y":1022,"width":1739,"height":51},"line":26,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8684725d18ac4279a33c0ca35d2be7eb","type":"text","conversion_output":true,"text":"Additionally, the purposive sampling technique we will use for the qualitative evaluation will specifically","text_display":" Additionally, the purposive sampling technique we will use for the qualitative evaluation will specifically","confidence":1,"confidence_rate":1},{"cnt":[[180,1068],[1717,1068],[1717,1115],[180,1115]],"region":{"top_left_x":180,"top_left_y":1067,"width":1537,"height":49},"line":27,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2301bb40475e401c84b61a7b4fc40876","type":"text","conversion_output":true,"text":"\"oversample\" female and minority participants in order to adequately represent their views.","text_display":" \"oversample\" female and minority participants in order to adequately represent their views.","confidence":1,"confidence_rate":1},{"cnt":[[176,1121],[526,1121],[526,1182],[176,1182]],"region":{"top_left_x":176,"top_left_y":1121,"width":351,"height":61},"line":28,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"34a560f9885f42fb85eba201c5a39c75","type":"section_header","conversion_output":false,"children_ids":["af42502742a744e9abbf6dcd6d54f4c2"],"text":"","text_display":""},{"cnt":[[185,1130],[518,1130],[518,1175],[185,1175]],"region":{"top_left_x":184,"top_left_y":1130,"width":334,"height":46},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"af42502742a744e9abbf6dcd6d54f4c2","type":"text","conversion_output":true,"parent_id":"34a560f9885f42fb85eba201c5a39c75","text":"D. Randomization","text_display":"\n\n\\section*{D. 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Randomization will","text_display":" randomized to the opioid-intensive arm ( \\(n =138\\) ) or the opioid-avoidant ( \\(n =138\\) ) arm. Randomization will","confidence":0.9820384986818453,"confidence_rate":0.9998514473708067},{"cnt":[[183,1263],[1936,1263],[1936,1313],[183,1313]],"region":{"top_left_x":182,"top_left_y":1263,"width":1754,"height":50},"line":32,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c1c0d82943f8482a982a16c1e5c5fb78","type":"text","conversion_output":true,"text":"be stratified by primary pain location (back or hip/knee) to assure balanced numbers of participants with","text_display":" be stratified by primary pain location (back or hip/knee) to assure balanced numbers of participants with","confidence":1,"confidence_rate":1},{"cnt":[[183,1306],[1549,1306],[1549,1356],[183,1356]],"region":{"top_left_x":182,"top_left_y":1306,"width":1368,"height":50},"line":33,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"07418b4c2bf546138c67e6a2a7c9bb72","type":"text","conversion_output":true,"text":"LBP or OA. Randomization will occur in randomly varying block sizes of 2 and 4.","text_display":" LBP or OA. Randomization will occur in randomly varying block sizes of 2 and 4.","confidence":0.9053194522857666,"confidence_rate":0.9988440707919659},{"cnt":[[176,1362],[939,1362],[939,1429],[176,1429]],"region":{"top_left_x":176,"top_left_y":1362,"width":763,"height":67},"line":34,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"79d598d1752647ab82a565f9101d2cef","type":"section_header","conversion_output":false,"children_ids":["2c1e5644650a426aa6c8d3cb4e149afc"],"text":"","text_display":""},{"cnt":[[185,1371],[932,1371],[932,1420],[185,1420]],"region":{"top_left_x":184,"top_left_y":1370,"width":749,"height":51},"line":35,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2c1e5644650a426aa6c8d3cb4e149afc","type":"text","conversion_output":true,"parent_id":"79d598d1752647ab82a565f9101d2cef","text":"D1. Masking and allocation concealment","text_display":"\n\n\\section*{D1. Masking and allocation concealment}","confidence":1,"confidence_rate":1},{"cnt":[[183,1414],[1886,1414],[1886,1463],[183,1463]],"region":{"top_left_x":182,"top_left_y":1413,"width":1705,"height":51},"line":36,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"41019cfabffa4e84996f72298b6cc93c","type":"text","conversion_output":true,"text":"Participants will not be masked to treatment arm assignment due to the complexity of the medication","text_display":"\n\nParticipants will not be masked to treatment arm assignment due to the complexity of the medication","confidence":1,"confidence_rate":1},{"cnt":[[183,1461],[1794,1461],[1794,1508],[183,1508]],"region":{"top_left_x":182,"top_left_y":1460,"width":1612,"height":49},"line":37,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4512104b47d74330b5c417c52d415a95","type":"text","conversion_output":true,"text":"prescribing strategies. The pharmacist care manager and supervising clinical investigators who","text_display":" prescribing strategies. The pharmacist care manager and supervising clinical investigators who","confidence":1,"confidence_rate":1},{"cnt":[[183,1504],[1785,1504],[1785,1549],[183,1549]],"region":{"top_left_x":182,"top_left_y":1503,"width":1604,"height":47},"line":38,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"aa589d36815449dfa6a605c535b5433b","type":"text","conversion_output":true,"text":"implement the interventions will also be aware of treatment assignment. To maintain allocation","text_display":" implement the interventions will also be aware of treatment assignment. To maintain allocation","confidence":1,"confidence_rate":1},{"cnt":[[183,1547],[1884,1547],[1884,1594],[183,1594]],"region":{"top_left_x":182,"top_left_y":1546,"width":1703,"height":49},"line":39,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ce7023f0836c4fe4af1158bd843dcb00","type":"text","conversion_output":true,"text":"concealment, randomization will be conducted by the pharmacist care manager at the first treatment","text_display":" concealment, randomization will be conducted by the pharmacist care manager at the first treatment","confidence":1,"confidence_rate":1},{"cnt":[[183,1590],[1809,1590],[1809,1639],[183,1639]],"region":{"top_left_x":182,"top_left_y":1589,"width":1627,"height":51},"line":40,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2bf3eef2357e4b5f9433b2ab2eafd840","type":"text","conversion_output":true,"text":"visit, using sealed envelopes prepared by the statistician. Outcome assessors will be masked to","text_display":" visit, using sealed envelopes prepared by the statistician. Outcome assessors will be masked to","confidence":1,"confidence_rate":1},{"cnt":[[183,1635],[1818,1635],[1818,1682],[183,1682]],"region":{"top_left_x":182,"top_left_y":1634,"width":1636,"height":49},"line":41,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0337ca6f8c104ccf82039881221c9280","type":"text","conversion_output":true,"text":"treatment assignment. The masking of outcome assessors and the structured nature of outcome","text_display":" treatment assignment. The masking of outcome assessors and the structured nature of outcome","confidence":1,"confidence_rate":1},{"cnt":[[183,1680],[1334,1680],[1334,1727],[183,1727]],"region":{"top_left_x":182,"top_left_y":1680,"width":1153,"height":48},"line":42,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8aa7382ffc0f40099831f60af86e00cd","type":"text","conversion_output":true,"text":"measures are expected to minimize potential biased ascertainment.","text_display":" measures are expected to minimize potential biased ascertainment.","confidence":1,"confidence_rate":1},{"cnt":[[176,1736],[494,1736],[494,1794],[176,1794]],"region":{"top_left_x":176,"top_left_y":1735,"width":319,"height":59},"line":43,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e581a1d1ff3647ada51cd6ad0d2f1dd3","type":"section_header","conversion_output":false,"children_ids":["196448b1fe7942eb95cdcd338aa79c77"],"text":"","text_display":""},{"cnt":[[185,1745],[488,1745],[488,1785],[185,1785]],"region":{"top_left_x":184,"top_left_y":1744,"width":304,"height":42},"line":44,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"196448b1fe7942eb95cdcd338aa79c77","type":"text","conversion_output":true,"parent_id":"e581a1d1ff3647ada51cd6ad0d2f1dd3","text":"E. Interventions","text_display":"\n\n\\section*{E. Interventions}","confidence":1,"confidence_rate":1},{"cnt":[[176,1781],[664,1781],[664,1837],[176,1837]],"region":{"top_left_x":176,"top_left_y":1781,"width":488,"height":56},"line":45,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"199aea7f12f043d49baea0c083bd3aeb","type":"section_header","conversion_output":false,"children_ids":["80cf8aa9fa25419d873b48b11e485c2d"],"text":"","text_display":""},{"cnt":[[183,1788],[655,1788],[655,1830],[183,1830]],"region":{"top_left_x":182,"top_left_y":1787,"width":474,"height":44},"line":46,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"80cf8aa9fa25419d873b48b11e485c2d","type":"text","conversion_output":true,"parent_id":"199aea7f12f043d49baea0c083bd3aeb","text":"E1. Intervention structure","text_display":"\n\n\\section*{E1. Intervention structure}","confidence":1,"confidence_rate":1},{"cnt":[[180,1830],[1828,1830],[1828,1880],[180,1880]],"region":{"top_left_x":180,"top_left_y":1830,"width":1649,"height":50},"line":47,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7987926321354025b9300f01319b269c","type":"text","conversion_output":true,"text":"A clinical pharmacist care manager will be the central intervention provider for both arms. Clinical","text_display":"\n\nA clinical pharmacist care manager will be the central intervention provider for both arms. Clinical","confidence":0.99951171875,"confidence_rate":0.9999953485775026},{"cnt":[[180,1876],[1863,1876],[1863,1923],[180,1923]],"region":{"top_left_x":180,"top_left_y":1875,"width":1683,"height":48},"line":48,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0872f8a80cd240d3a7d1442b00201e5b","type":"text","conversion_output":true,"text":"pharmacists have an established role in Minneapolis VA primary care clinics that includes protocol-","text_display":" pharmacists have an established role in Minneapolis VA primary care clinics that includes protocol","confidence":1,"confidence_rate":1},{"cnt":[[180,1919],[1919,1919],[1919,1966],[180,1966]],"region":{"top_left_x":180,"top_left_y":1918,"width":1739,"height":48},"line":49,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e00620d6401b4818b1142215cdfcba59","type":"text","conversion_output":true,"text":"driven adjustment of medication therapy. Clinical pharmacists assigned to each primary care clinic can","text_display":"driven adjustment of medication therapy. Clinical pharmacists assigned to each primary care clinic can","confidence":1,"confidence_rate":1},{"cnt":[[183,1964],[1841,1964],[1841,2013],[183,2013]],"region":{"top_left_x":182,"top_left_y":1963,"width":1660,"height":51},"line":50,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"305a258724f64caaa395be032329775e","type":"text","conversion_output":true,"text":"currently be consulted to see patients with difficult to control hypertension or hyperlipidemia. They","text_display":" currently be consulted to see patients with difficult to control hypertension or hyperlipidemia. They","confidence":0.99267578125,"confidence_rate":0.9999306517204479},{"cnt":[[183,2007],[1815,2007],[1815,2056],[183,2056]],"region":{"top_left_x":182,"top_left_y":2006,"width":1634,"height":51},"line":51,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c397aeaaece54d8498e424f8c76603f0","type":"text","conversion_output":true,"text":"adjust medications, monitor response, and return disease management back to the primary care","text_display":" adjust medications, monitor response, and return disease management back to the primary care","confidence":1,"confidence_rate":1},{"cnt":[[183,2052],[1850,2052],[1850,2099],[183,2099]],"region":{"top_left_x":182,"top_left_y":2051,"width":1668,"height":49},"line":52,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"955351cd02b546b99627a65e42d3f485","type":"text","conversion_output":true,"text":"provider once blood pressure or lipid medications are optimized. This program has been both well-","text_display":" provider once blood pressure or lipid medications are optimized. This program has been both well","confidence":1,"confidence_rate":1},{"cnt":[[183,2093],[1828,2093],[1828,2142],[183,2142]],"region":{"top_left_x":182,"top_left_y":2092,"width":1647,"height":50},"line":53,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f639f591a8e9458c8bc197eacf3ddc80","type":"text","conversion_output":true,"text":"received by primary care providers and associated with improvement in outcomes. \\({ }^{20}\\) The SPACE","text_display":"received by primary care providers and associated with improvement in outcomes. \\({ }^{20}\\) The SPACE","confidence":1,"confidence_rate":1},{"cnt":[[183,2140],[1300,2140],[1300,2189],[183,2189]],"region":{"top_left_x":182,"top_left_y":2139,"width":1118,"height":51},"line":54,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"478c779d8249424ba7d1524aa446938c","type":"text","conversion_output":true,"text":"intervention protocol echoes this familiar and successful program.","text_display":" intervention protocol echoes this familiar and successful program.","confidence":1,"confidence_rate":1},{"cnt":[[183,2202],[1818,2202],[1818,2254],[183,2254]],"region":{"top_left_x":182,"top_left_y":2202,"width":1636,"height":52},"line":55,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"aa9b210171c04555a6fa21ce8cb63d6f","type":"text","conversion_output":true,"text":"Participants will see the pharmacist care manager in a study clinic, with the first intervention visit","text_display":"\nParticipants will see the pharmacist care manager in a study clinic, with the first intervention visit","confidence":1,"confidence_rate":1},{"cnt":[[183,2247],[1826,2247],[1826,2297],[183,2297]],"region":{"top_left_x":182,"top_left_y":2247,"width":1645,"height":50},"line":56,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"75a95b827ec7488b9359372b0195e6b1","type":"text","conversion_output":true,"text":"scheduled as soon as possible after study enrollment. At this visit, the care manager will obtain a","text_display":" scheduled as soon as possible after study enrollment. At this visit, the care manager will obtain a","confidence":1,"confidence_rate":1},{"cnt":[[183,2292],[1846,2292],[1846,2340],[183,2340]],"region":{"top_left_x":182,"top_left_y":2292,"width":1664,"height":48},"line":57,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5a1932f6880243b19c70a938cccf858a","type":"text","conversion_output":true,"text":"detailed history of current and past pain medications. The medication history will include review of","text_display":" detailed history of current and past pain medications. The medication history will include review of","confidence":1,"confidence_rate":1},{"cnt":[[183,2333],[1921,2333],[1921,2383],[183,2383]],"region":{"top_left_x":182,"top_left_y":2333,"width":1739,"height":50},"line":58,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3edd0230df8445e48bee2ddac3ebd7a9","type":"text","conversion_output":true,"text":"current and past medications, including examination of patients' medication packages they will bring to","text_display":" current and past medications, including examination of patients' medication packages they will bring to","confidence":1,"confidence_rate":1},{"cnt":[[180,2380],[1919,2380],[1919,2428],[180,2428]],"region":{"top_left_x":180,"top_left_y":2380,"width":1739,"height":48},"line":59,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4d48d93470904c119231df7b9f45e9f8","type":"text","conversion_output":true,"text":"the visit and CPRS medication lists. Information from these sources will be supplemented by review of","text_display":" the visit and CPRS medication lists. Information from these sources will be supplemented by review of","confidence":1,"confidence_rate":1},{"cnt":[[183,2423],[1906,2423],[1906,2473],[183,2473]],"region":{"top_left_x":182,"top_left_y":2423,"width":1724,"height":50},"line":60,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7bb2d9cca4b14e37b3b73782e0209b14","type":"text","conversion_output":true,"text":"a checklist of analgesic and adjuvant medications, including photographs of drugs to stimulate patient","text_display":" a checklist of analgesic and adjuvant medications, including photographs of drugs to stimulate patient","confidence":1,"confidence_rate":1},{"cnt":[[180,2578],[1257,2578],[1257,2632],[180,2632]],"region":{"top_left_x":180,"top_left_y":2578,"width":1077,"height":54},"line":61,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e976d6952fc54fcdb38e57c76e5bc06e","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1852,2621],[1886,2621],[1886,2662],[1852,2662]],"region":{"top_left_x":1851,"top_left_y":2621,"width":36,"height":41},"line":62,"column":0,"font_size":28,"is_printed":true,"is_handwritten":false,"id":"6a42d59a39ac4cf98d3c4e8f70af29af","type":"page_info","conversion_output":false,"text":"9","text_display":"","confidence":1,"confidence_rate":1}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-10","page":10,"lines":[{"cnt":[[183,249],[1936,249],[1936,299],[183,299]],"region":{"top_left_x":182,"top_left_y":249,"width":1754,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e2fff068fe6b4e929ac06ddf61cf34bc","type":"text","conversion_output":true,"text":"recall. The care manager will confirm eligibility as described in Sections C, randomize the participant as","text_display":"\nrecall. The care manager will confirm eligibility as described in Sections C, randomize the participant as","confidence":0.9990234375,"confidence_rate":0.9999911978797494},{"cnt":[[180,294],[1843,294],[1843,346],[180,346]],"region":{"top_left_x":180,"top_left_y":294,"width":1664,"height":52},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ac9c613966374a5689fcb76ae714bb50","type":"text","conversion_output":true,"text":"described in Section D, and recommend initial medication adjustment according to the prescribing","text_display":" described in Section D, and recommend initial medication adjustment according to the prescribing","confidence":1,"confidence_rate":1},{"cnt":[[180,339],[870,339],[870,389],[180,389]],"region":{"top_left_x":180,"top_left_y":339,"width":691,"height":50},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bbdbd7806b7947608e8729addf918541","type":"text","conversion_output":true,"text":"strategy for the assigned treatment arm.","text_display":" strategy for the assigned treatment arm.","confidence":1,"confidence_rate":1},{"cnt":[[180,400],[1923,400],[1923,451],[180,451]],"region":{"top_left_x":180,"top_left_y":399,"width":1743,"height":53},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ccf7ebc7c44e4e73952cd313da842428","type":"text","conversion_output":true,"text":"We expect that most adjustments in pain medications will occur in the beginning of the study period for","text_display":"\nWe expect that most adjustments in pain medications will occur in the beginning of the study period for","confidence":1,"confidence_rate":1},{"cnt":[[180,447],[1867,447],[1867,496],[180,496]],"region":{"top_left_x":180,"top_left_y":446,"width":1687,"height":51},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6d248292e2754154aaebfacba28c1926","type":"text","conversion_output":true,"text":"most patients, so intervention visits will be scheduled at baseline and approximately monthly for the","text_display":" most patients, so intervention visits will be scheduled at baseline and approximately monthly for the","confidence":1,"confidence_rate":1},{"cnt":[[180,490],[1927,490],[1927,539],[180,539]],"region":{"top_left_x":180,"top_left_y":489,"width":1748,"height":51},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"79c1bb8fa0e840baba4db0d75e6768ad","type":"text","conversion_output":true,"text":"following two visits. Additional visits will be scheduled according to individual participants' needs during","text_display":" following two visits. Additional visits will be scheduled according to individual participants' needs during","confidence":1,"confidence_rate":1},{"cnt":[[180,535],[1846,535],[1846,582],[180,582]],"region":{"top_left_x":180,"top_left_y":534,"width":1666,"height":49},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"eca3a76da1ca4776aac3322cd50d07b5","type":"text","conversion_output":true,"text":"the remainder of the 12 month intervention period, with a maximum of 6 months between visits for","text_display":" the remainder of the 12 month intervention period, with a maximum of 6 months between visits for","confidence":1,"confidence_rate":1},{"cnt":[[180,578],[1927,578],[1927,627],[180,627]],"region":{"top_left_x":180,"top_left_y":577,"width":1748,"height":51},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ee932ecd20634f41b2e84127c1180cb5","type":"text","conversion_output":true,"text":"participants who achieve adequate pain control on a stable medication regimen. Because the extent of","text_display":" participants who achieve adequate pain control on a stable medication regimen. Because the extent of","confidence":1,"confidence_rate":1},{"cnt":[[180,623],[1796,623],[1796,672],[180,672]],"region":{"top_left_x":180,"top_left_y":623,"width":1617,"height":50},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"82a0b9dd037045779e818219f1c7b0c9","type":"text","conversion_output":true,"text":"care manager contact may differ among patients over the course of the trial, we will track these","text_display":" care manager contact may differ among patients over the course of the trial, we will track these","confidence":1,"confidence_rate":1},{"cnt":[[180,666],[1897,666],[1897,715],[180,715]],"region":{"top_left_x":180,"top_left_y":666,"width":1718,"height":50},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4cb902cb11dd4f438b74470b7d8bedea","type":"text","conversion_output":true,"text":"contacts and examine between-group differences in care manager contact as a potential confounder.","text_display":" contacts and examine between-group differences in care manager contact as a potential confounder.","confidence":1,"confidence_rate":1},{"cnt":[[180,709],[1824,709],[1824,758],[180,758]],"region":{"top_left_x":180,"top_left_y":708,"width":1645,"height":51},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6b5d9da8a28942a1b1a0e44606ac2306","type":"text","conversion_output":true,"text":"Before and between intervention clinic visits, patients will have their symptoms reassessed using","text_display":" Before and between intervention clinic visits, patients will have their symptoms reassessed using","confidence":1,"confidence_rate":1},{"cnt":[[180,752],[1008,752],[1008,804],[180,804]],"region":{"top_left_x":180,"top_left_y":751,"width":828,"height":53},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"75b8e65a4bdf4635959d223b23fa4c7f","type":"text","conversion_output":true,"text":"automated symptom monitoring (see Section F).","text_display":" automated symptom monitoring (see Section F).","confidence":1,"confidence_rate":1},{"cnt":[[180,816],[1921,816],[1921,868],[180,868]],"region":{"top_left_x":180,"top_left_y":816,"width":1741,"height":52},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"08021737d2b5478fb94abf4b06c72774","type":"text","conversion_output":true,"text":"Case review meetings with the pharmacist care manager and supervising clinician investigators will be","text_display":"\nCase review meetings with the pharmacist care manager and supervising clinician investigators will be","confidence":1,"confidence_rate":1},{"cnt":[[180,864],[1916,864],[1916,913],[180,913]],"region":{"top_left_x":180,"top_left_y":863,"width":1737,"height":51},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"41544626dca74698be633e871166f8a5","type":"text","conversion_output":true,"text":"held each week to review progress with pain management, adverse effects, and any clinical problems.","text_display":" held each week to review progress with pain management, adverse effects, and any clinical problems.","confidence":1,"confidence_rate":1},{"cnt":[[183,907],[1790,907],[1790,956],[183,956]],"region":{"top_left_x":182,"top_left_y":906,"width":1608,"height":51},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f280942f1f9a42abb10a0538a3b28d98","type":"text","conversion_output":true,"text":"Clinical pharmacists are able to write prescriptions for non-scheduled medications. A physician","text_display":" Clinical pharmacists are able to write prescriptions for non-scheduled medications. A physician","confidence":1,"confidence_rate":1},{"cnt":[[180,950],[1809,950],[1809,999],[180,999]],"region":{"top_left_x":180,"top_left_y":949,"width":1629,"height":51},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0fd5b466f48f4691a29290f8c1b14be6","type":"text","conversion_output":true,"text":"investigator will sign paper prescriptions for DEA scheduled medications (i.e., opioids). All study","text_display":" investigator will sign paper prescriptions for DEA scheduled medications (i.e., opioids). All study","confidence":1,"confidence_rate":1},{"cnt":[[180,993],[1757,993],[1757,1042],[180,1042]],"region":{"top_left_x":180,"top_left_y":992,"width":1578,"height":50},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4babf297aa3a4a539792af8cfe7d4745","type":"text","conversion_output":true,"text":"medications will be dispensed through the Minneapolis VA research pharmacy and mailed to","text_display":" medications will be dispensed through the Minneapolis VA research pharmacy and mailed to","confidence":1,"confidence_rate":1},{"cnt":[[180,1038],[1865,1038],[1865,1089],[180,1089]],"region":{"top_left_x":180,"top_left_y":1037,"width":1685,"height":53},"line":18,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"414f32ed5f134c9ca50411a02ede1ab2","type":"text","conversion_output":true,"text":"participants; from the participants' perspective, this dispensing process will not differ from the usual","text_display":" participants; from the participants' perspective, this dispensing process will not differ from the usual","confidence":1,"confidence_rate":1},{"cnt":[[183,1083],[1016,1083],[1016,1132],[183,1132]],"region":{"top_left_x":182,"top_left_y":1082,"width":835,"height":51},"line":19,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"74fa51a9fd0249ff9c184b41636e603e","type":"text","conversion_output":true,"text":"non-research medication dispensing experience.","text_display":" non-research medication dispensing experience.","confidence":1,"confidence_rate":1},{"cnt":[[180,1145],[1824,1145],[1824,1197],[180,1197]],"region":{"top_left_x":180,"top_left_y":1145,"width":1645,"height":52},"line":20,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4d114c04de994bd4a774a42e834d4612","type":"text","conversion_output":true,"text":"The primary method of communicating with primary care about routine patient progress and pain","text_display":"\nThe primary method of communicating with primary care about routine patient progress and pain","confidence":1,"confidence_rate":1},{"cnt":[[180,1190],[1876,1190],[1876,1240],[180,1240]],"region":{"top_left_x":180,"top_left_y":1190,"width":1696,"height":50},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"12b7de95c92e44b6bf7b6e820e547760","type":"text","conversion_output":true,"text":"treatment decisions will be care management notes entered into CPRS; this is consistent with usual","text_display":" treatment decisions will be care management notes entered into CPRS; this is consistent with usual","confidence":1,"confidence_rate":1},{"cnt":[[180,1233],[1897,1233],[1897,1283],[180,1283]],"region":{"top_left_x":180,"top_left_y":1233,"width":1718,"height":50},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c666510eb1264c4aa14fb970f48235fe","type":"text","conversion_output":true,"text":"consultant practice at our VAMC. If indicated by emergent adherence or safety issues (e.g., repeated","text_display":" consultant practice at our VAMC. If indicated by emergent adherence or safety issues (e.g., repeated","confidence":0.99951171875,"confidence_rate":0.9999953485775026},{"cnt":[[180,1278],[1912,1278],[1912,1330],[180,1330]],"region":{"top_left_x":180,"top_left_y":1278,"width":1733,"height":52},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5929a1806ac54cf9bb5901cc46eb9cc6","type":"text","conversion_output":true,"text":"attempts by a participant to receive pain medication outside of the study, important adverse effects), a","text_display":" attempts by a participant to receive pain medication outside of the study, important adverse effects), a","confidence":1,"confidence_rate":1},{"cnt":[[180,1323],[1901,1323],[1901,1371],[180,1371]],"region":{"top_left_x":180,"top_left_y":1323,"width":1722,"height":48},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"deff8acda4e6464faa03f6861572dba4","type":"text","conversion_output":true,"text":"care manager or investigator will communicate directly with the patient's primary care provider. At the","text_display":" care manager or investigator will communicate directly with the patient's primary care provider. At the","confidence":1,"confidence_rate":1},{"cnt":[[180,1366],[1940,1366],[1940,1416],[180,1416]],"region":{"top_left_x":180,"top_left_y":1366,"width":1761,"height":50},"line":25,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d44fb22e00ac432297c6faa5b0c8a85b","type":"text","conversion_output":true,"text":"end of the trial period, we will provide primary care providers with a synopsis of each patient's individual","text_display":" end of the trial period, we will provide primary care providers with a synopsis of each patient's individual","confidence":1,"confidence_rate":1},{"cnt":[[180,1409],[1783,1409],[1783,1459],[180,1459]],"region":{"top_left_x":180,"top_left_y":1409,"width":1604,"height":50},"line":26,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4871b751774d4d9bbe1ca1b8a24277dd","type":"text","conversion_output":true,"text":"response to therapy, including change in pain and function and any adverse effects. A plan for","text_display":" response to therapy, including change in pain and function and any adverse effects. A plan for","confidence":1,"confidence_rate":1},{"cnt":[[180,1452],[1846,1452],[1846,1504],[180,1504]],"region":{"top_left_x":180,"top_left_y":1452,"width":1666,"height":52},"line":27,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"535da5a4745c4461a3dd739be788ceb3","type":"text","conversion_output":true,"text":"continuation or discontinuation of study therapy will be developed for each patient on an individual","text_display":" continuation or discontinuation of study therapy will be developed for each patient on an individual","confidence":1,"confidence_rate":1},{"cnt":[[180,1500],[1826,1500],[1826,1549],[180,1549]],"region":{"top_left_x":180,"top_left_y":1499,"width":1647,"height":51},"line":28,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b1d50665381a48a5b035b366b1535769","type":"text","conversion_output":true,"text":"basis. The clinical pharmacist will facilitate tapering of opioids at the end of the study if, based on","text_display":" basis. The clinical pharmacist will facilitate tapering of opioids at the end of the study if, based on","confidence":0.99951171875,"confidence_rate":0.9999954777833909},{"cnt":[[180,1543],[1811,1543],[1811,1592],[180,1592]],"region":{"top_left_x":180,"top_left_y":1542,"width":1632,"height":50},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0292176266e74d8e9b21964fe2efb5f1","type":"text","conversion_output":true,"text":"individual patient outcomes, discontinuation of study opioids is determined to be the appropriate","text_display":" individual patient outcomes, discontinuation of study opioids is determined to be the appropriate","confidence":1,"confidence_rate":1},{"cnt":[[180,1590],[316,1590],[316,1631],[180,1631]],"region":{"top_left_x":180,"top_left_y":1589,"width":136,"height":42},"line":30,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"03565d9361164812a4d8a7ec1321fd2a","type":"text","conversion_output":true,"text":"course.","text_display":" course.","confidence":1,"confidence_rate":1},{"cnt":[[176,1644],[836,1644],[836,1704],[176,1704]],"region":{"top_left_x":176,"top_left_y":1643,"width":660,"height":61},"line":31,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a014cbd7f3bd427e89ee76435a0c3593","type":"section_header","conversion_output":false,"children_ids":["a61234d758f744f39f4ab4ee19e95b15"],"text":"","text_display":""},{"cnt":[[185,1650],[827,1650],[827,1699],[185,1699]],"region":{"top_left_x":184,"top_left_y":1650,"width":644,"height":50},"line":32,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a61234d758f744f39f4ab4ee19e95b15","type":"text","conversion_output":true,"parent_id":"a014cbd7f3bd427e89ee76435a0c3593","text":"F. Automated symptom monitoring","text_display":"\n\n\\section*{F. Automated symptom monitoring}","confidence":1,"confidence_rate":1},{"cnt":[[180,1695],[1867,1695],[1867,1745],[180,1745]],"region":{"top_left_x":180,"top_left_y":1695,"width":1687,"height":50},"line":33,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"af9d3a49415344679aab12baf864deb1","type":"text","conversion_output":true,"text":"Interval reassessment of pain, adverse effects, and adherence will be done by automated symptom","text_display":"\n\nInterval reassessment of pain, adverse effects, and adherence will be done by automated symptom","confidence":1,"confidence_rate":1},{"cnt":[[180,1738],[1897,1738],[1897,1790],[180,1790]],"region":{"top_left_x":180,"top_left_y":1738,"width":1718,"height":52},"line":34,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ad5ffe92efeb4ea0b4665373e7f7cf0d","type":"text","conversion_output":true,"text":"monitoring, through interactive voice recorded (IVR) phone calls. Automated symptom monitoring will","text_display":" monitoring, through interactive voice recorded (IVR) phone calls. Automated symptom monitoring will","confidence":1,"confidence_rate":1},{"cnt":[[180,1783],[1938,1783],[1938,1830],[180,1830]],"region":{"top_left_x":180,"top_left_y":1783,"width":1758,"height":48},"line":35,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5d14042cfab8495b879d96ca657570e3","type":"text","conversion_output":true,"text":"be scheduled to occur prior to in-person study clinic visits and at the time of medication refill or renewal.","text_display":" be scheduled to occur prior to in-person study clinic visits and at the time of medication refill or renewal.","confidence":0.99560546875,"confidence_rate":0.9999613672762195},{"cnt":[[180,1826],[1931,1826],[1931,1876],[180,1876]],"region":{"top_left_x":180,"top_left_y":1826,"width":1752,"height":50},"line":36,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"789a210c1b204b42b0f63e5b9e9571e9","type":"text","conversion_output":true,"text":"It can also be scheduled at interval time points as customized by the care manager, such as \\(1-2\\) weeks","text_display":" It can also be scheduled at interval time points as customized by the care manager, such as \\(1-2\\) weeks","confidence":0.9795200824737549,"confidence_rate":0.9998101782108493},{"cnt":[[180,1869],[1921,1869],[1921,1919],[180,1919]],"region":{"top_left_x":180,"top_left_y":1869,"width":1741,"height":50},"line":37,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"60c7ef47e5d348c19b80b6e447d6dbe0","type":"text","conversion_output":true,"text":"after a medication change. The automated symptom monitoring assessment will include the following","text_display":" after a medication change. The automated symptom monitoring assessment will include the following","confidence":1,"confidence_rate":1},{"cnt":[[180,1914],[1876,1914],[1876,1962],[180,1962]],"region":{"top_left_x":180,"top_left_y":1914,"width":1696,"height":48},"line":38,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ea112d17048a49d68d377bbdd92349d1","type":"text","conversion_output":true,"text":"abbreviated measures: (a) the 3 -item PEG, a brief measure of pain intensity and interference that is","text_display":" abbreviated measures: (a) the 3 -item PEG, a brief measure of pain intensity and interference that is","confidence":1,"confidence_rate":1},{"cnt":[[180,1955],[1914,1955],[1914,2007],[180,2007]],"region":{"top_left_x":180,"top_left_y":1955,"width":1735,"height":52},"line":39,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"717fc01f44e04e26acdd756e7cfd9fe3","type":"text","conversion_output":true,"text":"responsive to change; \\({ }^{; 1,22}\\) (b) a patient global impression of change rating; \\({ }^{23}\\) and (c) the PHQ-4, which","text_display":" responsive to change; \\({ }^{; 1,22}\\) (b) a patient global impression of change rating; \\({ }^{23}\\) and (c) the PHQ-4, which","confidence":0.5608266437386797,"confidence_rate":0.9955610855853663},{"cnt":[[180,1998],[1914,1998],[1914,2052],[180,2052]],"region":{"top_left_x":180,"top_left_y":1998,"width":1735,"height":54},"line":40,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f1958401a70344a9adf8d20714fb7b13","type":"text","conversion_output":true,"text":"includes the depression screening items of the widely used PHQ-2 plus two anxiety screening items. \\({ }^{24}\\)","text_display":" includes the depression screening items of the widely used PHQ-2 plus two anxiety screening items. \\({ }^{24}\\)","confidence":1,"confidence_rate":1},{"cnt":[[180,2045],[1927,2045],[1927,2095],[180,2095]],"region":{"top_left_x":180,"top_left_y":2045,"width":1748,"height":50},"line":41,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"74d114622f554ace9cb05cc0169b3a09","type":"text","conversion_output":true,"text":"Also included will be single questions about medication underuse, overuse, and side effects, as well as","text_display":" Also included will be single questions about medication underuse, overuse, and side effects, as well as","confidence":1,"confidence_rate":1},{"cnt":[[180,2090],[1886,2090],[1886,2138],[180,2138]],"region":{"top_left_x":180,"top_left_y":2090,"width":1707,"height":48},"line":42,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"149203ac1ea4495185d55b8318e0c241","type":"text","conversion_output":true,"text":"the option to send a request for contact by the care manager. Participants who do not complete their","text_display":" the option to send a request for contact by the care manager. Participants who do not complete their","confidence":1,"confidence_rate":1},{"cnt":[[180,2136],[1846,2136],[1846,2185],[180,2185]],"region":{"top_left_x":180,"top_left_y":2135,"width":1666,"height":50},"line":43,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"416c9bd7b0cd4fa48d19015b9b8fd4a5","type":"text","conversion_output":true,"text":"scheduled automated assessments will receive a reminder; if this fails, they will have the option of","text_display":" scheduled automated assessments will receive a reminder; if this fails, they will have the option of","confidence":1,"confidence_rate":1},{"cnt":[[180,2179],[1457,2179],[1457,2228],[180,2228]],"region":{"top_left_x":180,"top_left_y":2178,"width":1277,"height":50},"line":44,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b518d01923be45198815998ecd909f3d","type":"text","conversion_output":true,"text":"completing a paper version of the assessment at the time of their next visit.","text_display":" completing a paper version of the assessment at the time of their next visit.","confidence":0.9990234375,"confidence_rate":0.9999880849533282},{"cnt":[[180,2243],[1858,2243],[1858,2292],[180,2292]],"region":{"top_left_x":180,"top_left_y":2242,"width":1679,"height":51},"line":45,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"26146a7c5a8449cd93c0b81d9032aab3","type":"text","conversion_output":true,"text":"Automated symptom monitoring by IVR will be used solely as a clinical tool for the pharmacist care","text_display":"\nAutomated symptom monitoring by IVR will be used solely as a clinical tool for the pharmacist care","confidence":1,"confidence_rate":1},{"cnt":[[180,2286],[1858,2286],[1858,2335],[180,2335]],"region":{"top_left_x":180,"top_left_y":2285,"width":1679,"height":51},"line":46,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"13eac24276fd45f5bc35d167c25fc292","type":"text","conversion_output":true,"text":"manager and supervising clinician investigators to monitor and adjust therapy. It will not be used to","text_display":" manager and supervising clinician investigators to monitor and adjust therapy. It will not be used to","confidence":1,"confidence_rate":1},{"cnt":[[180,2329],[1876,2329],[1876,2378],[180,2378]],"region":{"top_left_x":180,"top_left_y":2328,"width":1696,"height":51},"line":47,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9fd9bd5c62ef4d7fa6eec2bf6a24be5d","type":"text","conversion_output":true,"text":"assess research outcomes. The Minneapolis VA has an existing contract with Audiocare for clinical","text_display":" assess research outcomes. The Minneapolis VA has an existing contract with Audiocare for clinical","confidence":1,"confidence_rate":1},{"cnt":[[180,2374],[1901,2374],[1901,2426],[180,2426]],"region":{"top_left_x":180,"top_left_y":2374,"width":1722,"height":52},"line":48,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5f1fb4c40e8a4c58a75c4399942a7bed","type":"text","conversion_output":true,"text":"and research IVR services. Appropriate VA data security, information privacy, and research oversight","text_display":" and research IVR services. Appropriate VA data security, information privacy, and research oversight","confidence":1,"confidence_rate":1},{"cnt":[[180,2419],[982,2419],[982,2469],[180,2469]],"region":{"top_left_x":180,"top_left_y":2419,"width":802,"height":50},"line":49,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e42df0350662496d96a529c174278d5f","type":"text","conversion_output":true,"text":"bodies have approved IVR use in prior studies.","text_display":" bodies have approved IVR use in prior studies.","confidence":0.99951171875,"confidence_rate":0.9999904235654993},{"cnt":[[180,2578],[1257,2578],[1257,2632],[180,2632]],"region":{"top_left_x":180,"top_left_y":2578,"width":1077,"height":54},"line":50,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4d92ce48694d4bdeb1a1610fdecdfc84","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1839,2625],[1882,2625],[1882,2658],[1839,2658]],"region":{"top_left_x":1839,"top_left_y":2625,"width":44,"height":33},"line":51,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"9c1cd7ce554e49fb9225f0232fd70c01","type":"page_info","conversion_output":false,"text":"10","text_display":"","confidence":0.99951171875,"confidence_rate":0.9997558295653994}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-11","page":11,"lines":[{"cnt":[[176,245],[862,245],[862,303],[176,303]],"region":{"top_left_x":176,"top_left_y":244,"width":686,"height":59},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"80d9caa92bb14b0f8af9ae5756efd30d","type":"section_header","conversion_output":false,"children_ids":["325c3a31248348359ec3f3c05b2fc655"],"text":"","text_display":""},{"cnt":[[180,249],[855,249],[855,299],[180,299]],"region":{"top_left_x":180,"top_left_y":249,"width":676,"height":50},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"325c3a31248348359ec3f3c05b2fc655","type":"text","conversion_output":true,"parent_id":"80d9caa92bb14b0f8af9ae5756efd30d","text":"G. Analgesic prescribing strategies","text_display":"\n\n\\section*{G. Analgesic prescribing strategies}","confidence":1,"confidence_rate":1},{"cnt":[[180,294],[1800,294],[1800,342],[180,342]],"region":{"top_left_x":180,"top_left_y":294,"width":1621,"height":48},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8eef6f4667ac433cba3be98cfa405ec8","type":"text","conversion_output":true,"text":"The analgesic prescribing strategies in this proposal were developed based on evidence-based","text_display":"\n\nThe analgesic prescribing strategies in this proposal were developed based on evidence-based","confidence":1,"confidence_rate":1},{"cnt":[[180,337],[1820,337],[1820,387],[180,387]],"region":{"top_left_x":180,"top_left_y":337,"width":1640,"height":50},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"1333a70f49544588a20b9fb708495189","type":"text","conversion_output":true,"text":"recommendations from published disease and drug class-specific guidelines, \\({ }^{5 ; 6 ; 25 ; 26 ; 27}\\) systematic","text_display":" recommendations from published disease and drug class-specific guidelines, \\({ }^{5 ; 6 ; 25 ; 26 ; 27}\\) systematic","confidence":0.9970703125,"confidence_rate":0.9999740358465011},{"cnt":[[180,380],[1906,380],[1906,432],[180,432]],"region":{"top_left_x":180,"top_left_y":380,"width":1726,"height":52},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f14e741b1d6f494fb399795f0cf81943","type":"text","conversion_output":true,"text":"reviews, \\({ }^{3 ; 4 ; 28-30}\\) and our own published reviews \\({ }^{31 ; 32}\\) and refined through our experience with algorithm-","text_display":" reviews, \\({ }^{3 ; 4 ; 28-30}\\) and our own published reviews \\({ }^{31 ; 32}\\) and refined through our experience with algorithm","confidence":0.99609375,"confidence_rate":0.9999698935353538},{"cnt":[[183,425],[1843,425],[1843,475],[183,475]],"region":{"top_left_x":182,"top_left_y":425,"width":1662,"height":50},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b8cf7c82a5f9460db29ad296fca8d06c","type":"text","conversion_output":true,"text":"based pain medication adjustment in the clinical trials at the Roudebush VA. Each medication has","text_display":"based pain medication adjustment in the clinical trials at the Roudebush VA. Each medication has","confidence":1,"confidence_rate":1},{"cnt":[[180,471],[1901,471],[1901,518],[180,518]],"region":{"top_left_x":180,"top_left_y":470,"width":1722,"height":48},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"42298c7bf03e4ec992ba9145ac04ee0e","type":"text","conversion_output":true,"text":"demonstrated efficacy for relevant indications from randomized clinical trials and, in most cases, from","text_display":" demonstrated efficacy for relevant indications from randomized clinical trials and, in most cases, from","confidence":1,"confidence_rate":1},{"cnt":[[183,516],[1884,516],[1884,561],[183,561]],"region":{"top_left_x":182,"top_left_y":515,"width":1703,"height":46},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3c9935d75c064308abfa0d890bc6b053","type":"text","conversion_output":true,"text":"meta-analyses or systematic reviews of multiple RCTs. Direct comparative data are not available for","text_display":" meta-analyses or systematic reviews of multiple RCTs. 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Decisions about whether to continue a current medication or change to another","text_display":" inherently subjective. 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SPACE will use a structured decision-making","text_display":" pain and pain medications, and personal coping styles. SPACE will use a structured decision-making","confidence":1,"confidence_rate":1},{"cnt":[[183,1478],[1841,1478],[1841,1525],[183,1525]],"region":{"top_left_x":182,"top_left_y":1478,"width":1660,"height":48},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"cff7730e27ab4c5b8034a2c2d7299940","type":"text","conversion_output":true,"text":"approach to consider patient preferences along with results of symptom monitoring. The two main","text_display":" approach to consider patient preferences along with results of symptom monitoring. The two main","confidence":1,"confidence_rate":1},{"cnt":[[183,1521],[1940,1521],[1940,1571],[183,1571]],"region":{"top_left_x":182,"top_left_y":1521,"width":1759,"height":50},"line":30,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"679a4323709445ecaa4626ed12aa5deb","type":"text","conversion_output":true,"text":"considerations included in the algorithm for medication change decisions (Figure 4) are the following: 1)","text_display":" considerations included in the algorithm for medication change decisions (Figure 4) are the following: 1)","confidence":1,"confidence_rate":1},{"cnt":[[183,1566],[1944,1566],[1944,1613],[183,1613]],"region":{"top_left_x":182,"top_left_y":1566,"width":1763,"height":48},"line":31,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4b0ce33b21094c74b24c99a91f07e17d","type":"text","conversion_output":true,"text":"presence of pain response, defined as improvement in both PEG score and patient global impression of","text_display":" presence of pain response, defined as improvement in both PEG score and patient global impression of","confidence":1,"confidence_rate":1},{"cnt":[[180,1611],[1317,1611],[1317,1659],[180,1659]],"region":{"top_left_x":180,"top_left_y":1611,"width":1137,"height":48},"line":32,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7c8239b1b57e41908a734eb04913695f","type":"text","conversion_output":true,"text":"change, and 2 ) whether the patient desires change in medications.","text_display":" change, and 2 ) whether the patient desires change in medications.","confidence":0.5378961563110352,"confidence_rate":0.9916554196244596},{"cnt":[[180,2578],[1257,2578],[1257,2632],[180,2632]],"region":{"top_left_x":180,"top_left_y":2578,"width":1077,"height":54},"line":33,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f04aa52eff964dabb9303724701be006","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1839,2625],[1882,2625],[1882,2658],[1839,2658]],"region":{"top_left_x":1839,"top_left_y":2625,"width":44,"height":33},"line":34,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"e90eff8d0929462ba3a34c577d69b8c8","type":"page_info","conversion_output":false,"text":"11","text_display":"","confidence":1,"confidence_rate":1}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-12","page":12,"lines":[{"cnt":[[185,249],[1149,249],[1149,299],[185,299]],"region":{"top_left_x":184,"top_left_y":249,"width":966,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2766bc8e8d2c45efb16a96ea974b4efd","type":"figure_label","conversion_output":false,"text":"Figure 4: Algorithm for medication change decisions","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[206,322],[1457,322],[1457,1491],[206,1491]],"region":{"top_left_x":206,"top_left_y":322,"width":1251,"height":1170},"line":2,"column":0,"font_size":28,"is_printed":true,"is_handwritten":false,"id":"d81da32561314a20a2f253b52471a198","type":"diagram","conversion_output":true,"selected_labels":["2766bc8e8d2c45efb16a96ea974b4efd"],"text":"","text_display":"\n\n\\begin{figure}\n\\captionsetup{labelformat=empty}\n\\caption{Figure 4: Algorithm for medication change decisions}\n\\includegraphics[alt={},max width=\\textwidth]{https://cdn.mathpix.com/cropped/e4ef1058-bc42-42cb-89c4-03db8e1cab4d-12.jpg?height=1170&width=1251&top_left_y=322&top_left_x=206}\n\\end{figure}"},{"cnt":[[180,1521],[947,1521],[947,1577],[180,1577]],"region":{"top_left_x":180,"top_left_y":1521,"width":768,"height":56},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"666a0a5dca8146feb641c663b6f55b89","type":"section_header","conversion_output":false,"children_ids":["f19eee6668214bbcbe7fa344085896e3"],"text":"","text_display":""},{"cnt":[[185,1525],[943,1525],[943,1573],[185,1573]],"region":{"top_left_x":184,"top_left_y":1525,"width":760,"height":48},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f19eee6668214bbcbe7fa344085896e3","type":"text","conversion_output":true,"parent_id":"666a0a5dca8146feb641c663b6f55b89","text":"G1. Opioid-intensive prescribing strategy","text_display":"\n\n\\section*{G1. Opioid-intensive prescribing strategy}","confidence":1,"confidence_rate":1},{"cnt":[[185,1571],[1850,1571],[1850,1618],[185,1618]],"region":{"top_left_x":184,"top_left_y":1570,"width":1666,"height":48},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4d2784ef676d4f979027ca5f17f80a72","type":"text","conversion_output":true,"text":"Evidence for relative effectiveness of various opioid regimens, including different drugs and dosing","text_display":"\n\nEvidence for relative effectiveness of various opioid regimens, including different drugs and dosing","confidence":1,"confidence_rate":1},{"cnt":[[183,1611],[1897,1611],[1897,1661],[183,1661]],"region":{"top_left_x":182,"top_left_y":1611,"width":1716,"height":50},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8d440ef1916740a993a807dc5f1f0f58","type":"text","conversion_output":true,"text":"schedules, is extremely limited; \\({ }^{36}\\) therefore, opioid initiation and adjustment will be guided by VA/DoD","text_display":" schedules, is extremely limited; \\({ }^{36}\\) therefore, opioid initiation and adjustment will be guided by VA/DoD","confidence":0.9960966110229492,"confidence_rate":0.9999671347662701},{"cnt":[[183,1659],[1837,1659],[1837,1704],[183,1704]],"region":{"top_left_x":182,"top_left_y":1658,"width":1655,"height":46},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f4121c3e601b4b059ad005baf5a709df","type":"text","conversion_output":true,"text":"guideline-concordant principles, applied in a personalized manner. \\({ }^{6}\\) Figure 5 outlines principles of","text_display":" guideline-concordant principles, applied in a personalized manner. \\({ }^{6}\\) Figure 5 outlines principles of","confidence":0.9990234375,"confidence_rate":0.9999917200372636},{"cnt":[[183,1702],[1051,1702],[1051,1749],[183,1749]],"region":{"top_left_x":182,"top_left_y":1701,"width":869,"height":48},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5254019893714babb2f651d93b9dced7","type":"text","conversion_output":true,"text":"opioid adjustment and stepped medication options.","text_display":" opioid adjustment and stepped medication options.","confidence":1,"confidence_rate":1},{"cnt":[[185,1766],[1927,1766],[1927,1815],[185,1815]],"region":{"top_left_x":184,"top_left_y":1766,"width":1744,"height":50},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a8902a40514c4cbb9e442085d39686c0","type":"text","conversion_output":true,"text":"Opioid medications will be titrated gradually, with frequent reassessment, until treatment goals are met,","text_display":"\nOpioid medications will be titrated gradually, with frequent reassessment, until treatment goals are met,","confidence":1,"confidence_rate":1},{"cnt":[[183,1811],[1899,1811],[1899,1858],[183,1858]],"region":{"top_left_x":182,"top_left_y":1811,"width":1718,"height":48},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0d3055a5a9d14726aa1a5f8b32cb1b4d","type":"text","conversion_output":true,"text":"dosing is limited by adverse effects, or a morphine equivalent (MEq) daily dose of 200 mg is reached.","text_display":" dosing is limited by adverse effects, or a morphine equivalent (MEq) daily dose of 200 mg is reached.","confidence":0.99951171875,"confidence_rate":0.9999956000051925},{"cnt":[[183,1856],[1863,1856],[1863,1901],[183,1901]],"region":{"top_left_x":182,"top_left_y":1856,"width":1681,"height":46},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b5a55e494c964a48a0c4150ac73946c0","type":"text","conversion_output":true,"text":"The issue of opioid dosing limits is highly controversial and no well-accepted upper dosing limit has","text_display":" The issue of opioid dosing limits is highly controversial and no well-accepted upper dosing limit has","confidence":1,"confidence_rate":1},{"cnt":[[183,1899],[1841,1899],[1841,1944],[183,1944]],"region":{"top_left_x":182,"top_left_y":1899,"width":1660,"height":46},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"1d168b30b5914abda84489a5da74fc2f","type":"text","conversion_output":true,"text":"been established; however, evidence for use of high-dose opioids is limited and reports suggest a","text_display":" been established; however, evidence for use of high-dose opioids is limited and reports suggest a","confidence":1,"confidence_rate":1},{"cnt":[[183,1942],[1760,1942],[1760,1992],[183,1992]],"region":{"top_left_x":182,"top_left_y":1942,"width":1578,"height":50},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"92175c5289624f62ac82ab9f23b334dd","type":"text","conversion_output":true,"text":"positive relationship between dose and serious adverse events. \\({ }^{37}\\) Current VA/DoD guidelines","text_display":" positive relationship between dose and serious adverse events. \\({ }^{37}\\) Current VA/DoD guidelines","confidence":1,"confidence_rate":1},{"cnt":[[183,1985],[1871,1985],[1871,2035],[183,2035]],"region":{"top_left_x":182,"top_left_y":1985,"width":1690,"height":50},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a3ff5c697c534c66be31c6c1fed046b3","type":"text","conversion_output":true,"text":"recommend dosing based on patient need, not on predetermined maximal dose. \\({ }^{6}\\) In contrast, opioid","text_display":" recommend dosing based on patient need, not on predetermined maximal dose. \\({ }^{6}\\) In contrast, opioid","confidence":1,"confidence_rate":1},{"cnt":[[183,2030],[1893,2030],[1893,2078],[183,2078]],"region":{"top_left_x":182,"top_left_y":2030,"width":1711,"height":48},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c605bc0c5bf74b3abcd0c274efe98786","type":"text","conversion_output":true,"text":"prescribing guidelines from a Washington State interagency group recommend specialty consultation","text_display":" prescribing guidelines from a Washington State interagency group recommend specialty consultation","confidence":0.99951171875,"confidence_rate":0.999995211771286},{"cnt":[[180,2073],[1863,2073],[1863,2121],[180,2121]],"region":{"top_left_x":180,"top_left_y":2073,"width":1683,"height":48},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b21d0bb675d544ca9fc7f617f46a33fc","type":"text","conversion_output":true,"text":"for doses \\(>120 mg /\\) day. \\({ }^{38}\\) Given these data and remaining uncertainties, we will not increase doses","text_display":" for doses \\(>120 mg /\\) day. \\({ }^{38}\\) Given these data and remaining uncertainties, we will not increase doses","confidence":0.99462890625,"confidence_rate":0.9999547441338877},{"cnt":[[183,2118],[1927,2118],[1927,2168],[183,2168]],"region":{"top_left_x":182,"top_left_y":2118,"width":1746,"height":50},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"42e8a8bb7fc14a0cbebf5264146f1cb2","type":"text","conversion_output":true,"text":"beyond \\(200 MEq mg /\\) day in this study. Participants reaching this limit may be rotated to another opioid,","text_display":" beyond \\(200 MEq mg /\\) day in this study. 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guidelines","text_display":" although evidence for their effectiveness in preventing opioid misuse is limited. \\({ }^{39}\\) VA/DoD guidelines","confidence":0.99609375,"confidence_rate":0.9999665484285664},{"cnt":[[183,1482],[1871,1482],[1871,1528],[183,1528]],"region":{"top_left_x":182,"top_left_y":1482,"width":1690,"height":46},"line":37,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"67ead77018314d2d9a6faacc7c68df9b","type":"text","conversion_output":true,"text":"recommend reviewing a written Opioid Pain Care Agreement before initiating opioid therapy. \\({ }^{6}\\) In the","text_display":" recommend reviewing a written Opioid Pain Care Agreement before initiating opioid therapy. \\({ }^{6}\\) In the","confidence":0.99951171875,"confidence_rate":0.9999957157942815},{"cnt":[[183,1525],[1811,1525],[1811,1573],[183,1573]],"region":{"top_left_x":182,"top_left_y":1525,"width":1630,"height":48},"line":38,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9d3bdbedd7904dd38b78cd3d500ddb87","type":"text","conversion_output":true,"text":"proposed trial, a Pain Care Agreement will be employed in both intervention arms (regardless of","text_display":" proposed trial, a Pain Care Agreement will be employed in both intervention arms (regardless of","confidence":1,"confidence_rate":1},{"cnt":[[185,1571],[1747,1571],[1747,1618],[185,1618]],"region":{"top_left_x":184,"top_left_y":1570,"width":1563,"height":48},"line":39,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"617e6573b4ad48fb9e1fa41af33853b5","type":"text","conversion_output":true,"text":"medication type prescribed) as a way to structure medication education and clarify roles and","text_display":" medication type prescribed) as a way to structure medication education and clarify roles and","confidence":1,"confidence_rate":1},{"cnt":[[183,1611],[1901,1611],[1901,1661],[183,1661]],"region":{"top_left_x":182,"top_left_y":1611,"width":1720,"height":50},"line":40,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"722a4328d5a549cd91098d89f73f5591","type":"text","conversion_output":true,"text":"responsibilities. At the time of study enrollment, the SPACE Pain Care Agreement will be entered into","text_display":" responsibilities. At the time of study enrollment, the SPACE Pain Care Agreement will be entered into","confidence":1,"confidence_rate":1},{"cnt":[[183,1659],[1899,1659],[1899,1704],[183,1704]],"region":{"top_left_x":182,"top_left_y":1658,"width":1718,"height":46},"line":41,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7f7a745a62df4d2b88d68bcdbb0976d7","type":"text","conversion_output":true,"text":"the patient's CPRS medical record and copies will be provided to the patient and his/her primary care","text_display":" the patient's CPRS medical record and copies will be provided to the patient and his/her primary care","confidence":1,"confidence_rate":1},{"cnt":[[185,1702],[1807,1702],[1807,1747],[185,1747]],"region":{"top_left_x":184,"top_left_y":1701,"width":1623,"height":46},"line":42,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5c2ec9f014794b24964f6964f005c550","type":"text","conversion_output":true,"text":"provider. Violations of the agreement will be handled according to the nature of the behavior, as","text_display":" provider. Violations of the agreement will be handled according to the nature of the behavior, as","confidence":1,"confidence_rate":1},{"cnt":[[183,1745],[574,1745],[574,1785],[183,1785]],"region":{"top_left_x":182,"top_left_y":1744,"width":392,"height":42},"line":43,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3a84b51b43094b16bfdcddc052f776fd","type":"text","conversion_output":true,"text":"described in Section J.","text_display":" described in Section J.","confidence":1,"confidence_rate":1},{"cnt":[[180,1809],[1841,1809],[1841,1858],[180,1858]],"region":{"top_left_x":180,"top_left_y":1808,"width":1662,"height":51},"line":44,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f6566fd3f8db40da92a5cdded0e8e996","type":"text","conversion_output":true,"text":"At each intervention visit, use of non-study medications, over-the-counter medications, and herbal","text_display":"\n\nAt each intervention visit, use of non-study medications, over-the-counter medications, and herbal","confidence":1,"confidence_rate":1},{"cnt":[[180,1852],[1850,1852],[1850,1901],[180,1901]],"region":{"top_left_x":180,"top_left_y":1851,"width":1670,"height":51},"line":45,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"75ea3cef0906418eb95c0066342e3c7b","type":"text","conversion_output":true,"text":"therapies or supplements will be evaluated, along with risk of drug interactions. Participants will be","text_display":" therapies or supplements will be evaluated, along with risk of drug interactions. Participants will be","confidence":1,"confidence_rate":1},{"cnt":[[183,1899],[1931,1899],[1931,1944],[183,1944]],"region":{"top_left_x":182,"top_left_y":1899,"width":1750,"height":46},"line":46,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"be5db3a40c57405fbc66f1ad81425572","type":"text","conversion_output":true,"text":"informed of potential interactions and study therapy will be adjusted as needed to avoid or minimize the","text_display":" informed of potential interactions and study therapy will be adjusted as needed to avoid or minimize the","confidence":1,"confidence_rate":1},{"cnt":[[183,1942],[1919,1942],[1919,1987],[183,1987]],"region":{"top_left_x":182,"top_left_y":1942,"width":1737,"height":46},"line":47,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d1b2f163f9084cf8987beaf7469a5906","type":"text","conversion_output":true,"text":"likelihood of adverse drug interactions and maximize therapeutic response. A number of medication or","text_display":" likelihood of adverse drug interactions and maximize therapeutic response. A number of medication or","confidence":1,"confidence_rate":1},{"cnt":[[183,1985],[1742,1985],[1742,2032],[183,2032]],"region":{"top_left_x":182,"top_left_y":1985,"width":1561,"height":48},"line":48,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ffa1facb439c429fa138aee0c6cd6626","type":"text","conversion_output":true,"text":"class-specific safety rules will also be employed, including but not limited to the following: 1)","text_display":" class-specific safety rules will also be employed, including but not limited to the following: 1)","confidence":0.78515625,"confidence_rate":0.9976315099326856},{"cnt":[[180,2030],[1940,2030],[1940,2078],[180,2078]],"region":{"top_left_x":180,"top_left_y":2030,"width":1761,"height":48},"line":49,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0ac3bfa51517467f8cfae1cc8d28c754","type":"text","conversion_output":true,"text":"Acetaminophen will be limited to \\(\\leq 2 gm /\\) day in liver disease or regular alcohol use ( \\(\\geq 3\\) drinks per day or","text_display":" Acetaminophen will be limited to \\(\\leq 2 gm /\\) day in liver disease or regular alcohol use ( \\(\\geq 3\\) drinks per day or","confidence":0.986328125,"confidence_rate":0.9998843243735954},{"cnt":[[180,2073],[1858,2073],[1858,2121],[180,2121]],"region":{"top_left_x":180,"top_left_y":2073,"width":1679,"height":48},"line":50,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6fd34b9672d044bfa3d1873ba4fb9e1a","type":"text","conversion_output":true,"text":"\\(\\geq 5\\) drinks episodically) and \\(\\leq 4 gm /\\) day in other patients. 2) Patients considered for an NSAID must","text_display":" \\(\\geq 5\\) drinks episodically) and \\(\\leq 4 gm /\\) day in other patients. 2) Patients considered for an NSAID must","confidence":0.8015734670916572,"confidence_rate":0.9979350447807681},{"cnt":[[183,2118],[1841,2118],[1841,2163],[183,2163]],"region":{"top_left_x":182,"top_left_y":2118,"width":1660,"height":46},"line":51,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"22e64e6c547e4bde8f998d1c2f08c442","type":"text","conversion_output":true,"text":"have had a creatinine within 6 months of initiation. Patients with estimated GFR \\(<60\\), heart failure,","text_display":" have had a creatinine within 6 months of initiation. Patients with estimated GFR \\(<60\\), heart failure,","confidence":0.9970703125,"confidence_rate":0.9999738040267384},{"cnt":[[183,2161],[1893,2161],[1893,2209],[183,2209]],"region":{"top_left_x":182,"top_left_y":2161,"width":1711,"height":48},"line":52,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c1d92e593e7a4ab996cfcc8e07bce52f","type":"text","conversion_output":true,"text":"peptic ulcer disease, or liver failure will not be started on an NSAID. Patients initiating an NSAID who","text_display":" peptic ulcer disease, or liver failure will not be started on an NSAID. Patients initiating an NSAID who","confidence":1,"confidence_rate":1},{"cnt":[[183,2204],[1863,2204],[1863,2254],[183,2254]],"region":{"top_left_x":182,"top_left_y":2204,"width":1681,"height":50},"line":53,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"145c73af1d16407987cfd488f9afbb7c","type":"text","conversion_output":true,"text":"are older than 65, have diabetes, or use a diuretic will have a follow-up creatinine within 4-8 weeks.","text_display":" are older than 65, have diabetes, or use a diuretic will have a follow-up creatinine within 4-8 weeks.","confidence":0.54248046875,"confidence_rate":0.9943003870528524},{"cnt":[[183,2247],[1880,2247],[1880,2297],[183,2297]],"region":{"top_left_x":182,"top_left_y":2247,"width":1698,"height":50},"line":54,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"dba519b952f14558a310342171a43ac7","type":"text","conversion_output":true,"text":"Gastrointestinal prophylaxis will be prescribed in concordance with current guidelines. \\({ }^{40}\\) 3) Tramadol","text_display":" Gastrointestinal prophylaxis will be prescribed in concordance with current guidelines. \\({ }^{40}\\) 3) Tramadol","confidence":0.9980475902557373,"confidence_rate":0.9999832965653107},{"cnt":[[180,2295],[1798,2295],[1798,2340],[180,2340]],"region":{"top_left_x":180,"top_left_y":2294,"width":1619,"height":46},"line":55,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"61011ae15df94582a4185315a5d04455","type":"text","conversion_output":true,"text":"will not be used in patients with a history of seizures. 4) Patients with a history of heart disease,","text_display":" will not be used in patients with a history of seizures. 4) Patients with a history of heart disease,","confidence":1,"confidence_rate":1},{"cnt":[[183,2337],[1852,2337],[1852,2383],[183,2383]],"region":{"top_left_x":182,"top_left_y":2337,"width":1670,"height":46},"line":56,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"11d6efbaa21842d48d9a6f4d123ecabb","type":"text","conversion_output":true,"text":"arrhythmia, or syncope will not be started on methadone. Patients considered for methadone must","text_display":" arrhythmia, or syncope will not be started on methadone. Patients considered for methadone must","confidence":1,"confidence_rate":1},{"cnt":[[183,2380],[1794,2380],[1794,2430],[183,2430]],"region":{"top_left_x":182,"top_left_y":2380,"width":1612,"height":50},"line":57,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d6cdc89fc1844dd0800cd65b319381e2","type":"text","conversion_output":true,"text":"have had an electrocardiogram (ECG) within 3 months. If the baseline QTc interval is \\(>450 ms\\),","text_display":" have had an electrocardiogram (ECG) within 3 months. If the baseline QTc interval is \\(>450 ms\\),","confidence":0.99951171875,"confidence_rate":0.9999954355197808},{"cnt":[[183,2426],[1884,2426],[1884,2473],[183,2473]],"region":{"top_left_x":182,"top_left_y":2425,"width":1703,"height":48},"line":58,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c5c37e55da6441c48cf39a02f176a827","type":"text","conversion_output":true,"text":"methadone will not be started. Patients receiving methadone will receive a follow-up ECG 3-6 weeks","text_display":" methadone will not be started. Patients receiving methadone will receive a follow-up ECG 3-6 weeks","confidence":0.94677734375,"confidence_rate":0.9994691571516393},{"cnt":[[185,2578],[1257,2578],[1257,2628],[185,2628]],"region":{"top_left_x":184,"top_left_y":2578,"width":1073,"height":50},"line":59,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8e95214da0a548649e566f180dca29fa","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1843,2625],[1886,2625],[1886,2662],[1843,2662]],"region":{"top_left_x":1843,"top_left_y":2625,"width":44,"height":37},"line":60,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"1c29f98a122d4d4181c24764a9bd9593","type":"page_info","conversion_output":false,"text":"14","text_display":"","confidence":0.9990234375,"confidence_rate":0.9995115994824673}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-15","page":15,"lines":[{"cnt":[[180,249],[1904,249],[1904,299],[180,299]],"region":{"top_left_x":180,"top_left_y":249,"width":1724,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d88fc58545944174a71ec2662c961488","type":"text","conversion_output":true,"text":"after starting therapy; if the follow-up QTc is \\(>450 ms\\) and \\(<500 ms\\), the potential risks and benefits of","text_display":"\nafter starting therapy; if the follow-up QTc is \\(>450 ms\\) and \\(<500 ms\\), the potential risks and benefits of","confidence":0.9990234375,"confidence_rate":0.9999918580360807},{"cnt":[[180,294],[1897,294],[1897,342],[180,342]],"region":{"top_left_x":180,"top_left_y":294,"width":1718,"height":48},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"442ac7611325477ba852fcbd7d81f2d3","type":"text","conversion_output":true,"text":"therapy will be reevaluated with the patient and the ECG will be monitored at least every 2 months. If","text_display":" therapy will be reevaluated with the patient and the ECG will be monitored at least every 2 months. If","confidence":1,"confidence_rate":1},{"cnt":[[180,337],[1472,337],[1472,389],[180,389]],"region":{"top_left_x":180,"top_left_y":337,"width":1292,"height":52},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"60c077afbd8a4d90bb7dba2dc708e238","type":"text","conversion_output":true,"text":"any follow-up QTc is \\(>500 ms\\), methadone will be discontinued or tapered. \\({ }^{41}\\)","text_display":" any follow-up QTc is \\(>500 ms\\), methadone will be discontinued or tapered. \\({ }^{41}\\)","confidence":1,"confidence_rate":1},{"cnt":[[180,400],[1858,400],[1858,449],[180,449]],"region":{"top_left_x":180,"top_left_y":399,"width":1679,"height":51},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"344810c2efdd48f78570510e7b3733e3","type":"text","conversion_output":true,"text":"The American Geriatrics Society (AGS) recently published updated guidelines for pain treatment in","text_display":"\nThe American Geriatrics Society (AGS) recently published updated guidelines for pain treatment in","confidence":1,"confidence_rate":1},{"cnt":[[180,447],[1871,447],[1871,496],[180,496]],"region":{"top_left_x":180,"top_left_y":446,"width":1692,"height":51},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"1b8137087fac49958e02fabd22773962","type":"text","conversion_output":true,"text":"patients who are frail or \\(\\geq 75\\) years old. \\({ }^{42}\\) For older adults, as well as participants with higher risk for","text_display":" patients who are frail or \\(\\geq 75\\) years old. \\({ }^{42}\\) For older adults, as well as participants with higher risk for","confidence":1,"confidence_rate":1},{"cnt":[[180,490],[1876,490],[1876,539],[180,539]],"region":{"top_left_x":180,"top_left_y":489,"width":1696,"height":51},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"94b2307d303541fc96e901a3ba774ea9","type":"text","conversion_output":true,"text":"adverse effects (e.g., those with chronic medical conditions), we will follow safety recommendations","text_display":" adverse effects (e.g., those with chronic medical conditions), we will follow safety recommendations","confidence":0.99951171875,"confidence_rate":0.9999953485775026},{"cnt":[[180,535],[1921,535],[1921,582],[180,582]],"region":{"top_left_x":180,"top_left_y":534,"width":1741,"height":49},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e35121003041485e91228e4b8575589a","type":"text","conversion_output":true,"text":"outlined in the AGS guidelines as well as the classic geriatrics maxim to \"start low, go slow.\" Examples","text_display":" outlined in the AGS guidelines as well as the classic geriatrics maxim to \"start low, go slow.\" Examples","confidence":1,"confidence_rate":1},{"cnt":[[180,578],[1923,578],[1923,625],[180,625]],"region":{"top_left_x":180,"top_left_y":577,"width":1743,"height":49},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6a84dd17ec90495885fc74fbb147585e","type":"text","conversion_output":true,"text":"of specific safety rules that will be employed include, but are not limited to, the following: 1) The lowest","text_display":" of specific safety rules that will be employed include, but are not limited to, the following: 1) The lowest","confidence":0.9501953125,"confidence_rate":0.9995479984364776},{"cnt":[[180,623],[1833,623],[1833,672],[180,672]],"region":{"top_left_x":180,"top_left_y":623,"width":1653,"height":50},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"19defc3b5be445e7a28a62d4484bf06b","type":"text","conversion_output":true,"text":"possible dose of a given drug will be used as the starting dose; 2 ) Nortriptyline will be titrated to a","text_display":" possible dose of a given drug will be used as the starting dose; 2 ) Nortriptyline will be titrated to a","confidence":0.5182638538444735,"confidence_rate":0.9941486966976293},{"cnt":[[180,666],[1927,666],[1927,715],[180,715]],"region":{"top_left_x":180,"top_left_y":666,"width":1748,"height":50},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"060e587aeecb4f08a1a06cda5330411d","type":"text","conversion_output":true,"text":"maximum dose of 50 mg ; amitriptyline will not be used; 3) Tramadol will be titrated to a maximum dose","text_display":" maximum dose of 50 mg ; amitriptyline will not be used; 3) Tramadol will be titrated to a maximum dose","confidence":0.99951171875,"confidence_rate":0.9999956392907748},{"cnt":[[180,709],[1923,709],[1923,758],[180,758]],"region":{"top_left_x":180,"top_left_y":708,"width":1743,"height":51},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d66ffe95c8ae45c7b2653cce06a4529e","type":"text","conversion_output":true,"text":"of 300 mg ; 4) An immediate-release opioid will be used prior to any long-acting opioid to determine the","text_display":" of 300 mg ; 4) An immediate-release opioid will be used prior to any long-acting opioid to determine the","confidence":0.97216796875,"confidence_rate":0.9997524281764436},{"cnt":[[180,752],[1919,752],[1919,804],[180,804]],"region":{"top_left_x":180,"top_left_y":751,"width":1739,"height":53},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c439427f38834448b3f2d44f36d41a63","type":"text","conversion_output":true,"text":"appropriate starting dose; 5) NSAIDs with high cyclooxygenase-2 inhibitor selectivity (e.g., diclofenac)","text_display":" appropriate starting dose; 5) NSAIDs with high cyclooxygenase-2 inhibitor selectivity (e.g., diclofenac)","confidence":0.99853515625,"confidence_rate":0.9999865513043565},{"cnt":[[180,799],[1888,799],[1888,846],[180,846]],"region":{"top_left_x":180,"top_left_y":799,"width":1709,"height":48},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0537920898d647c1a5c8036fd53c249e","type":"text","conversion_output":true,"text":"will not be used. All participants will receive closer monitoring than is available in usual practice, with","text_display":" will not be used. All participants will receive closer monitoring than is available in usual practice, with","confidence":1,"confidence_rate":1},{"cnt":[[180,842],[1863,842],[1863,892],[180,892]],"region":{"top_left_x":180,"top_left_y":842,"width":1683,"height":50},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"baff7cbf24c847468fd30b884708356b","type":"text","conversion_output":true,"text":"reassessment of pain and adverse effects after each medication change, and dose adjustments no","text_display":" reassessment of pain and adverse effects after each medication change, and dose adjustments no","confidence":1,"confidence_rate":1},{"cnt":[[180,885],[696,885],[696,930],[180,930]],"region":{"top_left_x":180,"top_left_y":885,"width":517,"height":46},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"27dc88104bf446688fc3e184c2ba239a","type":"text","conversion_output":true,"text":"more often than once a week.","text_display":" more often than once a week.","confidence":1,"confidence_rate":1},{"cnt":[[176,945],[1070,945],[1070,1003],[176,1003]],"region":{"top_left_x":176,"top_left_y":945,"width":894,"height":59},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f0fd0ef54da342d19acd141d36460fd7","type":"section_header","conversion_output":false,"children_ids":["9fdb751cd8a645108f191248d0796cca"],"text":"","text_display":""},{"cnt":[[180,950],[1063,950],[1063,999],[180,999]],"region":{"top_left_x":180,"top_left_y":949,"width":884,"height":51},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9fdb751cd8a645108f191248d0796cca","type":"text","conversion_output":true,"parent_id":"f0fd0ef54da342d19acd141d36460fd7","text":"I. Clinical management of adverse effects (AEs)","text_display":"\n\n\\section*{I. Clinical management of adverse effects (AEs)}","confidence":0.99658203125,"confidence_rate":0.9999341594108645},{"cnt":[[180,993],[1841,993],[1841,1042],[180,1042]],"region":{"top_left_x":180,"top_left_y":992,"width":1662,"height":50},"line":18,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"05276f8e1a8b42b6b60388561ca5d7ea","type":"text","conversion_output":true,"text":"Reports of side effects from automated symptom monitoring (Section F) will be followed up by the","text_display":"\n\nReports of side effects from automated symptom monitoring (Section F) will be followed up by the","confidence":0.99951171875,"confidence_rate":0.9999951643631956},{"cnt":[[180,1040],[1906,1040],[1906,1085],[180,1085]],"region":{"top_left_x":180,"top_left_y":1039,"width":1726,"height":46},"line":19,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"73e54f506da84741aae93e91a3fb0df1","type":"text","conversion_output":true,"text":"pharmacist care manager. In response to patient reports of adverse effects (AE), medications may be","text_display":" pharmacist care manager. In response to patient reports of adverse effects (AE), medications may be","confidence":1,"confidence_rate":1},{"cnt":[[180,1083],[1931,1083],[1931,1132],[180,1132]],"region":{"top_left_x":180,"top_left_y":1082,"width":1752,"height":51},"line":20,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bfad10bccb7c407c8fb2b051de6a9b74","type":"text","conversion_output":true,"text":"adjusted or clinical strategies may be employed to address ameliorable or preventable minor AEs (e.g.,","text_display":" adjusted or clinical strategies may be employed to address ameliorable or preventable minor AEs (e.g.,","confidence":0.9975600242614746,"confidence_rate":0.999977168883715},{"cnt":[[180,1126],[1854,1126],[1854,1175],[180,1175]],"region":{"top_left_x":180,"top_left_y":1125,"width":1675,"height":51},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e47767bb83fe403a8271cef547844cff","type":"text","conversion_output":true,"text":"itching). Recommendations for prevention of constipation will be provided to all participants in both","text_display":" itching). Recommendations for prevention of constipation will be provided to all participants in both","confidence":1,"confidence_rate":1},{"cnt":[[180,1171],[1796,1171],[1796,1218],[180,1218]],"region":{"top_left_x":180,"top_left_y":1170,"width":1617,"height":49},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6193c13f47e74113b06d957474800359","type":"text","conversion_output":true,"text":"study arms at the outset. Important AEs (e.g., rectal bleeding) will also be evaluated by a study","text_display":" study arms at the outset. Important AEs (e.g., rectal bleeding) will also be evaluated by a study","confidence":0.99951171875,"confidence_rate":0.999995211771286},{"cnt":[[180,1216],[1901,1216],[1901,1263],[180,1263]],"region":{"top_left_x":180,"top_left_y":1216,"width":1722,"height":48},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d802b4d2832344f1ade1d5b814cc80e5","type":"text","conversion_output":true,"text":"physician and reported to the patient's primary care provider. Potentially urgent AEs (e.g., chest pain)","text_display":" physician and reported to the patient's primary care provider. Potentially urgent AEs (e.g., chest pain)","confidence":1,"confidence_rate":1},{"cnt":[[180,1259],[1691,1259],[1691,1308],[180,1308]],"region":{"top_left_x":180,"top_left_y":1258,"width":1511,"height":51},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"41bbc034196f4dbfb3f28a0e694796bd","type":"text","conversion_output":true,"text":"will be referred for immediate evaluation in the medicine clinic or emergency department.","text_display":" will be referred for immediate evaluation in the medicine clinic or emergency department.","confidence":1,"confidence_rate":1},{"cnt":[[180,1319],[1867,1319],[1867,1369],[180,1369]],"region":{"top_left_x":180,"top_left_y":1319,"width":1687,"height":50},"line":25,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"1bef2b7557f24aaab462ec3544af4a48","type":"text","conversion_output":true,"text":"Patients with mood symptoms will be further evaluated with the PHQ-9 for depression or GAD-7 for","text_display":"\nPatients with mood symptoms will be further evaluated with the PHQ-9 for depression or GAD-7 for","confidence":1,"confidence_rate":1},{"cnt":[[180,1366],[1929,1366],[1929,1416],[180,1416]],"region":{"top_left_x":180,"top_left_y":1366,"width":1750,"height":50},"line":26,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c3a381b9f76e499188f226523ef6b9e7","type":"text","conversion_output":true,"text":"anxiety. \\({ }^{43 ; 44}\\) Clinically significant new or worsening psychiatric symptoms will be reported to the primary","text_display":" anxiety. \\({ }^{43 ; 44}\\) Clinically significant new or worsening psychiatric symptoms will be reported to the primary","confidence":1,"confidence_rate":1},{"cnt":[[180,1412],[1934,1412],[1934,1459],[180,1459]],"region":{"top_left_x":180,"top_left_y":1411,"width":1754,"height":48},"line":27,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"41dabe8b10c745028419a6362715833c","type":"text","conversion_output":true,"text":"care provider and patients will be offered referral to their primary care team psychologist. Veterans who","text_display":" care provider and patients will be offered referral to their primary care team psychologist. Veterans who","confidence":1,"confidence_rate":1},{"cnt":[[180,1454],[1929,1454],[1929,1502],[180,1502]],"region":{"top_left_x":180,"top_left_y":1454,"width":1750,"height":48},"line":28,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"06a38e76510343b7892eca18c7507c4c","type":"text","conversion_output":true,"text":"endorse thoughts of self-harm on item 9 of the PHQ-9 depression scale will be assessed with a suicide","text_display":" endorse thoughts of self-harm on item 9 of the PHQ-9 depression scale will be assessed with a suicide","confidence":1,"confidence_rate":1},{"cnt":[[180,1500],[432,1500],[432,1549],[180,1549]],"region":{"top_left_x":180,"top_left_y":1499,"width":252,"height":51},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"fab545215b1b46d0bdd48bcd586b5fcb","type":"text","conversion_output":true,"text":"risk algorithm.","text_display":" risk algorithm.","confidence":1,"confidence_rate":1},{"cnt":[[176,1558],[836,1558],[836,1613],[176,1613]],"region":{"top_left_x":176,"top_left_y":1557,"width":660,"height":57},"line":30,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8059c69e6dbb4be1b5ba4d07d4e5a963","type":"section_header","conversion_output":false,"children_ids":["b290d8ddfa8847c6b0f78655b3f63c5c"],"text":"","text_display":""},{"cnt":[[183,1564],[831,1564],[831,1609],[183,1609]],"region":{"top_left_x":182,"top_left_y":1564,"width":650,"height":46},"line":31,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b290d8ddfa8847c6b0f78655b3f63c5c","type":"text","conversion_output":true,"parent_id":"8059c69e6dbb4be1b5ba4d07d4e5a963","text":"J. Clinical monitoring of adherence","text_display":"\n\n\\section*{J. Clinical monitoring of adherence}","confidence":1,"confidence_rate":1},{"cnt":[[180,1607],[1921,1607],[1921,1656],[180,1656]],"region":{"top_left_x":180,"top_left_y":1607,"width":1741,"height":50},"line":32,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5e61f8e018fe473eaaaa02c93018fbcf","type":"text","conversion_output":true,"text":"Problems with medication overuse or underuse have many potential causes, including those related to","text_display":"\n\nProblems with medication overuse or underuse have many potential causes, including those related to","confidence":1,"confidence_rate":1},{"cnt":[[180,1652],[1897,1652],[1897,1699],[180,1699]],"region":{"top_left_x":180,"top_left_y":1652,"width":1718,"height":48},"line":33,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"87f76f0917b14342af9c45cf51a848bf","type":"text","conversion_output":true,"text":"the therapy (e.g., inadequate efficacy, side effects) and those related to patient (e.g., concerns about","text_display":" the therapy (e.g., inadequate efficacy, side effects) and those related to patient (e.g., concerns about","confidence":1,"confidence_rate":1},{"cnt":[[180,1697],[1897,1697],[1897,1742],[180,1742]],"region":{"top_left_x":180,"top_left_y":1697,"width":1718,"height":46},"line":34,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f98df1e53df34e328c76749439bcbe97","type":"text","conversion_output":true,"text":"medication). When medication adherence issues are identified, they will be evaluated and addressed","text_display":" medication). When medication adherence issues are identified, they will be evaluated and addressed","confidence":1,"confidence_rate":1},{"cnt":[[180,1740],[1884,1740],[1884,1790],[180,1790]],"region":{"top_left_x":180,"top_left_y":1740,"width":1705,"height":50},"line":35,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ee7143ec496f4879b590c52f64506026","type":"text","conversion_output":true,"text":"by the study care team on an individual basis with the goals of improving pain and tolerability of pain","text_display":" by the study care team on an individual basis with the goals of improving pain and tolerability of pain","confidence":1,"confidence_rate":1},{"cnt":[[180,1783],[406,1783],[406,1828],[180,1828]],"region":{"top_left_x":180,"top_left_y":1783,"width":227,"height":46},"line":36,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7d9a8ee9a5eb4879918c3691cb274af2","type":"text","conversion_output":true,"text":"medications.","text_display":" medications.","confidence":1,"confidence_rate":1},{"cnt":[[180,1846],[1882,1846],[1882,1897],[180,1897]],"region":{"top_left_x":180,"top_left_y":1845,"width":1703,"height":53},"line":37,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"357f3e954e094d8c8d5b8ce0f4ac4d4a","type":"text","conversion_output":true,"text":"Aberrant drug-related behaviors (ADRB) are a particular class of nonadherence behaviors that have","text_display":"\nAberrant drug-related behaviors (ADRB) are a particular class of nonadherence behaviors that have","confidence":1,"confidence_rate":1},{"cnt":[[180,1891],[1927,1891],[1927,1940],[180,1940]],"region":{"top_left_x":180,"top_left_y":1890,"width":1748,"height":51},"line":38,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"04e27fcf7702479aa88161d71094b25b","type":"text","conversion_output":true,"text":"been associated with opioid misuse and substance use disorders. Although ADRB are often discussed","text_display":" been associated with opioid misuse and substance use disorders. Although ADRB are often discussed","confidence":1,"confidence_rate":1},{"cnt":[[180,1936],[1854,1936],[1854,1983],[180,1983]],"region":{"top_left_x":180,"top_left_y":1935,"width":1675,"height":49},"line":39,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"dd84a102330e4f1e86db557bf68f9966","type":"text","conversion_output":true,"text":"in relation to opioid analgesic therapy, they may occur in any patient with pain. Indeed, ADRB may","text_display":" in relation to opioid analgesic therapy, they may occur in any patient with pain. Indeed, ADRB may","confidence":1,"confidence_rate":1},{"cnt":[[180,1981],[1923,1981],[1923,2030],[180,2030]],"region":{"top_left_x":180,"top_left_y":1980,"width":1743,"height":51},"line":40,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e8b34330e87e4f3597518320d431020d","type":"text","conversion_output":true,"text":"represent \"pseudo-addiction\" in the context of pain under-treatment, which may be more likely to occur","text_display":" represent \"pseudo-addiction\" in the context of pain under-treatment, which may be more likely to occur","confidence":1,"confidence_rate":1},{"cnt":[[180,2024],[1944,2024],[1944,2073],[180,2073]],"region":{"top_left_x":180,"top_left_y":2023,"width":1765,"height":51},"line":41,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c254499222d44383a326299c01747bb2","type":"text","conversion_output":true,"text":"among patients receiving only non-opioids or low-dose opioids. For these reasons, the clinical response","text_display":" among patients receiving only non-opioids or low-dose opioids. For these reasons, the clinical response","confidence":1,"confidence_rate":1},{"cnt":[[180,2067],[1811,2067],[1811,2116],[180,2116]],"region":{"top_left_x":180,"top_left_y":2066,"width":1632,"height":51},"line":42,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"65126f804cc34184993b5f36f5f84e7e","type":"text","conversion_output":true,"text":"to ADRB will be determined by the nature of the observed behaviors, rather than the medication","text_display":" to ADRB will be determined by the nature of the observed behaviors, rather than the medication","confidence":0.99951171875,"confidence_rate":0.9999950666738041},{"cnt":[[180,2110],[831,2110],[831,2159],[180,2159]],"region":{"top_left_x":180,"top_left_y":2109,"width":652,"height":51},"line":43,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2373ffc331f640ffb707bd9432494865","type":"text","conversion_output":true,"text":"prescribed or the study arm assigned.","text_display":" prescribed or the study arm assigned.","confidence":1,"confidence_rate":1},{"cnt":[[180,2174],[1880,2174],[1880,2224],[180,2224]],"region":{"top_left_x":180,"top_left_y":2174,"width":1700,"height":50},"line":44,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b784abc9cbd14566875d911cf0da1c43","type":"text","conversion_output":true,"text":"A validated checklist of potentially concerning ADRB will be completed by the care manager at each","text_display":"\nA validated checklist of potentially concerning ADRB will be completed by the care manager at each","confidence":1,"confidence_rate":1},{"cnt":[[180,2219],[1858,2219],[1858,2271],[180,2271]],"region":{"top_left_x":180,"top_left_y":2219,"width":1679,"height":52},"line":45,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b56a0efd53c5400fb5c0f9bf6649b925","type":"text","conversion_output":true,"text":"visit for participants in both arms. \\({ }^{45}\\) Any emerging pattern of ADRB will be reviewed at weekly case","text_display":" visit for participants in both arms. \\({ }^{45}\\) Any emerging pattern of ADRB will be reviewed at weekly case","confidence":1,"confidence_rate":1},{"cnt":[[180,2264],[1826,2264],[1826,2314],[180,2314]],"region":{"top_left_x":180,"top_left_y":2264,"width":1647,"height":50},"line":46,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"80cd2354a97445bf9944315fc8c74753","type":"text","conversion_output":true,"text":"meetings and the study team will prescribe an individual monitoring plan to aid in diagnosing and","text_display":" meetings and the study team will prescribe an individual monitoring plan to aid in diagnosing and","confidence":1,"confidence_rate":1},{"cnt":[[180,2307],[1910,2307],[1910,2357],[180,2357]],"region":{"top_left_x":180,"top_left_y":2307,"width":1730,"height":50},"line":47,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3db14de3e53b49c783bd8d9598181e81","type":"text","conversion_output":true,"text":"ameliorating the behavior. This plan will be reassessed at each visit and may include any combination","text_display":" ameliorating the behavior. This plan will be reassessed at each visit and may include any combination","confidence":1,"confidence_rate":1},{"cnt":[[180,2350],[1775,2350],[1775,2400],[180,2400]],"region":{"top_left_x":180,"top_left_y":2350,"width":1595,"height":50},"line":48,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9a3adf1ca8384fd59b9d84c4f891782a","type":"text","conversion_output":true,"text":"of the following actions: a) medication adjustment; b) more frequent study visits; c) adherence","text_display":" of the following actions: a) medication adjustment; b) more frequent study visits; c) adherence","confidence":1,"confidence_rate":1},{"cnt":[[180,2396],[1858,2396],[1858,2443],[180,2443]],"region":{"top_left_x":180,"top_left_y":2395,"width":1679,"height":48},"line":49,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"383ed625de2845a9a0dbbfe113184da4","type":"text","conversion_output":true,"text":"counseling or education; d) review of state prescription monitoring database to identify duplicate or","text_display":" counseling or education; d) review of state prescription monitoring database to identify duplicate or","confidence":1,"confidence_rate":1},{"cnt":[[180,2441],[1824,2441],[1824,2488],[180,2488]],"region":{"top_left_x":180,"top_left_y":2440,"width":1645,"height":48},"line":50,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"85878916b0004e35a3069567bcee67d6","type":"text","conversion_output":true,"text":"unreported external opioid prescriptions; e) referral for evaluation by a mental health or addiction","text_display":" unreported external opioid prescriptions; e) referral for evaluation by a mental health or addiction","confidence":1,"confidence_rate":1},{"cnt":[[180,2574],[1257,2574],[1257,2632],[180,2632]],"region":{"top_left_x":180,"top_left_y":2573,"width":1077,"height":59},"line":51,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"1fe51ab3ca0e4db4a9e0d89ae03aff14","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1839,2623],[1886,2623],[1886,2660],[1839,2660]],"region":{"top_left_x":1839,"top_left_y":2623,"width":48,"height":37},"line":52,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"b8a7fad6093f4263ae553bc218da4318","type":"page_info","conversion_output":false,"text":"15","text_display":"","confidence":1,"confidence_rate":1}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-16","page":16,"lines":[{"cnt":[[180,249],[1828,249],[1828,299],[180,299]],"region":{"top_left_x":180,"top_left_y":249,"width":1649,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"28de29a93d7146a2afc398886d5c9db0","type":"text","conversion_output":true,"text":"clinician; f) shorter prescription renewal intervals; g) urine drug testing; and h) pill counts. Serious","text_display":"\nclinician; f) shorter prescription renewal intervals; g) urine drug testing; and h) pill counts. Serious","confidence":0.97216796875,"confidence_rate":0.9997410731411521},{"cnt":[[180,296],[1914,296],[1914,342],[180,342]],"region":{"top_left_x":180,"top_left_y":296,"width":1735,"height":46},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d9635ce68806481cab9a78f2e0a3c302","type":"text","conversion_output":true,"text":"ADRB, such as illicit drug use or potential diversion of prescribed medication, may result in medication","text_display":" ADRB, such as illicit drug use or potential diversion of prescribed medication, may result in medication","confidence":0.99951171875,"confidence_rate":0.9999955192715237},{"cnt":[[183,339],[1820,339],[1820,385],[183,385]],"region":{"top_left_x":182,"top_left_y":339,"width":1638,"height":46},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"39e602e11cf546c891ec11f1fc76eabd","type":"text","conversion_output":true,"text":"changes, including tapering or discontinuation of opioids. These behaviors will not be considered","text_display":" changes, including tapering or discontinuation of opioids. These behaviors will not be considered","confidence":0.99951171875,"confidence_rate":0.999995211771286},{"cnt":[[185,385],[1792,385],[1792,432],[185,432]],"region":{"top_left_x":184,"top_left_y":384,"width":1608,"height":48},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"be388068a2234bd88cac1d9665cc5083","type":"text","conversion_output":true,"text":"reasons for withdrawal from the trial and all participants will be evaluated in their assigned arm.","text_display":" reasons for withdrawal from the trial and all participants will be evaluated in their assigned arm.","confidence":1,"confidence_rate":1},{"cnt":[[178,443],[535,443],[535,492],[178,492]],"region":{"top_left_x":178,"top_left_y":442,"width":357,"height":50},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5352ff9943d04c6cb541622769903d8d","type":"section_header","conversion_output":false,"children_ids":["72203d3aa08140cda711f9ffaea7095b"],"text":"","text_display":""},{"cnt":[[185,447],[531,447],[531,488],[185,488]],"region":{"top_left_x":184,"top_left_y":446,"width":347,"height":42},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"72203d3aa08140cda711f9ffaea7095b","type":"text","conversion_output":true,"parent_id":"5352ff9943d04c6cb541622769903d8d","text":"K. Data Collection","text_display":"\n\n\\section*{K. Data Collection}","confidence":1,"confidence_rate":1},{"cnt":[[183,490],[1910,490],[1910,539],[183,539]],"region":{"top_left_x":182,"top_left_y":489,"width":1728,"height":51},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e3191383710647c9b77a6ed74afb7b93","type":"text","conversion_output":true,"text":"Study measures include both patient-reported outcomes that will be collected in interviews at baseline","text_display":"\n\nStudy measures include both patient-reported outcomes that will be collected in interviews at baseline","confidence":1,"confidence_rate":1},{"cnt":[[183,537],[1880,537],[1880,582],[183,582]],"region":{"top_left_x":182,"top_left_y":537,"width":1698,"height":46},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"df427bc3b047484a8ba60a507989092a","type":"text","conversion_output":true,"text":"and \\(3,6,9\\), and 12 months and test-based outcomes that will be completed in person at baseline, 6 ,","text_display":" and \\(3,6,9\\), and 12 months and test-based outcomes that will be completed in person at baseline, 6 ,","confidence":0.739511666353792,"confidence_rate":0.9973330739019103},{"cnt":[[183,580],[1755,580],[1755,625],[183,625]],"region":{"top_left_x":182,"top_left_y":580,"width":1574,"height":46},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"cb2422f99bf94d76aa9e415681a17e08","type":"text","conversion_output":true,"text":"and 12 months. Interviews will require approximately 50 minutes at 0,6 , and 12 months and","text_display":" and 12 months. Interviews will require approximately 50 minutes at 0,6 , and 12 months and","confidence":0.99951171875,"confidence_rate":0.9999954355197808},{"cnt":[[183,623],[1895,623],[1895,672],[183,672]],"region":{"top_left_x":182,"top_left_y":623,"width":1713,"height":50},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d3ff144341d04119aa8c18799bbe073c","type":"text","conversion_output":true,"text":"approximately 15 minutes at 3 and 9 months. In-person outcome assessment visits will require 50-60","text_display":" approximately 15 minutes at 3 and 9 months. In-person outcome assessment visits will require 50-60","confidence":0.97607421875,"confidence_rate":0.9997838032697839},{"cnt":[[183,666],[1938,666],[1938,715],[183,715]],"region":{"top_left_x":182,"top_left_y":666,"width":1756,"height":50},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"dfeb52286f994207a33fb287aa2542f8","type":"text","conversion_output":true,"text":"minutes. A small incentive ( \\(\\$ 20\\) ) will be provided for each outcome assessment call and visit. Incentives","text_display":" minutes. A small incentive ( \\(\\$ 20\\) ) will be provided for each outcome assessment call and visit. Incentives","confidence":0.6981945037841797,"confidence_rate":0.9968535783194258},{"cnt":[[183,711],[1876,711],[1876,758],[183,758]],"region":{"top_left_x":182,"top_left_y":711,"width":1694,"height":48},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"484c8accc17e4df78a5863373aeb1cf0","type":"text","conversion_output":true,"text":"of this magnitude offset costs of participation and are in the standard range used in our previous VA","text_display":" of this magnitude offset costs of participation and are in the standard range used in our previous VA","confidence":0.99951171875,"confidence_rate":0.9999953924587458},{"cnt":[[183,756],[1934,756],[1934,804],[183,804]],"region":{"top_left_x":182,"top_left_y":756,"width":1752,"height":48},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5a35a3c98111495880b60bafaa5eb391","type":"text","conversion_output":true,"text":"and non-VA effectiveness trials. No incentives will be provided for study clinical visits nor for automated","text_display":" and non-VA effectiveness trials. No incentives will be provided for study clinical visits nor for automated","confidence":1,"confidence_rate":1},{"cnt":[[183,799],[1446,799],[1446,849],[183,849]],"region":{"top_left_x":182,"top_left_y":799,"width":1264,"height":50},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"649b8f06f5624ad8ad2df73bac0964e7","type":"text","conversion_output":true,"text":"symptom monitoring, which is conducted for clinical intervention purposes.","text_display":" symptom monitoring, which is conducted for clinical intervention purposes.","confidence":0.99951171875,"confidence_rate":0.999993817734324},{"cnt":[[183,864],[1772,864],[1772,913],[183,913]],"region":{"top_left_x":182,"top_left_y":863,"width":1591,"height":51},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5791438a708c4d2dadb41452158c05d1","type":"text","conversion_output":true,"text":"Patient-reported outcome measures and timing of administration are displayed in Table 2 and","text_display":"\nPatient-reported outcome measures and timing of administration are displayed in Table 2 and","confidence":1,"confidence_rate":1},{"cnt":[[180,907],[1944,907],[1944,956],[180,956]],"region":{"top_left_x":180,"top_left_y":906,"width":1765,"height":51},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9b3bbc79014e488daf9a9951365bc0bf","type":"text","conversion_output":true,"text":"described in Section K1. Although participants will be asked to complete a substantial battery of patient-","text_display":" described in Section K1. Although participants will be asked to complete a substantial battery of patient","confidence":1,"confidence_rate":1},{"cnt":[[183,952],[1809,952],[1809,999],[183,999]],"region":{"top_left_x":182,"top_left_y":951,"width":1627,"height":49},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"895ea5e893e540c28989c22ea5b9fd6c","type":"text","conversion_output":true,"text":"reported measures in this proposed study, we believe this outcome assessment protocol is both","text_display":"reported measures in this proposed study, we believe this outcome assessment protocol is both","confidence":1,"confidence_rate":1},{"cnt":[[180,997],[1869,997],[1869,1042],[180,1042]],"region":{"top_left_x":180,"top_left_y":996,"width":1690,"height":46},"line":18,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"00354ccb9cb84cbfb551c48d152c5d06","type":"text","conversion_output":true,"text":"appropriately comprehensive and reasonable in terms of respondent burden. Outcome assessment","text_display":" appropriately comprehensive and reasonable in terms of respondent burden. Outcome assessment","confidence":0.99853515625,"confidence_rate":0.9999848875607663},{"cnt":[[183,1040],[1880,1040],[1880,1087],[183,1087]],"region":{"top_left_x":182,"top_left_y":1039,"width":1698,"height":49},"line":19,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7ea3fa1357e64d799e23e4f9764ffcec","type":"text","conversion_output":true,"text":"protocols of similar length have been well tolerated in multiple symptom management trials involving","text_display":" protocols of similar length have been well tolerated in multiple symptom management trials involving","confidence":1,"confidence_rate":1},{"cnt":[[183,1083],[1841,1083],[1841,1132],[183,1132]],"region":{"top_left_x":182,"top_left_y":1082,"width":1660,"height":51},"line":20,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4e2f2f3178054555842da4aea6dffcfb","type":"text","conversion_output":true,"text":"thousands of patients with depression or pain. \\({ }^{12 ; 34 ; 46}\\) Indeed, many participants in these trials have","text_display":" thousands of patients with depression or pain. \\({ }^{12 ; 34 ; 46}\\) Indeed, many participants in these trials have","confidence":0.9990234375,"confidence_rate":0.9999916492686468},{"cnt":[[180,1126],[1871,1126],[1871,1175],[180,1175]],"region":{"top_left_x":180,"top_left_y":1125,"width":1692,"height":51},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6d899d7fd97d4516824512fd7226c70b","type":"text","conversion_output":true,"text":"reported that they appreciated the sustained attention to their symptoms and perceived benefit from","text_display":" reported that they appreciated the sustained attention to their symptoms and perceived benefit from","confidence":1,"confidence_rate":1},{"cnt":[[180,1173],[574,1173],[574,1218],[180,1218]],"region":{"top_left_x":180,"top_left_y":1173,"width":394,"height":46},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"794b116c7f6c4dd884daea6ec2c0b121","type":"text","conversion_output":true,"text":"therapeutic disclosure.","text_display":" therapeutic disclosure.","confidence":1,"confidence_rate":1},{"cnt":[[180,1233],[1222,1233],[1222,1283],[180,1283]],"region":{"top_left_x":180,"top_left_y":1233,"width":1043,"height":50},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"513c477bfa5b4a60ac4af5cef8131d56","type":"figure_label","conversion_output":false,"text":"Table 2: Patient-reported Outcome Assessment Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[127,1293],[2000,1293],[2000,2464],[127,2464]],"region":{"top_left_x":126,"top_left_y":1293,"width":1875,"height":1172},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"17d3db0ec2294cf9b7e0e9f847904621","type":"table","conversion_output":true,"children_ids":["00a341d31d2f46edbf4af0d03a5f34ac","dd9bc8ad7a60464e9251e6e26247346f","6a4e77060eb246d28ccba8d4128e40d0","04a4aa5337724b25ab8ffb726903fcb4","ea5173b46d27494884f1f4fa577f8a8e","abef2ce9e1ba41b8888815d6eee64d26","858990f9920d4683a028eca496b8c6d3","7c293d096bf442069642324e932315ae","0336c77cca8745dfb16023a063294a11","eb5a6c3703e44dab8b0b0fcc07a89607","83d1d0028d804800b437da5b9ebabd97","8b5be798c74842bba25283e1b0254b2f","eebf165db2464464839ae7325c531deb","793a3024e2c44dc3b91f24c2d0e981f2","f2ff5ce45c224332a0c4cb3cbbffe14b","d9bbd082a24145898160bbb393e07b1c","09d73cdaf2224df68b1f71462a945b92","42e21c59a4b84b9aae6ea1eb376e4b9d","a2a5670a9c124d59a5fec01e0f025d0f","40875673c27e4858bed2270021560b30","c011c2550c0b425093d9d57c26968e7c","b687183aacf240fda7704c49ade0aeaa","093de1df3e8b4dbbae50674a97c8489a","3c40a476ce014234a5b58ea6d91206df","22fe633bbe80468584c215fe5089643b","0e1d34d32d0b4f3e9c7f1b7d1b0ac55a","90e65c0435e44b9fa8caa438fc5cfbbc","c1204cf4623e427d87f982928b356e1c","9976cf3824bf4dffa56d0836c2b3c11b","4cc1367c0858490f987ab36b83e5be6a","4a3da796594141e28b46d87f4db6a786","3ef8c87a5c5446e1a37c9d94148f2ce2","77003f3297bf440ab6821c6cb9b7b9ed","c69c3f21df0e44849e8d9f6af9761f40","c0768ef206e64b1cb828ba1fdc928691","97643599775e43818bd23a753691776c","ea54217249aa4d97ae847af1f276f892","c6451ab91c804121bf73b709ad54a846","df392ccdf51c42d6a3deadf264766de8","775b3a8a900f4ba58e729134b4253c94","e579d9da1e60406ea1a63a01c5bdea4a","cbd8346e8d5c4395b0a729c76e9c415b","c5a27ee6947d440da1d77aff0c2774ec","c346f4bd6540499eac39f80523b32dbd","6cb2353707e6469dabb68bdd9d2243d6","1c276fa462784da08e7b14a885252778","c4cabf91eaa7483e8b146ed1df1c3713","cc6d668f1a9c4386951a93cfd26a7b14","e6b5b58d2fd54c0ca50e90ad039d44ce","52559fd60374424fbe92d3a5a860f53f","e5df8d49ea8a481781c34d196ae17240","2257501d61e748c9809fefc165cc34da","f882e9ef866e4afeb51cc2a1f0c65578","acfcf13ebac44f6ba6ea73ab84c5551d","b1c98ed1de9f45b3a7ce7ce5faf5401d","71b08cd1f5bf4fff816ed911fd0a236d","d7dfb9d860d54d6ab2864ffadbab16b1","e9182adf368148208251c4ad3e116633","f7d41d01f64d4445b22a864e8a818ac2","bc0c9fc46fcc478fadf696e891b31990","c12f50ebc7c9471abaf24adb412ef65d","d166e8b7f22e4b4c80db7ee72ed22b79","32f15c82438e46d8a63bf9a8c49e84d7","4cb6ccb8f0dd47f4af296d477699cda1","f1695a634c6248628425fd6c89edfb6a","385e472c20614284a7e09762b5592d79","d6e20bd501804b5fbe84574c530e0261","a7ccbe6c61e34fe3aa82633ff53f57e4","1d483f3d3e7149c8a7f0be8adeb0e32b","712c36f687d0457f8e345b05874ddbd3","88860e0cce544824ae28a6d10c36317a","89eb21bebffb46aaacede61042ec0050","396deaccd5af4c46b39905f2a3cddec9","6280afe545be40cd9b02d7a5f2e89454","aa8b0ede29e74c2d837cc56ee3dbf46a","71044d5da2354095b83b32f85308521d","bb3ae8be353d4a539ac8b3603f64711f","95d02c047e4945f88c42d63e6fe34165","f040b87e95b74520a0a9c577317bcf06","4b040f3129fd4867b80d52f4dd725268","fbe5354307b445e7ae546642f0e6fc21","5f176357d4974b8eb493206594c1b950","f021b5a14ca34e38b07febcfc180451b","86cef54a578145aba52ff7c020b5d1fe","e702ba0728e14e19aad127d9b508f5af","deb1161f19fb45d3b66fdea844bb3381","0c102ab4dd3d441e945908a605c2013d","78516dac61bc41d3b587206aac4df57b","b857ff43223145f794cc09db0f80aec8","0e2ca1dbd3204c8080b7ecf02b295bfc","86bc4af9efdb41318e5e2c1d35f2ea8f","4b435a5b86e840aebf3c2283f58a000d","c2aa268849794d65ad8415b7e28e64f5","ba74a2f96b6c492099a570422f65667a","caa773c7b36b48edb1b5e2b98a6ed590","e62425028ed2420f9490993945fee1b4","b417d8b374ca411ab7e6c94d6079d875","81ace1f3850f468f8e84b64ec6ebbe86","2466dd54edfa4c72a269d609555ae4eb","29f897f8c9d94da3bb8866c0d06c8feb","f125a34a84d64602ba402bdc33af8a8d","7fc48fcc2688420f87b2268ca5caf74c","3eb423d7f4a24105971e10de0cfefb15","fc1cd7fc25774ad98942bbd263b471cd","f38f4d8e10cb45c7b26bcc05404afccc","4e23099ec9bb40f185d9c7a0e42d0c11","f57083fd7b9949ab9247cf2122c5c2b0","c67d40bec5654eb686be9f54a8768962","ba16d1b4b4d1444eb04f7b5299af372f","4439fcdf3bc542ee8367618436f99090","7ea6a1d0fbb9480e827c2e5a2f998f5b","974506851419474dbdf5ec3453ce7821","a45f53158ccb41319a6095e0f3f0b94d","e439c39635334347982e9a01dc3aa9a1","edeca18924404407848d658eb48d1f17","2bdc27070e8a40289f6baca1f610f0a8","300a03fe0e694b1ca500aa312be66e46","a34a3c124866423bbf35ee8baa990a61","37f6103f53d84fd4ae7e4e3166e865ea","2e3f40df4ff04eb38e40da3d5107b183","96af8ea4617f498692c7fab1c91a4f73","a5a98fe706ba4b68ad720a208f275a98","e895fc33e1e841bebf45f03b1a3b2459","1cf777c3611647b28a6eeefcb64b5db3","5a182c6c07534d5f80582bea3299cc83","004022e33cab40eaabd182e1b4a61ffd","ead11510fcdb4539a5d672a6c41b7376","01d0e5e3d4dd4e81b976670f6185bdf8","3a42d36837ee475f84f81b020f6c227a","380bfd10ece4492ab8358730096188ab","bc74626338fe4858944349facea44dfd","55805a429a1f467cb6bfd198e14b8d76","2b3ca0c362c34a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\\multirow{2}{*}{Domain} & \\multirow{2}{*}{No} & \\multirow{2}{*}{Measure} & \\multirow{2}{*}{Items*} & \\multicolumn{5}{|c|}{Schedule} \\\\\n\\hline & & & & 0 mo & 3 mo & 6 mo & 9 mo & 12 mo \\\\\n\\hline \\multirow{3}{*}{Pain} & 1 & Brief Pain Inventory & 11 & X & X & X & X & X \\\\\n\\hline & 2 & Roland Disability-short form & 11 & X & & X & & X \\\\\n\\hline & 3 & Global Rating of Change & 1 & & X & X & X & X \\\\\n\\hline Health-related QOL & 4 & SF-12 & 12 & X & X & X & X & X \\\\\n\\hline Adverse effects & 5 & Symptom checklist & 15 & X & X & X & X & X \\\\\n\\hline \\multirow[b]{2}{*}{Fatigue \\& sleep} & 6 & Multidimensional Fatigue Inventory & 20 & X & & X & & X \\\\\n\\hline & 7 & Athens Insomnia Scale & 5 & X & & X & & X \\\\\n\\hline Headaches & 8 & Headache Impact Test & 6 & X & & X & & X \\\\\n\\hline Sexual function & 9 & Arizona Sexual Experience & 5 & X & & X & & X \\\\\n\\hline \\multirow{3}{*}{Mental health} & 10 & PHQ-9 & 9 & X & & X & & X \\\\\n\\hline & 11 & GAD-7 & 7 & X & & X & & X \\\\\n\\hline & 12 & Primary Care-PTSD & 4 & X & & X & & X \\\\\n\\hline \\multirow{2}{*}{Substance use} & 13 & AUDIT & 10(3) & X & & X & & X \\\\\n\\hline & 14 & Drug use \\& smoking items & 11(5) & X & & X & & X \\\\\n\\hline Medication beliefs & 15 & Medication Beliefs Questionnaire & 5 & X & & & & X \\\\\n\\hline Expectations & 16 & Treatment expectation items & 4 & X & X & & & \\\\\n\\hline Co-interventions & 17 & Treatment checklist & 5 & X & X & X & X & X \\\\\n\\hline\n\\end{tabular}","text_display":"\n\n\\begin{table}\n\\captionsetup{labelformat=empty}\n\\caption{Table 2: Patient-reported Outcome Assessment Protocol}\n\\begin{tabular}{|l|l|l|l|l|l|l|l|l|}\n\\hline \\multirow{2}{*}{Domain} & \\multirow{2}{*}{No} & \\multirow{2}{*}{Measure} & \\multirow{2}{*}{Items*} & \\multicolumn{5}{|c|}{Schedule} \\\\\n\\hline & & & & 0 mo & 3 mo & 6 mo & 9 mo & 12 mo \\\\\n\\hline \\multirow{3}{*}{Pain} & 1 & Brief Pain Inventory & 11 & X & X & X & X & X 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The BPI","confidence":1,"confidence_rate":1},{"cnt":[[180,864],[1869,864],[1869,913],[180,913]],"region":{"top_left_x":180,"top_left_y":863,"width":1690,"height":51},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"cc23567f75cb4d63b2c11e1a4f373739","type":"text","conversion_output":true,"text":"was originally developed for use in cancer-related pain, but has been validated for use in numerous","text_display":" was originally developed for use in cancer-related pain, but has been validated for use in numerous","confidence":1,"confidence_rate":1},{"cnt":[[180,907],[1886,907],[1886,956],[180,956]],"region":{"top_left_x":180,"top_left_y":906,"width":1707,"height":51},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a922616784974deba007fc4066c3b86f","type":"text","conversion_output":true,"text":"other populations, including primary care patients with non-cancer chronic pain. \\({ }^{47 ; 48 ; 49}\\) IMMPACT has","text_display":" other populations, including primary care patients with non-cancer chronic pain. \\({ }^{47 ; 48 ; 49}\\) IMMPACT has","confidence":1,"confidence_rate":1},{"cnt":[[183,950],[1876,950],[1876,999],[183,999]],"region":{"top_left_x":182,"top_left_y":949,"width":1694,"height":51},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"32bb5506c9d9467daeef881e38e9fc3a","type":"text","conversion_output":true,"text":"recommended the BPI as a core outcome measure for chronic pain clinical trials. 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The Athens Insomnia Scale- 5 item version is based on ICD-10 criteria and has been recommended","confidence":0.54638671875,"confidence_rate":0.994260076879523},{"cnt":[[180,2062],[1863,2062],[1863,2112],[180,2112]],"region":{"top_left_x":180,"top_left_y":2062,"width":1683,"height":50},"line":39,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d7e7d45282b74c099eaa68981b35c210","type":"text","conversion_output":true,"text":"by the OMERACT group for use in clinical trials on the basis of both its feasibility and psychometric","text_display":" by the OMERACT group for use in clinical trials on the basis of both its feasibility and psychometric","confidence":1,"confidence_rate":1},{"cnt":[[180,2105],[402,2105],[402,2157],[180,2157]],"region":{"top_left_x":180,"top_left_y":2105,"width":222,"height":53},"line":40,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c926523179694101bb95842d38c5a6a4","type":"text","conversion_output":true,"text":"properties. \\({ }^{57}\\)","text_display":" properties. \\({ }^{57}\\)","confidence":1,"confidence_rate":1},{"cnt":[[191,2166],[1588,2166],[1588,2224],[191,2224]],"region":{"top_left_x":191,"top_left_y":2165,"width":1397,"height":59},"line":41,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"12a105a78992430c9c70170b6f4a312c","type":"text","conversion_output":true,"text":"8. The Headache Impact Test is a brief validated measure of headache severity. \\({ }^{58}\\)","text_display":"\n8. The Headache Impact Test is a brief validated measure of headache severity. \\({ }^{58}\\)","confidence":1,"confidence_rate":1},{"cnt":[[180,2234],[1876,2234],[1876,2284],[180,2284]],"region":{"top_left_x":180,"top_left_y":2234,"width":1696,"height":50},"line":42,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d64d43c1d89b4657ae8fdbf28065b50b","type":"text","conversion_output":true,"text":"9. The Arizona Sexual Experience (ASEX) scale assesses 5 domains of sexual function in men and","text_display":"\n9. The Arizona Sexual Experience (ASEX) scale assesses 5 domains of sexual function in men and","confidence":1,"confidence_rate":1},{"cnt":[[180,2277],[354,2277],[354,2327],[180,2327]],"region":{"top_left_x":180,"top_left_y":2277,"width":175,"height":50},"line":43,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bd3eaecba15642f89da5b9c565b6da23","type":"text","conversion_output":true,"text":"women. \\({ }^{59}\\)","text_display":" women. \\({ }^{59}\\)","confidence":1,"confidence_rate":1},{"cnt":[[183,2344],[1886,2344],[1886,2396],[183,2396]],"region":{"top_left_x":182,"top_left_y":2343,"width":1705,"height":53},"line":44,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ca224282aad64f119df6b29332589742","type":"text","conversion_output":true,"text":"Mental health and substance use disorders are commonly comorbid with chronic pain and can affect","text_display":"\nMental health and substance use disorders are commonly comorbid with chronic pain and can affect","confidence":1,"confidence_rate":1},{"cnt":[[180,2389],[1712,2389],[1712,2438],[180,2438]],"region":{"top_left_x":180,"top_left_y":2389,"width":1533,"height":50},"line":45,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"93599f163906428cacf6d2cae3e2ed5c","type":"text","conversion_output":true,"text":"outcomes of pain treatment. These domains will be assessed with several brief measures.","text_display":" outcomes of pain treatment. These domains will be assessed with several brief measures.","confidence":1,"confidence_rate":1},{"cnt":[[180,2578],[1257,2578],[1257,2632],[180,2632]],"region":{"top_left_x":180,"top_left_y":2578,"width":1077,"height":54},"line":46,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f213c37c267048eb830c3d1a51cd52fa","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1839,2625],[1882,2625],[1882,2660],[1839,2660]],"region":{"top_left_x":1839,"top_left_y":2625,"width":44,"height":35},"line":47,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"36427091f09f4f14974871d14b290893","type":"page_info","conversion_output":false,"text":"17","text_display":"","confidence":0.99951171875,"confidence_rate":0.9997558295653994}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-18","page":18,"lines":[{"cnt":[[183,249],[1912,249],[1912,299],[183,299]],"region":{"top_left_x":182,"top_left_y":249,"width":1731,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"839ec3a889f94019a52012b22dea9610","type":"text","conversion_output":true,"text":"10. The Patient Health Questionnaire (PHQ)-9 is a well validated brief measure of depression severity","text_display":"\n10. The Patient Health Questionnaire (PHQ)-9 is a well validated brief measure of depression severity","confidence":0.99951171875,"confidence_rate":0.9999953924587458},{"cnt":[[180,292],[1081,292],[1081,342],[180,342]],"region":{"top_left_x":180,"top_left_y":292,"width":901,"height":50},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bc0f90344c8b4977bbd448ddcc495493","type":"text","conversion_output":true,"text":"that is based on DSM criteria for major depression. \\({ }^{43}\\)","text_display":" that is based on DSM criteria for major depression. \\({ }^{43}\\)","confidence":1,"confidence_rate":1},{"cnt":[[183,357],[1914,357],[1914,406],[183,406]],"region":{"top_left_x":182,"top_left_y":356,"width":1733,"height":51},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"269915ba686a46639f13b680ead13472","type":"text","conversion_output":true,"text":"11. The General Anxiety Disorders questionnaire (GAD-7) has been validated as an anxiety screening","text_display":"\n11. The General Anxiety Disorders questionnaire (GAD-7) has been validated as an anxiety screening","confidence":1,"confidence_rate":1},{"cnt":[[183,400],[862,400],[862,449],[183,449]],"region":{"top_left_x":182,"top_left_y":399,"width":680,"height":51},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8e44b22467d04e5493b5569b1c8c8ac9","type":"text","conversion_output":true,"text":"and severity measure in primary care. \\({ }^{44}\\)","text_display":" and severity measure in primary care. \\({ }^{44}\\)","confidence":1,"confidence_rate":1},{"cnt":[[185,466],[1910,466],[1910,513],[185,513]],"region":{"top_left_x":184,"top_left_y":466,"width":1726,"height":48},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ec207add19b34d40b2c4b3b183eec457","type":"text","conversion_output":true,"text":"12. The Primary Care Post-traumatic Stress Disorder (PC-PTSD) Screen is a screening test for PTSD","text_display":"\n12. The Primary Care Post-traumatic Stress Disorder (PC-PTSD) Screen is a screening test for PTSD","confidence":1,"confidence_rate":1},{"cnt":[[180,511],[1124,511],[1124,561],[180,561]],"region":{"top_left_x":180,"top_left_y":511,"width":944,"height":50},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e15e8de56d834098861e4f9ada0ce8de","type":"text","conversion_output":true,"text":"that was developed and validated in VA primary care. \\({ }^{60}\\)","text_display":" that was developed and validated in VA primary care. \\({ }^{60}\\)","confidence":1,"confidence_rate":1},{"cnt":[[185,576],[1828,576],[1828,625],[185,625]],"region":{"top_left_x":184,"top_left_y":575,"width":1645,"height":51},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"88c981e3aee2440595555a12420faee2","type":"text","conversion_output":true,"text":"13. The AUDIT questionnaire is a well-established assessment tool for alcohol use disorders that","text_display":"\n13. The AUDIT questionnaire is a well-established assessment tool for alcohol use disorders that","confidence":1,"confidence_rate":1},{"cnt":[[183,619],[1936,619],[1936,668],[183,668]],"region":{"top_left_x":182,"top_left_y":618,"width":1754,"height":51},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"95d394092ab743cfa3688e1608c92597","type":"text","conversion_output":true,"text":"accurately identifies primary care patients with at-risk drinking. \\({ }^{61}\\) The full AUDIT will be used at baseline","text_display":" accurately identifies primary care patients with at-risk drinking. \\({ }^{61}\\) The full AUDIT will be used at baseline","confidence":0.99462890625,"confidence_rate":0.9999565689275709},{"cnt":[[183,666],[1111,666],[1111,713],[183,713]],"region":{"top_left_x":182,"top_left_y":666,"width":929,"height":48},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8f79787da76344fa8244d9cde107980b","type":"text","conversion_output":true,"text":"and the brief 3 -item AUDIT-C will be used at follow-up.","text_display":" and the brief 3 -item AUDIT-C will be used at follow-up.","confidence":0.52734375,"confidence_rate":0.9900513394607785},{"cnt":[[185,728],[1929,728],[1929,778],[185,778]],"region":{"top_left_x":184,"top_left_y":728,"width":1746,"height":50},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f831a1a60a35446bae1a33b1fd520af8","type":"text","conversion_output":true,"text":"14. To assess past and current drug use, we will use a single item drug use screener that predicts drug","text_display":"\n14. To assess past and current drug use, we will use a single item drug use screener that predicts drug","confidence":1,"confidence_rate":1},{"cnt":[[183,773],[1927,773],[1927,819],[183,819]],"region":{"top_left_x":182,"top_left_y":773,"width":1746,"height":46},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2b0627d72448460c84aedcc7890e1a72","type":"text","conversion_output":true,"text":"use disorders in primary care, plus 6 history items we developed for a previous study. \\({ }^{62}\\) Four questions","text_display":" use disorders in primary care, plus 6 history items we developed for a previous study. \\({ }^{62}\\) Four questions","confidence":0.99951171875,"confidence_rate":0.9999959967252418},{"cnt":[[180,816],[1635,816],[1635,866],[180,866]],"region":{"top_left_x":180,"top_left_y":816,"width":1455,"height":50},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"63875b9c4a0c4f1cb65c482d6b6bb75b","type":"text","conversion_output":true,"text":"from the National Survey on Drug Use and Heath assess past and current smoking. \\({ }^{63}\\)","text_display":" from the National Survey on Drug Use and Heath assess past and current smoking. \\({ }^{63}\\)","confidence":1,"confidence_rate":1},{"cnt":[[183,881],[1910,881],[1910,930],[183,930]],"region":{"top_left_x":182,"top_left_y":880,"width":1728,"height":51},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e0d3028f957d41fb92b1cd2de76813e2","type":"text","conversion_output":true,"text":"Finally, we will include additional secondary measures that that may help explain response to therapy.","text_display":"\nFinally, we will include additional secondary measures that that may help explain response to therapy.","confidence":1,"confidence_rate":1},{"cnt":[[185,945],[1766,945],[1766,995],[185,995]],"region":{"top_left_x":184,"top_left_y":945,"width":1583,"height":50},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"206a8e1a54ac4e06a06bdf9e323c49a5","type":"text","conversion_output":true,"text":"15. The Medication Beliefs Questionnaire \\({ }^{64}\\) assesses beliefs that may mediate opioid misuse.","text_display":"\n15. The Medication Beliefs Questionnaire \\({ }^{64}\\) assesses beliefs that may mediate opioid misuse.","confidence":1,"confidence_rate":1},{"cnt":[[185,1010],[1876,1010],[1876,1059],[185,1059]],"region":{"top_left_x":184,"top_left_y":1009,"width":1692,"height":51},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4d9d708371c24942bd44c076eb94a855","type":"text","conversion_output":true,"text":"16. Treatment expectation questions adapted from prior pain trials will be asked at baseline (prior to","text_display":"\n16. Treatment expectation questions adapted from prior pain trials will be asked at baseline (prior to","confidence":1,"confidence_rate":1},{"cnt":[[183,1053],[1772,1053],[1772,1102],[183,1102]],"region":{"top_left_x":182,"top_left_y":1052,"width":1591,"height":51},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9c1ed099f45d4aebb33e62c505de7b7d","type":"text","conversion_output":true,"text":"intervention group assignment) and the first follow-up assessment (after group assignment). \\({ }^{65}\\)","text_display":" intervention group assignment) and the first follow-up assessment (after group assignment). \\({ }^{65}\\)","confidence":1,"confidence_rate":1},{"cnt":[[185,1121],[1792,1121],[1792,1171],[185,1171]],"region":{"top_left_x":184,"top_left_y":1121,"width":1608,"height":50},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"508670697bf14faab338f0abf09a5f35","type":"text","conversion_output":true,"text":"17. Participants will be asked to report prior pain treatment history at baseline and to report co-","text_display":"\n17. Participants will be asked to report prior pain treatment history at baseline and to report co","confidence":1,"confidence_rate":1},{"cnt":[[183,1164],[1893,1164],[1893,1212],[183,1212]],"region":{"top_left_x":182,"top_left_y":1164,"width":1711,"height":48},"line":18,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"92f2df8c56184d07a165d661a6a1b6b8","type":"text","conversion_output":true,"text":"interventions at each outcome assessment, including new medications, pain-related procedures, and","text_display":"interventions at each outcome assessment, including new medications, pain-related procedures, and","confidence":1,"confidence_rate":1},{"cnt":[[180,1207],[821,1207],[821,1257],[180,1257]],"region":{"top_left_x":180,"top_left_y":1207,"width":641,"height":50},"line":19,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"51a5d8e84fab45caa0669bb415debbc2","type":"text","conversion_output":true,"text":"physical and psychological therapies.","text_display":" physical and psychological therapies.","confidence":1,"confidence_rate":1},{"cnt":[[176,1332],[913,1332],[913,1388],[176,1388]],"region":{"top_left_x":176,"top_left_y":1332,"width":738,"height":56},"line":20,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b9836c5c1e4a46b5a88187aa222de6d4","type":"section_header","conversion_output":false,"children_ids":["2eabd38d79bc4404b66bfbd64262c781"],"text":"","text_display":""},{"cnt":[[185,1336],[909,1336],[909,1386],[185,1386]],"region":{"top_left_x":184,"top_left_y":1336,"width":725,"height":50},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2eabd38d79bc4404b66bfbd64262c781","type":"text","conversion_output":true,"parent_id":"b9836c5c1e4a46b5a88187aa222de6d4","text":"K2. Description of test-based measures","text_display":"\n\n\\section*{K2. Description of test-based measures}","confidence":1,"confidence_rate":1},{"cnt":[[180,1403],[1893,1403],[1893,1450],[180,1450]],"region":{"top_left_x":180,"top_left_y":1402,"width":1713,"height":49},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f15e8d424c6a4963ac0e2e2ed2ef0d9f","type":"text","conversion_output":true,"text":"At 0,6 , and 12 months, participants will undergo an in-person assessment of domains that cannot be","text_display":"\n\nAt 0,6 , and 12 months, participants will undergo an in-person assessment of domains that cannot be","confidence":0.9718334674835205,"confidence_rate":0.9997402990104163},{"cnt":[[180,1448],[1854,1448],[1854,1493],[180,1493]],"region":{"top_left_x":180,"top_left_y":1448,"width":1675,"height":46},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"81f443b800b943d98be7a4ba4c9621c3","type":"text","conversion_output":true,"text":"adequately captured with self-reported measures. A research assistant will administer tests of pain","text_display":" adequately captured with self-reported measures. A research assistant will administer tests of pain","confidence":1,"confidence_rate":1},{"cnt":[[183,1491],[1141,1491],[1141,1536],[183,1536]],"region":{"top_left_x":182,"top_left_y":1491,"width":959,"height":46},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"23a640bd38744202bd7242236826675f","type":"text","conversion_output":true,"text":"sensitivity, physical performance, and cognitive function.","text_display":" sensitivity, physical performance, and cognitive function.","confidence":1,"confidence_rate":1},{"cnt":[[183,1555],[1880,1555],[1880,1601],[183,1601]],"region":{"top_left_x":182,"top_left_y":1555,"width":1698,"height":46},"line":25,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0a068856acd643e6b043a9621bdd7fc4","type":"text","conversion_output":true,"text":"Painful conditions are associated with risk of falling among both middle-aged and older patients; this","text_display":"\n\nPainful conditions are associated with risk of falling among both middle-aged and older patients; this","confidence":1,"confidence_rate":1},{"cnt":[[183,1598],[1923,1598],[1923,1646],[183,1646]],"region":{"top_left_x":182,"top_left_y":1598,"width":1741,"height":48},"line":26,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"11e609de29ed44109907f83646fc076c","type":"text","conversion_output":true,"text":"risk may be exacerbated by medications with psychomotor effects. We will test 3 physical performance","text_display":" risk may be exacerbated by medications with psychomotor effects. We will test 3 physical performance","confidence":0.9990236759185791,"confidence_rate":0.9999909555872323},{"cnt":[[180,1641],[1927,1641],[1927,1691],[180,1691]],"region":{"top_left_x":180,"top_left_y":1641,"width":1748,"height":50},"line":27,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c962f10ccaca4fc9893974e9e3d30cc5","type":"text","conversion_output":true,"text":"factors that may be especially important in determining risk for falls-balance, lower extremity strength,","text_display":" factors that may be especially important in determining risk for falls-balance, lower extremity strength,","confidence":1,"confidence_rate":1},{"cnt":[[183,1689],[1790,1689],[1790,1734],[183,1734]],"region":{"top_left_x":182,"top_left_y":1688,"width":1608,"height":46},"line":28,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f6193cb97a444dd6add664c5a67a9ebf","type":"text","conversion_output":true,"text":"and gait speed. The Fullerton Advanced Balance scale is a 10 -item test that evaluates multiple","text_display":" and gait speed. The Fullerton Advanced Balance scale is a 10 -item test that evaluates multiple","confidence":0.9619140625,"confidence_rate":0.9996230791648684},{"cnt":[[183,1732],[1858,1732],[1858,1777],[183,1777]],"region":{"top_left_x":182,"top_left_y":1731,"width":1677,"height":46},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c37b91042d994db59b92cf60a99dddea","type":"text","conversion_output":true,"text":"dimensions of balance in independent adults. It was designed to be more challenging than balance","text_display":" dimensions of balance in independent adults. It was designed to be more challenging than balance","confidence":1,"confidence_rate":1},{"cnt":[[183,1775],[1910,1775],[1910,1824],[183,1824]],"region":{"top_left_x":182,"top_left_y":1774,"width":1728,"height":51},"line":30,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2e998440dd174f2f84a96f417c13f77f","type":"text","conversion_output":true,"text":"measures developed for frail elderly persons and has been validated as a predictor of falls risk among","text_display":" measures developed for frail elderly persons and has been validated as a predictor of falls risk among","confidence":1,"confidence_rate":1},{"cnt":[[183,1818],[1927,1818],[1927,1865],[183,1865]],"region":{"top_left_x":182,"top_left_y":1817,"width":1746,"height":48},"line":31,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f582903bfe2c44abbb22af0c73c11f93","type":"text","conversion_output":true,"text":"middle-aged and older adults with chronic pain. \\({ }^{66 ; 67}\\) Participants will also complete the Chair Stand test,","text_display":" middle-aged and older adults with chronic pain. \\({ }^{66 ; 67}\\) Participants will also complete the Chair Stand test,","confidence":1,"confidence_rate":1},{"cnt":[[183,1865],[1858,1865],[1858,1910],[183,1910]],"region":{"top_left_x":182,"top_left_y":1864,"width":1677,"height":46},"line":32,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ebe30d94bfb7474ab073d6844f9cb712","type":"text","conversion_output":true,"text":"a brief assessment of lower extremity strength. The Chair Stand measure assessed healthy adults'","text_display":" a brief assessment of lower extremity strength. The Chair Stand measure assessed healthy adults'","confidence":1,"confidence_rate":1},{"cnt":[[183,1904],[1884,1904],[1884,1953],[183,1953]],"region":{"top_left_x":182,"top_left_y":1903,"width":1703,"height":50},"line":33,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0ef1688509fc49a397a8a962d38cc40d","type":"text","conversion_output":true,"text":"(age 20-85) time to stand from a seated position ten times, but subsequent studies found substantial","text_display":" (age 20-85) time to stand from a seated position ten times, but subsequent studies found substantial","confidence":0.810546875,"confidence_rate":0.9980015604513213},{"cnt":[[180,1951],[1934,1951],[1934,1996],[180,1996]],"region":{"top_left_x":180,"top_left_y":1950,"width":1754,"height":46},"line":34,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e1dd8b43c65a45fda7382e8ffd5d71fc","type":"text","conversion_output":true,"text":"floor effects among older adults and arthritis patients, who were often unable to complete ten stands. In","text_display":" floor effects among older adults and arthritis patients, who were often unable to complete ten stands. In","confidence":1,"confidence_rate":1},{"cnt":[[183,1994],[1895,1994],[1895,2039],[183,2039]],"region":{"top_left_x":182,"top_left_y":1993,"width":1713,"height":46},"line":35,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"fe2b99436f3e4e32a910879a00b74574","type":"text","conversion_output":true,"text":"our population of patients with functional limitations due to back and lower-extremity arthritis pain, we","text_display":" our population of patients with functional limitations due to back and lower-extremity arthritis pain, we","confidence":1,"confidence_rate":1},{"cnt":[[180,2037],[1876,2037],[1876,2086],[180,2086]],"region":{"top_left_x":180,"top_left_y":2036,"width":1696,"height":51},"line":36,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"412730aa174640c78bfcd5fefbf9f9b5","type":"text","conversion_output":true,"text":"will use a modified version that counts the number of stands completed in 30 seconds. \\({ }^{68}\\) Gait speed","text_display":" will use a modified version that counts the number of stands completed in 30 seconds. \\({ }^{68}\\) Gait speed","confidence":1,"confidence_rate":1},{"cnt":[[180,2080],[1867,2080],[1867,2129],[180,2129]],"region":{"top_left_x":180,"top_left_y":2079,"width":1687,"height":51},"line":37,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f84ea776864742d19c301d2f6fcf59a1","type":"text","conversion_output":true,"text":"tests are commonly used as performance measures in osteoarthritis. \\({ }^{69}\\) We will use a timed 8 -meter","text_display":" tests are commonly used as performance measures in osteoarthritis. \\({ }^{69}\\) We will use a timed 8 -meter","confidence":0.9150390625,"confidence_rate":0.9992348745530298},{"cnt":[[180,2127],[1871,2127],[1871,2172],[180,2172]],"region":{"top_left_x":180,"top_left_y":2126,"width":1692,"height":47},"line":38,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c7ca2ce4cad94ae1a22909763e33fa34","type":"text","conversion_output":true,"text":"walk protocol that has been shown to reliably assess normal and fast-paced walking speeds among","text_display":" walk protocol that has been shown to reliably assess normal and fast-paced walking speeds among","confidence":1,"confidence_rate":1},{"cnt":[[183,2166],[952,2166],[952,2219],[183,2219]],"region":{"top_left_x":182,"top_left_y":2165,"width":770,"height":55},"line":39,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"31e4f22e0ac543aa92b1f08cd2e5fe85","type":"text","conversion_output":true,"text":"moderately-impaired osteoarthritis patients. \\({ }^{70}\\)","text_display":" moderately-impaired osteoarthritis patients. \\({ }^{70}\\)","confidence":1,"confidence_rate":1},{"cnt":[[185,2234],[1944,2234],[1944,2282],[185,2282]],"region":{"top_left_x":184,"top_left_y":2234,"width":1761,"height":48},"line":40,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0cb463a7a9a0467f80c2a266d5e99d1d","type":"text","conversion_output":true,"text":"Cognitive function will be assessed with a brief battery of tests, the Indiana University Telephone-Based","text_display":"\nCognitive function will be assessed with a brief battery of tests, the Indiana University Telephone-Based","confidence":1,"confidence_rate":1},{"cnt":[[180,2277],[1751,2277],[1751,2327],[180,2327]],"region":{"top_left_x":180,"top_left_y":2277,"width":1571,"height":50},"line":41,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"68c21d6f40cd4b1cbe4a738dc6035627","type":"text","conversion_output":true,"text":"Assessment of Neuropsychological Status (IU-TBANS), which includes four standard clinical","text_display":" Assessment of Neuropsychological Status (IU-TBANS), which includes four standard clinical","confidence":0.9990234375,"confidence_rate":0.9999896060152111},{"cnt":[[183,2322],[1828,2322],[1828,2370],[183,2370]],"region":{"top_left_x":182,"top_left_y":2322,"width":1647,"height":48},"line":42,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"395437bbee0e4a71967f1a195a1d8296","type":"text","conversion_output":true,"text":"instruments covering the following domains: attention, learning and recall, information processing","text_display":" instruments covering the following domains: attention, learning and recall, information processing","confidence":1,"confidence_rate":1},{"cnt":[[183,2365],[1929,2365],[1929,2413],[183,2413]],"region":{"top_left_x":182,"top_left_y":2365,"width":1748,"height":48},"line":43,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9f5db0e0eebc46b6b6f84f8ae19503fe","type":"text","conversion_output":true,"text":"speed, and verbal fluency. \\({ }^{71}\\) This test battery was developed as a sensitive measure of subtle cognitive","text_display":" speed, and verbal fluency. \\({ }^{71}\\) This test battery was developed as a sensitive measure of subtle cognitive","confidence":1,"confidence_rate":1},{"cnt":[[183,2411],[1833,2411],[1833,2460],[183,2460]],"region":{"top_left_x":182,"top_left_y":2410,"width":1651,"height":50},"line":44,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"04e26973781743878df81305b6b91eba","type":"text","conversion_output":true,"text":"dysfunction among community-dwelling cancer survivors (at least one year post-treatment) so we","text_display":" dysfunction among community-dwelling cancer survivors (at least one year post-treatment) so we","confidence":1,"confidence_rate":1},{"cnt":[[183,2578],[1257,2578],[1257,2632],[183,2632]],"region":{"top_left_x":182,"top_left_y":2578,"width":1075,"height":54},"line":45,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"86198315e5f040c98300301f07bbec56","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1841,2625],[1882,2625],[1882,2655],[1841,2655]],"region":{"top_left_x":1841,"top_left_y":2625,"width":42,"height":31},"line":46,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"6e17d925084340cd95412e845bf942ba","type":"page_info","conversion_output":false,"text":"18","text_display":"","confidence":1,"confidence_rate":1}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-19","page":19,"lines":[{"cnt":[[180,249],[1944,249],[1944,299],[180,299]],"region":{"top_left_x":180,"top_left_y":249,"width":1765,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"51dce6a7cddb4357aae3b08029f271fd","type":"text","conversion_output":true,"text":"believe it will be sensitive to small deficits in cognitive function among patients with pain. IU-TBANS has","text_display":"\nbelieve it will be sensitive to small deficits in cognitive function among patients with pain. IU-TBANS has","confidence":1,"confidence_rate":1},{"cnt":[[180,294],[1785,294],[1785,346],[180,346]],"region":{"top_left_x":180,"top_left_y":294,"width":1606,"height":52},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d85c1585015c42e58cfff053957fab8d","type":"text","conversion_output":true,"text":"been validated in both telephone and in-person forms and can be completed in 15-20 minutes.","text_display":" been validated in both telephone and in-person forms and can be completed in 15-20 minutes.","confidence":0.9951193332672119,"confidence_rate":0.9999490365478158},{"cnt":[[180,357],[1858,357],[1858,408],[180,408]],"region":{"top_left_x":180,"top_left_y":356,"width":1679,"height":53},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4c226d9a96d04ef199712f9581b4b0da","type":"text","conversion_output":true,"text":"Participants will also have blood collected by VA clinical staff according to their routine procedures.","text_display":"\nParticipants will also have blood collected by VA clinical staff according to their routine procedures.","confidence":1,"confidence_rate":1},{"cnt":[[180,404],[1729,404],[1729,451],[180,451]],"region":{"top_left_x":180,"top_left_y":403,"width":1550,"height":49},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6fcf9243db57444f88257524b2de7be9","type":"text","conversion_output":true,"text":"Urine for drug testing will be collected at 0,6 , and 12 months. All participants will have total","text_display":" Urine for drug testing will be collected at 0,6 , and 12 months. All participants will have total","confidence":0.7916466693857913,"confidence_rate":0.9978390039581064},{"cnt":[[180,447],[1846,447],[1846,494],[180,494]],"region":{"top_left_x":180,"top_left_y":446,"width":1666,"height":49},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e559b6258a8542faaa3da62f8c50d636","type":"text","conversion_output":true,"text":"testosterone measured at 0 and 12 months; women will also have estradiol measured at 0 and 12","text_display":" testosterone measured at 0 and 12 months; women will also have estradiol measured at 0 and 12","confidence":0.99951171875,"confidence_rate":0.9999953924587458},{"cnt":[[180,490],[1888,490],[1888,539],[180,539]],"region":{"top_left_x":180,"top_left_y":489,"width":1709,"height":51},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4b42b4de14254451b4e8b0f3913166b1","type":"text","conversion_output":true,"text":"months. \\({ }^{8}\\) We will assess pain sensitivity at baseline and follow-up visits with the Cold Pressor task, a","text_display":" months. \\({ }^{8}\\) We will assess pain sensitivity at baseline and follow-up visits with the Cold Pressor task, a","confidence":1,"confidence_rate":1},{"cnt":[[180,535],[1944,535],[1944,582],[180,582]],"region":{"top_left_x":180,"top_left_y":534,"width":1765,"height":49},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a4742c99708740688a9cdef29422fc7d","type":"text","conversion_output":true,"text":"method that has been used in clinical research with adults and children since the 1960s and is the most","text_display":" method that has been used in clinical research with adults and children since the 1960s and is the most","confidence":0.98779296875,"confidence_rate":0.9998862828645091},{"cnt":[[180,576],[1914,576],[1914,627],[180,627]],"region":{"top_left_x":180,"top_left_y":575,"width":1735,"height":53},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d5654f9218cf4e42af77ec35ca439b50","type":"text","conversion_output":true,"text":"sensitive measure of opioid-associated pain hypersensitivity. \\({ }^{7 ; 72}\\) Following recommended protocols for","text_display":" sensitive measure of opioid-associated pain hypersensitivity. \\({ }^{7 ; 72}\\) Following recommended protocols for","confidence":0.9931697845458984,"confidence_rate":0.9999414235264651},{"cnt":[[180,623],[1893,623],[1893,672],[180,672]],"region":{"top_left_x":180,"top_left_y":623,"width":1713,"height":50},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"21ab76f5145440c3bfd56985462e4a9c","type":"text","conversion_output":true,"text":"testing, participants will submerge their non-dominant hand up to the wrist in \\(1^{\\circ} C\\) water continuously","text_display":" testing, participants will submerge their non-dominant hand up to the wrist in \\(1^{\\circ} C\\) water continuously","confidence":0.99951171875,"confidence_rate":0.9999958958025558},{"cnt":[[180,666],[1858,666],[1858,715],[180,715]],"region":{"top_left_x":180,"top_left_y":666,"width":1679,"height":50},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c43c64a19fa54acdbaa7645c6deea2ed","type":"text","conversion_output":true,"text":"circulated by a commercial cooling bath. \\({ }^{72}\\) They will be asked to keep their hand submerged until it","text_display":" circulated by a commercial cooling bath. \\({ }^{72}\\) They will be asked to keep their hand submerged until it","confidence":1,"confidence_rate":1},{"cnt":[[180,711],[1929,711],[1929,758],[180,758]],"region":{"top_left_x":180,"top_left_y":711,"width":1750,"height":48},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"466f41ff2ff04b51952d36a41ea9810a","type":"text","conversion_output":true,"text":"becomes too uncomfortable to continue, at which time they are instructed to withdraw it from the water.","text_display":" becomes too uncomfortable to continue, at which time they are instructed to withdraw it from the water.","confidence":1,"confidence_rate":1},{"cnt":[[180,752],[1779,752],[1779,804],[180,804]],"region":{"top_left_x":180,"top_left_y":751,"width":1599,"height":53},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3b45f49420104c01922b7111b80b072a","type":"text","conversion_output":true,"text":"Pain threshold is time until the stimulus is first perceived as painful; pain tolerance is time until","text_display":" Pain threshold is time until the stimulus is first perceived as painful; pain tolerance is time until","confidence":1,"confidence_rate":1},{"cnt":[[180,799],[587,799],[587,844],[180,844]],"region":{"top_left_x":180,"top_left_y":799,"width":407,"height":46},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"752845a9238c443fbe7d66c43fa7a5e2","type":"text","conversion_output":true,"text":"withdrawal of the hand.","text_display":" withdrawal of the hand.","confidence":1,"confidence_rate":1},{"cnt":[[176,879],[907,879],[907,939],[176,939]],"region":{"top_left_x":176,"top_left_y":878,"width":731,"height":61},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ea8ed34242024076b42ec4135b644aeb","type":"section_header","conversion_output":false,"children_ids":["39e2a3be55c1483da215e4e81484e279"],"text":"","text_display":""},{"cnt":[[183,885],[900,885],[900,935],[183,935]],"region":{"top_left_x":182,"top_left_y":885,"width":719,"height":50},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"39e2a3be55c1483da215e4e81484e279","type":"text","conversion_output":true,"parent_id":"ea8ed34242024076b42ec4135b644aeb","text":"K3. Description of additional measures","text_display":"\n\n\\section*{K3. Description of additional measures}","confidence":1,"confidence_rate":1},{"cnt":[[180,930],[1876,930],[1876,978],[180,978]],"region":{"top_left_x":180,"top_left_y":930,"width":1696,"height":48},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8330032bb3744f73963b617d2198fba3","type":"text","conversion_output":true,"text":"Adverse events will be ascertained using a combination of patient report and medical record review.","text_display":"\n\nAdverse events will be ascertained using a combination of patient report and medical record review.","confidence":0.99951171875,"confidence_rate":0.9999953038523912},{"cnt":[[180,975],[1927,975],[1927,1023],[180,1023]],"region":{"top_left_x":180,"top_left_y":975,"width":1748,"height":48},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"99faadb73628415a9ac1eaf8c9499780","type":"text","conversion_output":true,"text":"Participants will also be asked to report occurence of any falls, hospitalizations, or emergency visits at","text_display":" Participants will also be asked to report occurence of any falls, hospitalizations, or emergency visits at","confidence":0.71875,"confidence_rate":0.9970292710417445},{"cnt":[[180,1018],[724,1018],[724,1063],[180,1063]],"region":{"top_left_x":180,"top_left_y":1018,"width":545,"height":46},"line":18,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"be8bf793a8e9436e8b7f19e8f9c86721","type":"text","conversion_output":true,"text":"each outcome assessment call.","text_display":" each outcome assessment call.","confidence":1,"confidence_rate":1},{"cnt":[[180,1079],[1869,1079],[1869,1130],[180,1130]],"region":{"top_left_x":180,"top_left_y":1078,"width":1690,"height":53},"line":19,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"59687c17f17b449a937d37fc1283642d","type":"text","conversion_output":true,"text":"Additionally, falls will be assessed using a prospective calendar and postcard monitoring protocol. \\({ }^{73}\\)","text_display":"\nAdditionally, falls will be assessed using a prospective calendar and postcard monitoring protocol. \\({ }^{73}\\)","confidence":1,"confidence_rate":1},{"cnt":[[180,1126],[1936,1126],[1936,1175],[180,1175]],"region":{"top_left_x":180,"top_left_y":1125,"width":1756,"height":51},"line":20,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b14b64d7a7e74b2b8e9c157b27b5ef37","type":"text","conversion_output":true,"text":"Participants will track falls on monthly falls calendars and will be asked to complete a postcard and mail","text_display":" Participants will track falls on monthly falls calendars and will be asked to complete a postcard and mail","confidence":1,"confidence_rate":1},{"cnt":[[180,1171],[1927,1171],[1927,1218],[180,1218]],"region":{"top_left_x":180,"top_left_y":1170,"width":1748,"height":49},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3421edf691cf465a83911256308eeb7b","type":"text","conversion_output":true,"text":"it to the research team if a fall occurs. When postcards are received, a research assistant will follow-up","text_display":" it to the research team if a fall occurs. When postcards are received, a research assistant will follow-up","confidence":0.9990234375,"confidence_rate":0.9999911978797494},{"cnt":[[180,1216],[1906,1216],[1906,1261],[180,1261]],"region":{"top_left_x":180,"top_left_y":1216,"width":1726,"height":46},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"69b69b1d1d974058a451847dc46655a0","type":"text","conversion_output":true,"text":"with a phone call to obtain information about the cause and outcome of the fall. To ensure no falls are","text_display":" with a phone call to obtain information about the cause and outcome of the fall. To ensure no falls are","confidence":1,"confidence_rate":1},{"cnt":[[183,1259],[1876,1259],[1876,1308],[183,1308]],"region":{"top_left_x":182,"top_left_y":1258,"width":1694,"height":51},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f703779f4905442d9089df3936bce95f","type":"text","conversion_output":true,"text":"missed, the calendars will be collected every three months and outcome assessors will follow-up on","text_display":" missed, the calendars will be collected every three months and outcome assessors will follow-up on","confidence":1,"confidence_rate":1},{"cnt":[[180,1302],[1910,1302],[1910,1351],[180,1351]],"region":{"top_left_x":180,"top_left_y":1301,"width":1730,"height":51},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5b8782c2e663497f94274953d9940d31","type":"text","conversion_output":true,"text":"any additional falls recorded on the calendars but not previously reported by postcard. This method of","text_display":" any additional falls recorded on the calendars but not previously reported by postcard. This method of","confidence":1,"confidence_rate":1},{"cnt":[[180,1347],[1878,1347],[1878,1394],[180,1394]],"region":{"top_left_x":180,"top_left_y":1347,"width":1698,"height":48},"line":25,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5088a5e68c3f43409d6e493a1e1bfae7","type":"text","conversion_output":true,"text":"fall ascertainment is consistent with recommendations based on a systematic review of fall outcome","text_display":" fall ascertainment is consistent with recommendations based on a systematic review of fall outcome","confidence":1,"confidence_rate":1},{"cnt":[[180,1388],[436,1388],[436,1433],[180,1433]],"region":{"top_left_x":180,"top_left_y":1387,"width":257,"height":47},"line":26,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6a558b99ea6041959a6c24892bbc2a2d","type":"text","conversion_output":true,"text":"assessment. \\({ }^{73}\\)","text_display":" assessment. \\({ }^{73}\\)","confidence":1,"confidence_rate":1},{"cnt":[[180,1452],[1893,1452],[1893,1504],[180,1504]],"region":{"top_left_x":180,"top_left_y":1452,"width":1713,"height":52},"line":27,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"56953da3bf904f25a7ffc7f37111ede1","type":"text","conversion_output":true,"text":"Hospitalizations and emergency visits will be identified and confirmed using medical record review at","text_display":"\n\nHospitalizations and emergency visits will be identified and confirmed using medical record review at","confidence":1,"confidence_rate":1},{"cnt":[[180,1500],[1921,1500],[1921,1549],[180,1549]],"region":{"top_left_x":180,"top_left_y":1499,"width":1741,"height":51},"line":28,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f4cbf8e77c2a4588a8c799de1e961dfa","type":"text","conversion_output":true,"text":"the end of the study. VA hospitalizations and emergency visits will be ascertained using complete data","text_display":" the end of the study. VA hospitalizations and emergency visits will be ascertained using complete data","confidence":1,"confidence_rate":1},{"cnt":[[180,1543],[1927,1543],[1927,1592],[180,1592]],"region":{"top_left_x":180,"top_left_y":1542,"width":1748,"height":50},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d61180dea9c1498a812538f079deeecd","type":"text","conversion_output":true,"text":"available in VistA; non-VA hospitalizations and emergency visits will be ascertained from patient report","text_display":" available in VistA; non-VA hospitalizations and emergency visits will be ascertained from patient report","confidence":1,"confidence_rate":1},{"cnt":[[180,1586],[1938,1586],[1938,1635],[180,1635]],"region":{"top_left_x":180,"top_left_y":1585,"width":1758,"height":50},"line":30,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3e36b648da61414280fb6565fbf7a856","type":"text","conversion_output":true,"text":"and confirmed by medical records. These events will be considered as adverse outcomes regardless of","text_display":" and confirmed by medical records. These events will be considered as adverse outcomes regardless of","confidence":1,"confidence_rate":1},{"cnt":[[180,1629],[1936,1629],[1936,1678],[180,1678]],"region":{"top_left_x":180,"top_left_y":1628,"width":1756,"height":50},"line":31,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8bad08f675274d9cae8479fec8aaa40e","type":"text","conversion_output":true,"text":"where they occurred. To determine whether the events were analgesic-related, two physicians who are","text_display":" where they occurred. To determine whether the events were analgesic-related, two physicians who are","confidence":1,"confidence_rate":1},{"cnt":[[180,1676],[1923,1676],[1923,1723],[180,1723]],"region":{"top_left_x":180,"top_left_y":1675,"width":1743,"height":49},"line":32,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bb02837f014f44d5b9f6c88f2d2d1ce4","type":"text","conversion_output":true,"text":"masked to study arm assignment will review records of emergency visits and hospital admissions. The","text_display":" masked to study arm assignment will review records of emergency visits and hospital admissions. The","confidence":1,"confidence_rate":1},{"cnt":[[180,1719],[1777,1719],[1777,1766],[180,1766]],"region":{"top_left_x":180,"top_left_y":1718,"width":1597,"height":49},"line":33,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"430cae594c0940fb965ae834f8b31d0d","type":"text","conversion_output":true,"text":"World Health Organization system for standardized case causality assessment will be used to","text_display":" World Health Organization system for standardized case causality assessment will be used to","confidence":1,"confidence_rate":1},{"cnt":[[180,1760],[1923,1760],[1923,1811],[180,1811]],"region":{"top_left_x":180,"top_left_y":1759,"width":1743,"height":53},"line":34,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c32b32b7e1ab4c2c9a4bb33a931662b3","type":"text","conversion_output":true,"text":"determine whether the relationship between an event and analgesic use is probable or greater. \\({ }^{74}\\) Initial","text_display":" determine whether the relationship between an event and analgesic use is probable or greater. \\({ }^{74}\\) Initial","confidence":1,"confidence_rate":1},{"cnt":[[180,1807],[1901,1807],[1901,1854],[180,1854]],"region":{"top_left_x":180,"top_left_y":1806,"width":1722,"height":49},"line":35,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"39e316b412134a35bfb021503daf4fd2","type":"text","conversion_output":true,"text":"reviews will be conducted independently to allow for calculation of inter-rater reliability. Subsequently,","text_display":" reviews will be conducted independently to allow for calculation of inter-rater reliability. Subsequently,","confidence":1,"confidence_rate":1},{"cnt":[[180,1850],[1884,1850],[1884,1897],[180,1897]],"region":{"top_left_x":180,"top_left_y":1849,"width":1705,"height":49},"line":36,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e56ca18f0e5a40a9bde387a0624627e9","type":"text","conversion_output":true,"text":"reviewers will meet and attempt to reach consensus; if the two reviewers disagree and cannot reach","text_display":" reviewers will meet and attempt to reach consensus; if the two reviewers disagree and cannot reach","confidence":1,"confidence_rate":1},{"cnt":[[180,1895],[952,1895],[952,1940],[180,1940]],"region":{"top_left_x":180,"top_left_y":1894,"width":772,"height":47},"line":37,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3368897d97534ed8b71b8a8f13b04748","type":"text","conversion_output":true,"text":"consensus, a third reviewer will break the tie.","text_display":" consensus, a third reviewer will break the tie.","confidence":1,"confidence_rate":1},{"cnt":[[180,1955],[1837,1955],[1837,2007],[180,2007]],"region":{"top_left_x":180,"top_left_y":1955,"width":1657,"height":52},"line":38,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7027a729463d449a904f48898151fb93","type":"text","conversion_output":true,"text":"No single measure is adequately predictive or diagnostic of opioid misuse, \\({ }^{5}\\) so data from patients,","text_display":"\nNo single measure is adequately predictive or diagnostic of opioid misuse, \\({ }^{5}\\) so data from patients,","confidence":1,"confidence_rate":1},{"cnt":[[180,2002],[1936,2002],[1936,2052],[180,2052]],"region":{"top_left_x":180,"top_left_y":2002,"width":1756,"height":50},"line":39,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9590b51bdeff4ffba2b4960b8be7819b","type":"text","conversion_output":true,"text":"clinicians, records, and laboratory tests will be use to assess the occurrence of behaviors suggestive of","text_display":" clinicians, records, and laboratory tests will be use to assess the occurrence of behaviors suggestive of","confidence":0.99951171875,"confidence_rate":0.9999955600053285},{"cnt":[[180,2047],[1893,2047],[1893,2095],[180,2095]],"region":{"top_left_x":180,"top_left_y":2047,"width":1713,"height":48},"line":40,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"cd125df4b2a84476a7957a8064c2e702","type":"text","conversion_output":true,"text":"opioid misuse or addiction. In addition to previously described measures, patient-reported substance","text_display":" opioid misuse or addiction. In addition to previously described measures, patient-reported substance","confidence":1,"confidence_rate":1},{"cnt":[[180,2088],[1895,2088],[1895,2138],[180,2138]],"region":{"top_left_x":180,"top_left_y":2088,"width":1715,"height":50},"line":41,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d5f7ca1f83734272909e3753c15adf6f","type":"text","conversion_output":true,"text":"use history \\({ }^{75}\\) will be evaluated at baseline. The Addiction Behavior Checklist (ABC) will be completed","text_display":" use history \\({ }^{75}\\) will be evaluated at baseline. The Addiction Behavior Checklist (ABC) will be completed","confidence":1,"confidence_rate":1},{"cnt":[[180,2136],[1899,2136],[1899,2185],[180,2185]],"region":{"top_left_x":180,"top_left_y":2135,"width":1720,"height":50},"line":42,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"04396a26ba8140158701a07c45336d51","type":"text","conversion_output":true,"text":"by the clinical pharmacist at each intervention visit. The ABC was developed within a VA chronic pain","text_display":" by the clinical pharmacist at each intervention visit. The ABC was developed within a VA chronic pain","confidence":0.99462890625,"confidence_rate":0.9999491940271521},{"cnt":[[180,2179],[1895,2179],[1895,2228],[180,2228]],"region":{"top_left_x":180,"top_left_y":2178,"width":1715,"height":50},"line":43,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"762394b53f824e738f5e370519cde376","type":"text","conversion_output":true,"text":"setting to provide a brief measure for longitudinal clinician assessment of ADRB. \\({ }^{45}\\) Urine drug testing","text_display":" setting to provide a brief measure for longitudinal clinician assessment of ADRB. \\({ }^{45}\\) Urine drug testing","confidence":1,"confidence_rate":1},{"cnt":[[180,2221],[1729,2221],[1729,2271],[180,2271]],"region":{"top_left_x":180,"top_left_y":2221,"width":1550,"height":50},"line":44,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d82d7904946a4fe6a3454b4fc19f8ec1","type":"text","conversion_output":true,"text":"will be obtained at 0,6 , and 12 months as part of outcome assessments for all participants.","text_display":" will be obtained at 0,6 , and 12 months as part of outcome assessments for all participants.","confidence":0.9980475902557373,"confidence_rate":0.999981026217086},{"cnt":[[180,2264],[1858,2264],[1858,2314],[180,2314]],"region":{"top_left_x":180,"top_left_y":2264,"width":1679,"height":50},"line":45,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"68f742cde7b947ccb3c5b92f0de70eb1","type":"text","conversion_output":true,"text":"Additionally, medical record reviews will be completed at the end of the study. Research assistants","text_display":"\nAdditionally, medical record reviews will be completed at the end of the study. Research assistants","confidence":0.9721813201904297,"confidence_rate":0.9997287584415586},{"cnt":[[180,2310],[1921,2310],[1921,2359],[180,2359]],"region":{"top_left_x":180,"top_left_y":2309,"width":1741,"height":50},"line":46,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"436f09c6298b4f9cacb3b4450bad3bf9","type":"text","conversion_output":true,"text":"trained in chart abstraction will review the electronic medical record over the 12 month study period for","text_display":" trained in chart abstraction will review the electronic medical record over the 12 month study period for","confidence":1,"confidence_rate":1},{"cnt":[[180,2355],[1210,2355],[1210,2404],[180,2404]],"region":{"top_left_x":180,"top_left_y":2354,"width":1030,"height":51},"line":47,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"798418253ace429ab65ba92b6def9384","type":"text","conversion_output":true,"text":"documented ADRB and evidence of potential opioid misuse.","text_display":" documented ADRB and evidence of potential opioid misuse.","confidence":0.998046875,"confidence_rate":0.9999679507621811},{"cnt":[[176,2413],[733,2413],[733,2473],[176,2473]],"region":{"top_left_x":176,"top_left_y":2412,"width":557,"height":61},"line":48,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4f8e003d12534a68b3780eaea0b0ac57","type":"section_header","conversion_output":false,"children_ids":["8ab81fd347cd4096bec1423adfad25db"],"text":"","text_display":""},{"cnt":[[183,2419],[728,2419],[728,2469],[183,2469]],"region":{"top_left_x":182,"top_left_y":2419,"width":547,"height":50},"line":49,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8ab81fd347cd4096bec1423adfad25db","type":"text","conversion_output":true,"parent_id":"4f8e003d12534a68b3780eaea0b0ac57","text":"L. Prevention of missing data","text_display":"\n\n\\section*{L. Prevention of missing data}","confidence":1,"confidence_rate":1},{"cnt":[[180,2578],[1257,2578],[1257,2632],[180,2632]],"region":{"top_left_x":180,"top_left_y":2578,"width":1077,"height":54},"line":50,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8d1e635943e74b3db53189fc5d303d04","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1839,2625],[1886,2625],[1886,2660],[1839,2660]],"region":{"top_left_x":1839,"top_left_y":2625,"width":48,"height":35},"line":51,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"002eaf2b3b014c2bafc72dd941afa2f4","type":"page_info","conversion_output":false,"text":"19","text_display":"","confidence":0.99951171875,"confidence_rate":0.9997558295653994}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-20","page":20,"lines":[{"cnt":[[183,249],[1888,249],[1888,299],[183,299]],"region":{"top_left_x":182,"top_left_y":249,"width":1707,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a9323c81f9bf4b2f8e15b47a24049981","type":"text","conversion_output":true,"text":"In pain clinical studies, dropouts often occur due to intervention-related factors (e.g., adverse effects,","text_display":"\n\nIn pain clinical studies, dropouts often occur due to intervention-related factors (e.g., adverse effects,","confidence":0.9990234375,"confidence_rate":0.9999911978797494},{"cnt":[[183,296],[1884,296],[1884,342],[183,342]],"region":{"top_left_x":182,"top_left_y":296,"width":1703,"height":46},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5868af8b68904a41adaf1950b3e0322d","type":"text","conversion_output":true,"text":"lack of treatment efficacy) and missing data can pose a substantial threat to internal validity. SPACE","text_display":" lack of treatment efficacy) and missing data can pose a substantial threat to internal validity. SPACE","confidence":1,"confidence_rate":1},{"cnt":[[183,339],[1882,339],[1882,387],[183,387]],"region":{"top_left_x":182,"top_left_y":339,"width":1701,"height":48},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f884ceef77404895af146b9c03df75d9","type":"text","conversion_output":true,"text":"has several design features meant to enhance participant retention and reduce missing data. \\({ }^{76}\\) First,","text_display":" has several design features meant to enhance participant retention and reduce missing data. \\({ }^{76}\\) First,","confidence":1,"confidence_rate":1},{"cnt":[[180,382],[1888,382],[1888,432],[180,432]],"region":{"top_left_x":180,"top_left_y":382,"width":1709,"height":50},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"1f5bbb24f0f04f65b1d3f6ad489fd470","type":"text","conversion_output":true,"text":"the interventions are flexible treat-to-target prescribing strategies that allow tailoring to each patient's","text_display":" the interventions are flexible treat-to-target prescribing strategies that allow tailoring to each patient's","confidence":1,"confidence_rate":1},{"cnt":[[180,425],[1742,425],[1742,475],[180,475]],"region":{"top_left_x":180,"top_left_y":425,"width":1563,"height":50},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"9083f1c598c34c2a832cb22fd2aace5a","type":"text","conversion_output":true,"text":"needs. Medications will be adjusted individually, reducing dropouts due to lack of efficacy or","text_display":" needs. Medications will be adjusted individually, reducing dropouts due to lack of efficacy or","confidence":1,"confidence_rate":1},{"cnt":[[180,468],[1927,468],[1927,518],[180,518]],"region":{"top_left_x":180,"top_left_y":468,"width":1748,"height":50},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"34c3ed87d674437190d199f69365735e","type":"text","conversion_output":true,"text":"intolerance. Second, both study arms are active interventions, which should reduce differential dropout","text_display":" intolerance. Second, both study arms are active interventions, which should reduce differential dropout","confidence":0.998046875,"confidence_rate":0.9999818979894378},{"cnt":[[180,516],[1846,516],[1846,561],[180,561]],"region":{"top_left_x":180,"top_left_y":515,"width":1666,"height":46},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"f96902e2061c49719023d6c33df77c15","type":"text","conversion_output":true,"text":"that can occur among patients assigned to a control arm. Third, all randomized participants will be","text_display":" that can occur among patients assigned to a control arm. Third, all randomized participants will be","confidence":0.99951171875,"confidence_rate":0.9999953038523912},{"cnt":[[180,559],[1794,559],[1794,606],[180,606]],"region":{"top_left_x":180,"top_left_y":558,"width":1614,"height":48},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4ec063773ef64051b92ae3a799e001ba","type":"text","conversion_output":true,"text":"strongly encouraged to complete all outcome assessments, whether or not they continue in the","text_display":" strongly encouraged to complete all outcome assessments, whether or not they continue in the","confidence":1,"confidence_rate":1},{"cnt":[[183,602],[1790,602],[1790,649],[183,649]],"region":{"top_left_x":182,"top_left_y":601,"width":1608,"height":48},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"62d208be424342f8b9b4a7aee7c93ed7","type":"text","conversion_output":true,"text":"intervention. Fourth, to reinforce participants' sense of commitment to the study, we will send a","text_display":" intervention. Fourth, to reinforce participants' sense of commitment to the study, we will send a","confidence":1,"confidence_rate":1},{"cnt":[[180,645],[1901,645],[1901,694],[180,694]],"region":{"top_left_x":180,"top_left_y":644,"width":1722,"height":50},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"179cd21f596749d8a5eba0c0201b7b4c","type":"text","conversion_output":true,"text":"quarterly SPACE newsletter to participants including tips on pain self-management and positive news","text_display":" quarterly SPACE newsletter to participants including tips on pain self-management and positive news","confidence":1,"confidence_rate":1},{"cnt":[[180,692],[1888,692],[1888,737],[180,737]],"region":{"top_left_x":180,"top_left_y":691,"width":1709,"height":46},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"76db688a1e5e4271b744719cbe4b6871","type":"text","conversion_output":true,"text":"from pain research. Finally, if participants are at risk of dropping out due to assessment burden, they","text_display":" from pain research. Finally, if participants are at risk of dropping out due to assessment burden, they","confidence":1,"confidence_rate":1},{"cnt":[[180,735],[1899,735],[1899,782],[180,782]],"region":{"top_left_x":180,"top_left_y":734,"width":1720,"height":49},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"78c39b1759674930a1fab7297b9d776c","type":"text","conversion_output":true,"text":"will be given the option of completing a minimum core assessment comprising primary pain (i.e., BPI)","text_display":" will be given the option of completing a minimum core assessment comprising primary pain (i.e., BPI)","confidence":1,"confidence_rate":1},{"cnt":[[180,778],[1128,778],[1128,827],[180,827]],"region":{"top_left_x":180,"top_left_y":777,"width":948,"height":51},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"aa0edcee5885473893a3925dc1504970","type":"text","conversion_output":true,"text":"and adverse effect (e.g., symptom checklist) measures.","text_display":" and adverse effect (e.g., symptom checklist) measures.","confidence":1,"confidence_rate":1},{"cnt":[[176,838],[1025,838],[1025,892],[176,892]],"region":{"top_left_x":176,"top_left_y":837,"width":849,"height":55},"line":14,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"827cff44e4f84e05b7003fbd085716d3","type":"section_header","conversion_output":false,"children_ids":["a259a4e1a68745cdb6d7f18701d265e4"],"text":"","text_display":""},{"cnt":[[183,842],[1021,842],[1021,887],[183,887]],"region":{"top_left_x":182,"top_left_y":842,"width":839,"height":46},"line":15,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a259a4e1a68745cdb6d7f18701d265e4","type":"text","conversion_output":true,"parent_id":"827cff44e4f84e05b7003fbd085716d3","text":"M. Qualitative recruitment and data collection","text_display":"\n\n\\section*{M. Qualitative recruitment and data collection}","confidence":1,"confidence_rate":1},{"cnt":[[180,885],[1906,885],[1906,935],[180,935]],"region":{"top_left_x":180,"top_left_y":885,"width":1726,"height":50},"line":16,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0fd089cb966047a581727cc23e9581fc","type":"text","conversion_output":true,"text":"We will recruit four subgroups of SPACE participants for qualitative interviews-those who respond to","text_display":"\n\nWe will recruit four subgroups of SPACE participants for qualitative interviews-those who respond to","confidence":1,"confidence_rate":1},{"cnt":[[180,932],[1901,932],[1901,978],[180,978]],"region":{"top_left_x":180,"top_left_y":932,"width":1722,"height":46},"line":17,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8bd4b94d2b3e49d2b4eccfee18b79344","type":"text","conversion_output":true,"text":"paint treatment and non-responders from each of the two arms. Within each of the subgroups, we will","text_display":" paint treatment and non-responders from each of the two arms. Within each of the subgroups, we will","confidence":1,"confidence_rate":1},{"cnt":[[180,975],[1904,975],[1904,1023],[180,1023]],"region":{"top_left_x":180,"top_left_y":975,"width":1724,"height":48},"line":18,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a3597ab648804f73a0b9f82b93929772","type":"text","conversion_output":true,"text":"purposefully sample participants with a broad range of intervention adherence behavior (e.g., number","text_display":" purposefully sample participants with a broad range of intervention adherence behavior (e.g., number","confidence":1,"confidence_rate":1},{"cnt":[[183,1018],[1876,1018],[1876,1068],[183,1068]],"region":{"top_left_x":182,"top_left_y":1018,"width":1694,"height":50},"line":19,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e0e997563c9549869a0f507227dd0b7a","type":"text","conversion_output":true,"text":"of completed care manager contacts). \\({ }^{77}\\) Experience with conduct of the trial will inform our sampling","text_display":" of completed care manager contacts). \\({ }^{77}\\) Experience with conduct of the trial will inform our sampling","confidence":0.98095703125,"confidence_rate":0.9998342669995032},{"cnt":[[180,1061],[1914,1061],[1914,1111],[180,1111]],"region":{"top_left_x":180,"top_left_y":1061,"width":1735,"height":50},"line":20,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5c753d1699014fb49c66d13a8e20a127","type":"text","conversion_output":true,"text":"strategy; for example, we may identify patterns of non-adherence that merit further exploration. During","text_display":" strategy; for example, we may identify patterns of non-adherence that merit further exploration. During","confidence":1,"confidence_rate":1},{"cnt":[[180,1106],[1888,1106],[1888,1154],[180,1154]],"region":{"top_left_x":180,"top_left_y":1106,"width":1709,"height":48},"line":21,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3ae579df38144f47a98211428e0391d1","type":"text","conversion_output":true,"text":"the initial consent process for the SPACE trial, all participants will be asked for permission to contact","text_display":" the initial consent process for the SPACE trial, all participants will be asked for permission to contact","confidence":0.9990234375,"confidence_rate":0.9999911178608298},{"cnt":[[180,1152],[1919,1152],[1919,1197],[180,1197]],"region":{"top_left_x":180,"top_left_y":1151,"width":1739,"height":46},"line":22,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c7c3231751ef490b89d125d9e4bb9cfe","type":"text","conversion_output":true,"text":"them after intervention completion. The data analyst will provide names of potential participants for the","text_display":" them after intervention completion. The data analyst will provide names of potential participants for the","confidence":1,"confidence_rate":1},{"cnt":[[180,1195],[1820,1195],[1820,1242],[180,1242]],"region":{"top_left_x":180,"top_left_y":1194,"width":1640,"height":48},"line":23,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6133f07029ac4f4cb49e43290e73c130","type":"text","conversion_output":true,"text":"qualitative phase and the study coordinator will contact them within four weeks of completing the","text_display":" qualitative phase and the study coordinator will contact them within four weeks of completing the","confidence":1,"confidence_rate":1},{"cnt":[[180,1238],[404,1238],[404,1283],[180,1283]],"region":{"top_left_x":180,"top_left_y":1237,"width":224,"height":46},"line":24,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"c7cd4b69327148299680d66d377fbf94","type":"text","conversion_output":true,"text":"SPACE trial.","text_display":" SPACE trial.","confidence":1,"confidence_rate":1},{"cnt":[[180,1302],[1785,1302],[1785,1351],[180,1351]],"region":{"top_left_x":180,"top_left_y":1301,"width":1606,"height":51},"line":25,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"3ae0ed2e4fd34970b8caa03137ea5597","type":"text","conversion_output":true,"text":"Throughout data collection and analysis, the research team will remain masked to participants'","text_display":"\n\nThroughout data collection and analysis, the research team will remain masked to participants'","confidence":1,"confidence_rate":1},{"cnt":[[180,1349],[1850,1349],[1850,1394],[180,1394]],"region":{"top_left_x":180,"top_left_y":1349,"width":1670,"height":46},"line":26,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"71492421fb4946c78cf5ded70dd42ae2","type":"text","conversion_output":true,"text":"responder and adherence status. We will use individual semi-structured interviews to address our","text_display":" responder and adherence status. We will use individual semi-structured interviews to address our","confidence":1,"confidence_rate":1},{"cnt":[[180,1388],[1738,1388],[1738,1437],[180,1437]],"region":{"top_left_x":180,"top_left_y":1387,"width":1559,"height":51},"line":27,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"dfa7a76cf056483b84d99fa81be433f5","type":"text","conversion_output":true,"text":"qualitative aims. Development of the semi-structured interview guide will be informed by the","text_display":" qualitative aims. Development of the semi-structured interview guide will be informed by the","confidence":1,"confidence_rate":1},{"cnt":[[180,1435],[1916,1435],[1916,1482],[180,1482]],"region":{"top_left_x":180,"top_left_y":1435,"width":1737,"height":48},"line":28,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4d2226b6e36e4f5298c19bfb9100f394","type":"text","conversion_output":true,"text":"collaborative management framework and TCM as well as questions that arise during the conduct and","text_display":" collaborative management framework and TCM as well as questions that arise during the conduct and","confidence":1,"confidence_rate":1},{"cnt":[[180,1478],[1854,1478],[1854,1525],[180,1525]],"region":{"top_left_x":180,"top_left_y":1478,"width":1675,"height":48},"line":29,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bc8d742c20ae45cd821031cc5e8e27ab","type":"text","conversion_output":true,"text":"analysis of the main SPACE trial. Based on experience with the main trial, questions will be further","text_display":" analysis of the main SPACE trial. Based on experience with the main trial, questions will be further","confidence":1,"confidence_rate":1},{"cnt":[[180,1521],[1919,1521],[1919,1571],[180,1571]],"region":{"top_left_x":180,"top_left_y":1521,"width":1739,"height":50},"line":30,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a465c5f5317146cf875f7da4d0c28844","type":"text","conversion_output":true,"text":"developed, revised, and piloted prior to the beginning of the qualitative phase. The project coordinator,","text_display":" developed, revised, and piloted prior to the beginning of the qualitative phase. The project coordinator,","confidence":1,"confidence_rate":1},{"cnt":[[180,1566],[1835,1566],[1835,1613],[180,1613]],"region":{"top_left_x":180,"top_left_y":1566,"width":1655,"height":48},"line":31,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"58ce8b4276414b0da83c8f811298ba85","type":"text","conversion_output":true,"text":"will conduct interviews in a private VA office within 2 months of each participant's trial completion.","text_display":" will conduct interviews in a private VA office within 2 months of each participant's trial completion.","confidence":0.99951171875,"confidence_rate":0.9999955600053285},{"cnt":[[180,1611],[1884,1611],[1884,1656],[180,1656]],"region":{"top_left_x":180,"top_left_y":1611,"width":1705,"height":46},"line":32,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ef160f67bd184874a433a8fb29392b2f","type":"text","conversion_output":true,"text":"Interviews will be digitally audio-recorded and transcribed for analysis as they become available. We","text_display":" Interviews will be digitally audio-recorded and transcribed for analysis as they become available. We","confidence":1,"confidence_rate":1},{"cnt":[[180,1654],[1876,1654],[1876,1699],[180,1699]],"region":{"top_left_x":180,"top_left_y":1654,"width":1696,"height":46},"line":33,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ab4c15d68dbc4c308bcc803e5100d8c5","type":"text","conversion_output":true,"text":"will continue to conduct interviews with patients until theoretical saturation is reached. Based on our","text_display":" will continue to conduct interviews with patients until theoretical saturation is reached. Based on our","confidence":1,"confidence_rate":1},{"cnt":[[180,1697],[1910,1697],[1910,1747],[180,1747]],"region":{"top_left_x":180,"top_left_y":1697,"width":1730,"height":50},"line":34,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"b511be7ac09c432691636a9149f56ac5","type":"text","conversion_output":true,"text":"experience and recommendations for sampling subgroups, \\({ }^{77}\\) we expect to conduct up to 10 interviews","text_display":" experience and recommendations for sampling subgroups, \\({ }^{77}\\) we expect to conduct up to 10 interviews","confidence":1,"confidence_rate":1},{"cnt":[[180,1742],[1796,1742],[1796,1790],[180,1790]],"region":{"top_left_x":180,"top_left_y":1742,"width":1617,"height":48},"line":35,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"5e6b64b5278c4aad894e3a4dc8aa9c57","type":"text","conversion_output":true,"text":"for each group (responders and non-responders in each study arm), for a total of 40 participant","text_display":" for each group (responders and non-responders in each study arm), for a total of 40 participant","confidence":1,"confidence_rate":1},{"cnt":[[183,1788],[372,1788],[372,1828],[183,1828]],"region":{"top_left_x":182,"top_left_y":1787,"width":190,"height":42},"line":36,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"69351794d6f14ffba31027f6f9d197b9","type":"text","conversion_output":true,"text":"interviews.","text_display":" interviews.","confidence":1,"confidence_rate":1},{"cnt":[[178,1843],[683,1843],[683,1901],[178,1901]],"region":{"top_left_x":178,"top_left_y":1843,"width":506,"height":59},"line":37,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2e2886ad54e94ba5a362b22de401838f","type":"section_header","conversion_output":false,"children_ids":["a937a213cb6d49e7aeedee0643d045ce"],"text":"","text_display":""},{"cnt":[[185,1848],[679,1848],[679,1897],[185,1897]],"region":{"top_left_x":184,"top_left_y":1847,"width":495,"height":51},"line":38,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a937a213cb6d49e7aeedee0643d045ce","type":"text","conversion_output":true,"parent_id":"2e2886ad54e94ba5a362b22de401838f","text":"N. DISSEMINATION PLAN","text_display":"\n\n\\section*{N. DISSEMINATION PLAN}","confidence":1,"confidence_rate":1},{"cnt":[[183,1916],[1768,1916],[1768,1962],[183,1962]],"region":{"top_left_x":182,"top_left_y":1916,"width":1587,"height":46},"line":39,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"eaa058912f414fb685a68f5748b3a843","type":"text","conversion_output":true,"text":"Results of the SPACE trial will be interpreted not in isolation, but in the context of results from","text_display":"\n\nResults of the SPACE trial will be interpreted not in isolation, but in the context of results from","confidence":0.99951171875,"confidence_rate":0.9999953038523912},{"cnt":[[180,1959],[1884,1959],[1884,2007],[180,2007]],"region":{"top_left_x":180,"top_left_y":1959,"width":1705,"height":48},"line":40,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"03d6b3303e9840f1a0826ff191b73038","type":"text","conversion_output":true,"text":"complementary VA-funded pain clinical trials designed to address different gaps in our knowledge of","text_display":" complementary VA-funded pain clinical trials designed to address different gaps in our knowledge of","confidence":1,"confidence_rate":1},{"cnt":[[180,2002],[1912,2002],[1912,2052],[180,2052]],"region":{"top_left_x":180,"top_left_y":2002,"width":1733,"height":50},"line":41,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"337b04f9ea064ae3921bb22122adfde7","type":"text","conversion_output":true,"text":"chronic pain management. Together, these distinct but complementary studies will provide necessary","text_display":" chronic pain management. Together, these distinct but complementary studies will provide necessary","confidence":1,"confidence_rate":1},{"cnt":[[180,2047],[1377,2047],[1377,2095],[180,2095]],"region":{"top_left_x":180,"top_left_y":2047,"width":1198,"height":48},"line":42,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ef079f86f1a94d3e869660d5839aea18","type":"text","conversion_output":true,"text":"data for clinicians and policy-makers working to improve VA pain care.","text_display":" data for clinicians and policy-makers working to improve VA pain care.","confidence":1,"confidence_rate":1},{"cnt":[[180,2110],[1762,2110],[1762,2159],[180,2159]],"region":{"top_left_x":180,"top_left_y":2109,"width":1582,"height":51},"line":43,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"8f39e0a3110e4680acb2b91027859496","type":"text","conversion_output":true,"text":"The primary knowledge gap SPACE addresses is the long-term benefit of an opioid-intensive","text_display":"\nThe primary knowledge gap SPACE addresses is the long-term benefit of an opioid-intensive","confidence":1,"confidence_rate":1},{"cnt":[[180,2157],[1871,2157],[1871,2202],[180,2202]],"region":{"top_left_x":180,"top_left_y":2157,"width":1692,"height":46},"line":44,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"d5514ec9b6a14b46bc0c96f3956feb19","type":"text","conversion_output":true,"text":"prescribing strategy compared with an opioid-avoidant strategy. Information about the magnitude of","text_display":" prescribing strategy compared with an opioid-avoidant strategy. Information about the magnitude of","confidence":1,"confidence_rate":1},{"cnt":[[183,2200],[1854,2200],[1854,2247],[183,2247]],"region":{"top_left_x":182,"top_left_y":2200,"width":1673,"height":48},"line":45,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2d7181ea1b5f4fa3a75ea4ceca151515","type":"text","conversion_output":true,"text":"benefit, along with additional information about the likelihood of harm, is necessary for providers to","text_display":" benefit, along with additional information about the likelihood of harm, is necessary for providers to","confidence":1,"confidence_rate":1},{"cnt":[[180,2243],[1910,2243],[1910,2290],[180,2290]],"region":{"top_left_x":180,"top_left_y":2242,"width":1730,"height":49},"line":46,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"6272dc2f673544b2a12ea8d5d6e95434","type":"text","conversion_output":true,"text":"make the best decisions with individual patients about their pain treatment options. Meanwhile, results","text_display":" make the best decisions with individual patients about their pain treatment options. Meanwhile, results","confidence":0.99951171875,"confidence_rate":0.9999954777833909},{"cnt":[[180,2288],[1863,2288],[1863,2335],[180,2335]],"region":{"top_left_x":180,"top_left_y":2288,"width":1683,"height":48},"line":47,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"416dce29978541338a8f6f0cb0a8086e","type":"text","conversion_output":true,"text":"of complementary studies, including SCOPE and ESCAPE at the Roudebush VA, will inform VA on","text_display":" of complementary studies, including SCOPE and ESCAPE at the Roudebush VA, will inform VA on","confidence":1,"confidence_rate":1},{"cnt":[[180,2333],[1201,2333],[1201,2378],[180,2378]],"region":{"top_left_x":180,"top_left_y":2333,"width":1021,"height":46},"line":48,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"815378894567406895e95aa8a7eabcc0","type":"text","conversion_output":true,"text":"how to address provider and structural barriers to pain care.","text_display":" how to address provider and structural barriers to pain care.","confidence":1,"confidence_rate":1},{"cnt":[[180,2393],[1927,2393],[1927,2443],[180,2443]],"region":{"top_left_x":180,"top_left_y":2393,"width":1748,"height":50},"line":49,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"79a6b77d1acb4638ae48993b9aca642d","type":"text","conversion_output":true,"text":"To disseminate pain research findings, we will take full advantage of the robust pain care infrastructure","text_display":"\nTo disseminate pain research findings, we will take full advantage of the robust pain care infrastructure","confidence":1,"confidence_rate":1},{"cnt":[[180,2441],[1824,2441],[1824,2488],[180,2488]],"region":{"top_left_x":180,"top_left_y":2440,"width":1645,"height":48},"line":50,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"1c645facc2874ee6a9f19cbe181d80b9","type":"text","conversion_output":true,"text":"that exists within the VA. The National Pain Management Strategy Coordinating Committee is an","text_display":" that exists within the VA. The National Pain Management Strategy Coordinating Committee is an","confidence":0.9990234375,"confidence_rate":0.9999900302573734},{"cnt":[[183,2578],[1257,2578],[1257,2632],[183,2632]],"region":{"top_left_x":182,"top_left_y":2578,"width":1075,"height":54},"line":51,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"cc45f6a19b1849de974536a702fd6a20","type":"page_info","conversion_output":false,"text":"SPACE Protocol Supplement: Original IRB-Approved Protocol","text_display":"","confidence":1,"confidence_rate":1},{"cnt":[[1839,2625],[1882,2625],[1882,2658],[1839,2658]],"region":{"top_left_x":1839,"top_left_y":2625,"width":44,"height":33},"line":52,"column":0,"font_size":22,"is_printed":true,"is_handwritten":false,"id":"f1b140b388d3424a9c6d536ccadc5e38","type":"page_info","conversion_output":false,"text":"20","text_display":"","confidence":1,"confidence_rate":1}],"page_height":2750,"page_width":2125,"languages_detected":[]},{"image_id":"e4ef1058-bc42-42cb-89c4-03db8e1cab4d-21","page":21,"lines":[{"cnt":[[183,249],[1871,249],[1871,299],[183,299]],"region":{"top_left_x":182,"top_left_y":249,"width":1690,"height":50},"line":1,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4e7a8f6f2ccc4de3b7a3e451090a2b0c","type":"text","conversion_output":true,"text":"important channel for disseminating findings to VA providers, administrators, and policy makers. Dr.","text_display":"\nimportant channel for disseminating findings to VA providers, administrators, and policy makers. Dr.","confidence":1,"confidence_rate":1},{"cnt":[[183,296],[1766,296],[1766,342],[183,342]],"region":{"top_left_x":182,"top_left_y":296,"width":1585,"height":46},"line":2,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"7382dbc7e6ef4be78098416b75098951","type":"text","conversion_output":true,"text":"Bair serves on this committee and will facilitate reporting of findings in the form of reports and","text_display":" Bair serves on this committee and will facilitate reporting of findings in the form of reports and","confidence":1,"confidence_rate":1},{"cnt":[[183,339],[1846,339],[1846,385],[183,385]],"region":{"top_left_x":182,"top_left_y":339,"width":1664,"height":46},"line":3,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"860e15e838d8451cb3664cc7462d6055","type":"text","conversion_output":true,"text":"presentations at their meetings. Findings will be further disseminated through VISN Pain Points of","text_display":" presentations at their meetings. Findings will be further disseminated through VISN Pain Points of","confidence":1,"confidence_rate":1},{"cnt":[[183,385],[1850,382],[1850,432],[183,434]],"region":{"top_left_x":182,"top_left_y":382,"width":1668,"height":52},"line":4,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"2f0ea710d23849ad8d3335329dff2930","type":"text","conversion_output":true,"text":"Contact, the Office of Quality and Performance, and VA Center for Medication Safety. We will also","text_display":" Contact, the Office of Quality and Performance, and VA Center for Medication Safety. We will also","confidence":1,"confidence_rate":1},{"cnt":[[183,425],[1912,425],[1912,475],[183,475]],"region":{"top_left_x":182,"top_left_y":425,"width":1731,"height":50},"line":5,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"a196fb3fdd9047369f39b729ed633714","type":"text","conversion_output":true,"text":"present to the large clinically-oriented audience of the VA pain list-serve and monthly national VA pain","text_display":" present to the large clinically-oriented audience of the VA pain list-serve and monthly national VA pain","confidence":1,"confidence_rate":1},{"cnt":[[183,473],[677,473],[677,513],[183,513]],"region":{"top_left_x":182,"top_left_y":472,"width":495,"height":42},"line":6,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"bda2a0bb6c3748e78b3e860a4367b221","type":"text","conversion_output":true,"text":"educational teleconferences.","text_display":" educational teleconferences.","confidence":1,"confidence_rate":1},{"cnt":[[185,535],[1755,535],[1755,582],[185,582]],"region":{"top_left_x":184,"top_left_y":534,"width":1572,"height":49},"line":7,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"4cca820e6f634ef7a4ea610f6b99110d","type":"text","conversion_output":true,"text":"Findings will be disseminated to our research audiences through scientific presentations and","text_display":"\n\nFindings will be disseminated to our research audiences through scientific presentations and","confidence":0.99951171875,"confidence_rate":0.9999949649559944},{"cnt":[[183,580],[1893,580],[1893,625],[183,625]],"region":{"top_left_x":182,"top_left_y":580,"width":1711,"height":46},"line":8,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"77349d0554fa47868f1b053c30e390ce","type":"text","conversion_output":true,"text":"publications, HSR\\&D cyber seminars, and presentations to VA and non-VA interest groups. Principal","text_display":" publications, HSR\\&D cyber seminars, and presentations to VA and non-VA interest groups. Principal","confidence":1,"confidence_rate":1},{"cnt":[[183,623],[1906,623],[1906,672],[183,672]],"region":{"top_left_x":182,"top_left_y":623,"width":1724,"height":50},"line":9,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"e09ad45d00d84ab984076260c725fcd1","type":"text","conversion_output":true,"text":"Investigator Dr. Krebs and Co-Investigator Dr. Bair are both active members of the VA Pain Research","text_display":" Investigator Dr. Krebs and Co-Investigator Dr. Bair are both active members of the VA Pain Research","confidence":1,"confidence_rate":1},{"cnt":[[180,666],[1854,666],[1854,715],[180,715]],"region":{"top_left_x":180,"top_left_y":666,"width":1675,"height":50},"line":10,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"ff03cd22c25645158bd24a4c09becd4e","type":"text","conversion_output":true,"text":"Working Group and Society of General Internal Medicine (SGIM) Pain Interest Group. Both groups","text_display":" Working Group and Society of General Internal Medicine (SGIM) Pain Interest Group. Both groups","confidence":0.99951171875,"confidence_rate":0.9999950666738041},{"cnt":[[183,711],[1897,711],[1897,758],[183,758]],"region":{"top_left_x":182,"top_left_y":711,"width":1716,"height":48},"line":11,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"086709aef18241d499d4d36519b443ce","type":"text","conversion_output":true,"text":"have active list-serves and annual face-to-face meetings. The VA Pain Research Working Group has","text_display":" have active list-serves and annual face-to-face meetings. The VA Pain Research Working Group has","confidence":1,"confidence_rate":1},{"cnt":[[185,756],[1792,756],[1792,801],[185,801]],"region":{"top_left_x":184,"top_left_y":756,"width":1608,"height":46},"line":12,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"0609eaf5ba3e47faad27fc32c7ebcd35","type":"text","conversion_output":true,"text":"monthly telephone conferences to promote coordination and dissemination of VA-relevant pain","text_display":" monthly telephone conferences to promote coordination and dissemination of VA-relevant pain","confidence":1,"confidence_rate":1},{"cnt":[[183,799],[1940,799],[1940,846],[183,846]],"region":{"top_left_x":182,"top_left_y":799,"width":1759,"height":48},"line":13,"column":0,"font_size":35,"is_printed":true,"is_handwritten":false,"id":"169727b562824c10929edd0a2419ff74","type":"text","conversion_output":true,"text":"research. 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