The overall aim of our CCCR is to develop and provide scientifically rigorous, state-of-the-art methods and resources for conducting musculoskeletal clinical research, thereby expanding the community of investigators performing high-quality musculoskeletal clinical research and increasing the amount of available useful data for researchers, clinicians, patients and policy makers. During the first funding cycle for our CCCR, we successfully engaged with a large cohort of musculoskeletal clinical researchers, introducing them to new methods and datasets. Through multiple projects focused on musculoskeletal conditions and funded by a variety of entities (NIH, AHRQ and PCORI), our group at the University of Washington (UW) has accumulated extensive experience and expertise performing large, clinical, effectiveness trials and transforming routine clinical data into research-ready data. We have developed state-of-the-art methods and accumulated a sizeable amount of cleaned, analyzable data to be used by musculoskeletal researchers. Because of our expertise and resources, we are well-positioned to advance our UW Core Center for Clinical Research (CCCR) in Musculoskeletal Diseases, the UW Clinical Learning, Evidence, And Research (CLEAR) Center for Musculoskeletal Disorders. Our UW CCCR Specific Aims are: 1) Continue to improve methods for clinical musculoskeletal studies, focusing on confirmatory learning methods (study design for both observational studies and clinical trials) and predictive learning methods (artificial intelligence for image processing and electronic health record [EHR] data, both structured and unstructured free text); 2) Continue a Resource Core that provides analysis-ready data sets and services for conducting clinical musculoskeletal research; and 3) Continue an Administrative Core that provides overall leadership for the CCCR, manages the financial aspects of the CCCR, provides communication and outreach to musculoskeletal researchers, and evaluates the success of our efforts. By achieving these aims, we will improve access to expertise and research-quality data, improve analytics by developing methods and pipelines for the analysis of clinical data, and apply and disseminate knowledge regarding the conduct of rigorous clinical trials. Our CCCR will be able to provide useful research data to health system decision-makers who will then be able to apply the results of the research to real-world decisions. By achieving these aims, we will facilitate the transition of health care delivery systems to true learning health care systems. Finally, and importantly, we will work with training programs to train the next generation of investigators in the methods and approaches outlined above.