Tools

Rheumatology

Center for Treatment Comparison and Integrative Analysis

Overview

Who we are

We are specialists in comparative effectiveness research and advanced evidence-based medicine techniques. Our approach considers the growing need for improvements in the quality and relevance of health research in the face of increasing demands on health care spending and the need for further innovation.

Our Mission

To improve the effectiveness and affordability of health care by advancing the quality, scope, and efficiency of clinical research.

We endeavor to create meaningful public health impact through:

  • State-of-the-art, high-value technologies rapidly adopted and appropriately utilized
  • Coverage and reimbursement decisions based on comparative effectiveness and value
  • Health professionals and clinical guideline committees delivering evidence-based clinical advice
  • Informed patient decisions leading to improved health outcomes and quality of life

Our Services

The Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center focuses on innovative efforts in three target areas: Evidence Synthesis, Clinical Practice Guidelines Development and Regulatory Support.

Evidence Synthesis

The Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center has expertise in aggregating and synthesizing comparative effectiveness evidence to fit the individual information needs of patients, clinicians, and payers.

Our team designs and executes both large-scale and small-scale studies, answering complex questions involving multiple treatments, research methods, and diseases.

We provide evidence report and technology assessments informed by our understanding of disease processes and treatments, experience in designing clinical trials, and methodological expertise in gathering and analyzing data.

Our evidence reports have made a significant impact in health policy not only nationally but also internationally (i.e., Austria, Brazil, China, France, Hong Kong, Japan, and Thailand).

Clinical Practice Guidelines Development

The Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center provides comprehensive evidence support and step-by-step methodological assistance to improve the speed and quality of guidelines development.

Our team has developed a web-based fully integrated system to facilitate systematic literature searches, capture data from clinical trials, compile literature summaries, perform evidence synthesis and generate evidence reports. Our customized trial databases also facilitate quick and cost-efficient annual updates for existing guideline recommendations.

Aside from evidence synthesis, our team handles the guideline voting process from start to finish, creating voting forms, conducting the voting process and assimilating these votes to translate expert appraisals into guidelines/recommendations. Our current clients include the American College of Rheumatology and Osteoarthritis Research Society International.

Regulatory Support

The Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center provides detailed and cost-effective empirical support to help achieve new drug indications and allow crossover into new markets.

Our team specializes in employing advanced evidence-based comparative efficacy and meta-epidemiological techniques to support FDA approval processes.

We assist pharmaceutical companies through regulatory review using applied evidence synthesis and comparative efficacy methods. Previously, our group has provided evidence support to prepare knee OA devices for FDA review.

Competencies and Core Principles

Competencies

Technical Expertise

  • CTCIA brings a high degree of expertise in advanced evidence-based comparative efficacy techniques including innovative network (multiple treatment comparison) meta-analysis and meta-epidemiological studies. We also bring a wealth of experience in clinical trial design, clinical practice guidelines development, and gathering and synthesizing evidence.

Cross-Sector Partnerships

  • A trusted affiliate and collaborator, CTCIA develops partnerships and generates resources from government, industry,  professional societies, and international nonprofit organizations.

Stakeholder Engagement

  • CTCIA is committed to engaging its international network of thought leaders, patients, clinicians, industry representatives, and payers so that all of these perspectives inform each stage of the clinical research process.

Core Principles

Collaboration

  • To optimize health care, we believe research should involve the perspectives and trust of all relevant stakeholders. CTCIA works to ensure that all stakeholders are engaged with courtesy, openness, fairness, and accountability.

Quality

  • We are highly attentive to detail and strive to fill our collaborators’ specific needs. Our center is independent, impartial, and transparent.

Impact

  • CTCIA works to create measureable advances and to contribute positive change by improving research that steers clinical decision-making.

Knowledge

  • CTCIA is committed to remaining informed with diverse and practicable current knowledge.

Innovation

  • We apply forward-looking principles to develop new ideas and impactful advances.

Our Team

Raveendhara Bannuru, MD, FAGE

Dr. Bannuru is the director of the Center for Treatment Comparison and Integrative Analysis (CTCIA). Dr. Bannuru’s diverse research interests include evidence synthesis and multiple treatment comparison methodology, clinical practice guideline development, and musculoskeletal epidemiology. He has applied evidence synthesis and comparative effectiveness research methods in preparing knee osteoarthritis devices for the Food and Drug Administration's regulatory review.  Beyond utilizing evidence-based methods for a variety of clinical topics, Dr. Bannuru is also interested in the use of cost-effectiveness analysis in informing public and private sector health care decisions.  Over the past few years, Dr. Bannuru has developed evidence reports for Agency for Healthcare Research and Quality (AHRQ) as part of Tufts’ Evidence-based Practice Center and also for American college of Rheumatology and Osteoarthritis Research Society International. Currently, he guides international expert workgroups in the development of evidence-based clinical practice guidelines for the treatment of musculoskeletal disorders.

Timothy McAlindon, MD, MPH

Dr. Timothy McAlindon is Chief of Rheumatology at Tufts Medical Center, where his extensive clinical research experience includes epidemiologic and clinical studies of rheumatic diseases, with a focus on osteoarthritis and the evaluation of disease-modifying therapies for this disorder. Dr. McAlindon brings research experience in the treatment of several rheumatic disorders, along with considerable experience designing and conducting clinical trials and comparative effectiveness research. He has chaired guidelines development panels for the Osteoarthritis Research Society International (OARSI) and the American College of Rheumatology. He is a current member of the Board of Directors of OARSI.

Elizaveta Vaysbrot, MD, MS

Elizaveta Vaysbrot, MD, MS received her Masters of Science in Drug Regulatory Affairs from the Massachusetts College of Pharmacy and Health Sciences. Dr. Vaysbrot received her MD from Saint Petersburg State Pavlov Medical University, before spending three years conducting clinical research and rheumatology practice in Russia. Since moving to the US, she spent seven years in epidemiological research, working primarily as a rheumatology consultant for the Black Women’s Health Study. She has since worked in evidence synthesis research with Tufts Medical Center’s Rheumatology Division. 

Matthew Sullivan, BA

Matthew Sullivan has been a member of the CTCIA’s Evidence Team for the past few years, supporting a variety of CTCIA projects including clinical practice guidelines development. He has previous clinical research experience as a member of Tufts Medical Center’s Mood Disorders program, where he helped coordinate multiple clinical trials in psychopharmacology. Matthew received his BA from Williams College.

Our Work

Our researchers bring experience in clinical care, evidence synthesis and guideline development to a host of clinical and public health policy issues.

Our team has provided consulting and conducted evidence reviews under contract from professional societies, pharmaceutical companies and other organizations internationally.

Our past and current clients include the American College of Rheumatology and Osteoarthritis Research Society International. We have also provided evidence support to prepare knee OA devices for FDA regulatory review.

Please view our selected publications below: 

Bannuru RR, Flavin NE, Vaysbrot EE, Harvey W, McAlindon, TE. High-energy extracorporeal shock wave therapy is effective for treating chronic calcific tendonitis of the shoulder: a systematic review and meta-analysis. Annals of Internal Medicine. 2014. In press.

McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis and Cartilage. 2014 Jan 24.

Bannuru RR, Vaysbrot EE, McIntyre LF. Did the American Academy of Orthopaedic Surgeons osteoarthritis guidelines miss the mark? Arthroscopy. 2014 Jan;30(1):86-9.

Bannuru RR, Vaysbrot EE, Sullivan MC, McAlindon TE. Relative efficacy of hyaluronic acid in comparison with NSAIDs for knee osteoarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. 2013 Oct 14.

McAlindon T, LaValley M, Schneider E, Nuite M, Lee J, Price L, Lo G, Dawson-Hughes B. Effect of Vitamin D Supplementation on Progression of Knee Pain and Cartilage Volume Loss in Patients With Symptomatic Osteoarthritis A Randomized Controlled Trial. JAMA. 2013; 309(2):155-162.

McAlindon T, Kissin E, Nazarian L, Ranganath V, Prakash S, Taylor M, Bannuru RR, Srinivasan S, Gogia M, McMahon MA et al: American College of Rheumatology report on reasonable use of musculoskeletal ultrasonography in rheumatology clinical practice. Arthritis Care Res (Hoboken), 2012 Nov; 64(11):1625-1640.

McAlindon TEBannuru RR. Osteoarthritis: Is viscosupplementation really so unsafe for knee OA? Nat Rev Rheumatol. 2012 Nov; 8(11):635-6.

Stefan MS, Bannuru RR, Lessard D, Gore JM, Lindenauer PK, Goldberg RJ. The impact of COPD on management and outcomes of patients hospitalized with acute myocardial infarction: a 10-year retrospective observational study. Chest. 2012 Jun; 141(6):1441-8.

Balk EM, Moorthy D, Obadan NO, Patel K, Ip S, Chung M, Bannuru RR, Kitsios GD, Sen S, Iovin RC, Gaylor JM, D’Ambrosio C, Lau J. Diagnosis and Treatment of Obstructive Sleep Apnea in Adults [Internet]. AHRQ Comparative Effectiveness Reviews. 2011 Jul; Report No. 11-EHC052.

Bannuru RR, Dvorak T, Obadan N, Yu WW, Patel K, Chung M, Ip S. Comparative evaluation of radiation treatments for clinically localized prostate cancer: an updated systematic review. Ann Intern Med. 2011 Aug 2; 155(3):171-8.

Bannuru RR, Natov NS, Dasi UR, Schmid CH, McAlindon TE. Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis - meta-analysis. Osteoarthritis Cartilage. 2011; 19(6):611-9.

Kalichman L, Bannuru RR, Severin M, Harvey W. Injection of botulinum toxin for treatment of chronic lateral epicondylitis: systematic review and meta-analysis. Semin Arthritis Rheum. 2011 Jun; 40(6):532-8.

Ip S, Dvorak T, Yu WW, Patel K, Obadan NO, Chung M, Bannuru RR, Lau J. Comparative Evaluation of Radiation Treatments for Clinically Localized Prostate Cancer: An Update. (Prepared by the Tufts Evidence-based Practice Center under contract no. 209 2007 10055 I). Technology Assessment report. Rockville, MD: Agency for Healthcare Research and Quality. August 2010 [www.cmms.hhs.gov/coveragegeninfo/downloads/id69ta.pdf].

McAlindon TEBannuru RR. OARSI recommendations for the management of hip and knee osteoarthritis: the semantics of differences and changes. Osteoarthritis Cartilage. 2010 Apr; 18(4):473-5.

Wang C, Bannuru R, Ramel J, Kupelnick B, Scott, T, Schmid C. Tai Chi on Psychological Well-being: Systematic Review and Meta-analysis. BMC, Complementary and Alternative Medicine.  2010; 23: 1186-1472.

Bannuru RR, Natov NS, Obadan I E, Price LL, Schmid CH, McAlindon TE. Therapeutic trajectory of hyaluronic acid versus corticosteroids in the treatment of knee osteoarthritis: a systematic review and meta-analysis. Arthritis Rheum. 2009; 61(12):1704-11.

Ramel J, Bannuru R, Griffith M, Wang C. Exercise for Fibromyalgia Pain: A Meta-analysis of Randomized controlled Trials. Current Rheumatology Reviews 2009; 5(4): 188-93.

Gloria Y, Wang C, Wayne P, Phillips R. Tai Chi Exercise for Patients with Cardiovascular Conditions and Risk Factors, A Systematic Review. J Cardiopulm Rehab Prev. 2009; 29 (3):152-60.

Wang C, Pablo P, Chen X, Schmid CH, McAlindon T. Acupuncture for Pain Relief in Patients with Rheumatoid Arthritis: A Systematic Review. Arthritis Care & Research. 2008; 28:1183-7.

Yeh GY, Wang C, Wayne PM, Phillips RS.  The Effect of Tai Chi Exercise on Blood Pressure: A Systematic Review.  Prev Cardiology. 2008; 11: 82-89.

Vlad SC, LaValley MP, McAlindon TE, Felson DT. Glucosamine for pain in osteoarthritis: why do trial results differ? Arthritis Rheum. 2007 Jul;56(7):2267-77. Review.

McAlindon TE.  Neutraceuticals: Do they work and when should we use them?  Best Practice & Research Clinical Rheumatology (Osteoarthritis). 2006; 20:99-115.

Wang C, Collet J, Lau J. The Effect of Tai Chi on Health Outcomes in Patients with Chronic Conditions: A Systematic Review. Archives of Internal Medicine. 2004; 164: 493-501.

Biggee BA, McAlindon T. Glucosamine for osteoarthritis: part I, review of the clinical evidence. Med Health R I. 2004; 87: 176-9.

Biggee BA, McAlindon T. Glucosamine for osteoarthritis: part II, biologic and metabolic controversies. Med Health R I. 2004; 87:180-1.

Lo GH, LaValley M, McAlindon T, Felson DT. Intra-articular hyaluronic acid in treatment of knee osteoarthritis: a meta-analysis. JAMA. 2003; 290:3115-21.

McAlindon TE, Lavalley M, Gulin J, Felson DT. Glucosamine and Chondroitin Treatment for Osteoarthritis? A Systematic Quality Assessment and Meta-Analysis. JAMA. 2000; 283:1469-75.

McAlindon TE. Does Diet Affect Potential for Osteoarthritis? (Q & A) Musculoskeletal Medicine 1999; 16:673.

McAlindon TE, Felson DT. Identifying individuals at risk for arthritis. IM Internal Medicine 1996; 17:17-28.


Contact Us

For more information about our services, please contact:

Raveendhara Bannuru, MD, FAGE
Director, Center for Treatment Comparison and Integrative Analysis

Tufts Medical Center
35 Kneeland Street
Boston, Massachusetts 02111
Phone: 617-636-8284

Email: rbannuru@tuftsmedicalcenter.org