Musculoskeletal Health Care (MCRC)

Research on the comparative effectiveness of musculoskeletal treatment options is conducted through the NIAMS Multidisciplinary Clinical Research Center (MCRC).

The overall goal of MCRC is to improve musculoskeletal outcomes for patients with musculoskeletal disease and injury. By taking advantage of cross-disciplinary collaborations, the MCRC is committed to improve the prevention, diagnosis, and treatment of musculoskeletal conditions that burden our aging populations’ health and the economy.

Current projects focus on:

  • Prevention of secondary fracture in elderly patients, using Medicare claims-based research to identify the most effective approaches to post-hip-fracture care.
  • Enhancing informed decision-making by developing an outcomes calculator for sharing individualized risk and benefit information among surgeons, primary care providers and patients considering treatment options for back-pain-related conditions.
  • Improving the safety of orthopedic devices by using claims data as early signals of poor performance.

Center Leadership


  • Anna N.A. Tosteson, ScD
    Anna N.A. Tosteson, ScD Dr. Tosteson's methodological interests include decision-analytic modeling, economic evaluation, preference-based measures of health-related quality of life, and statistical methods for diagnostic technology assessment. 
    Departments of Medicine and of Community & Family Medicine
    The Dartmouth Institute for Health Policy & Clinical Practice
    Geisel School of Medicine at Dartmouth
    Director, NCCC Office of Cancer Comparative Effectiveness Research
    James J. Carroll Professor in Oncology at the Norris Cotton Cancer Center and the Geisel School of Medicine.
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  • Jon Lurie, MD, MS
    Jon Lurie, MD, MS Low Back Pain Pragmatic Clinical Trials Fall Prevention Physician Workforce Modeling  
    Professor of Medicine, Orthopaedics, and of The Dartmouth Institute
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  • Tor Tosteson, ScD
    Tor Tosteson, ScD
    Professor, Biomedical Data Science
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Design of the Spine Patient Outcomes Research Trial
SPINE, 2002;27, No. 12: 1361-72 The Tortoise and the Hare: Is There a Place in Spine Surgery for Randomized Trials
SPINE, 1999;24, No. 23: 2548-9 United States' Trends and Regional Variations in Lumbar Spine Surgery: 1992-2003
SPINE, 2006;31, No. 23: 2707-14 Cost-Effectiveness of Spinal Surgery: The Jury's Out
Annals of Internal Medicine, December 16, 2008;149, No. 12: 901-904 Surgical Treatment of Spinal Stenosis with and without Degenerative Spondylotheisis: Cost-Effectiveness after 2 years
Annals of Internal Medicine, December 16, 2008;149: 845-54 Surgical versus Nonsurgical Therapy for Lumbar Spinal Stenosis
The New England Journal of Medicine, February 21, 2008;358, No. 8: 794-801 SPORT Lumbar Intervertebral Disk Herniation and Back Pain
SPINE, 2008;33: 428-35

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