Evidence-Based Practice and Health Technology Assessment

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Written by connie dello buono

Evidence-Based Practice and Health Technology Assessment

Evidence-Based Practice: “A way of providing health care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement.” 2009 Medical Subject Headings (MeSH).

Health technology assessment (HTA): “The systematic evaluation of properties, effects, and/or impacts of health care technology. It may address the direct, intended consequences of technologies as well as their indirect, unintended consequences. Its main purpose is to inform technology-related policymaking in health care. HTA is conducted by interdisciplinary groups using explicit analytical frameworks drawing from a variety of methods.” Goodman, Clifford S. HTA 101: Introduction to Health Technology Assessment, January 2004.

Additional information related to Evidence-Based Practice/Health Technology Assessment may be found in the Comparative Effectiveness Research (CER) Main Topic.

Search Tools from NLM

  • HSRR (Health Services and Sciences Research Resources) – (National Information Center on Health Services Research and Health Care Technology (NICHSR), NLM)

    HSRR is a searchable database of information about research datasets, instruments/indices and software employed in Health Services Research, the Behavioral and Social Sciences and Public Health. The database includes brief descriptions of research resources and links to PubMed.

  • PubMed Clinical Queries – (National Library of Medicine (NLM), NIH USA)

    A searching tool based on the work of Haynes, et al, to filter results via a series of evidence filters.

  • PubMed Health – (National Library of Medicine (NLM), NIH USA)

News: Evidence-based Practice/HTA

Data and Tools

  • Cancer Care Outcomes Research & Surveillance Consortium – (National Cancer Institute (NCI), NIH)

    Supports prospective cohort studies on 10,000 patients with newly diagnosed lung or colorectal cancers recruited in geographically diverse populations and health care systems.

  • Comprehensive Assessment of Reform Efforts (COMPARE) – (RAND Corporation USA)

    COMPARE is a transparent, evidence-based approach to providing information and tools to help policymakers, the media, and other interested parties understand, design, and evaluate health policies.

  • Evidence Based Practice Toolkit for Nursing – (Oregon Health & Science University (OHSU) USA)

    This tutorial is designed to support both curriculum-based EBP instruction and the ongoing education of practicing professionals. The tutorial consists of five instructional modules: What is EBP; Asking your question; Levels of evidence; resources; and evidence appraised.

  • Evidence-Based Public Health Training Series – (University of Washington, Northwest Center for Public Health Practice)

    Free online training consisting of nine modules that cover core concepts of the evidence-based public health framework, such as defining public health issues, conducting community assessments, prioritizing options, and evaluating program and policy impacts.

  • Global Health Evidence Evaluation Framework (2013) – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    The Global Health Evidence Evaluation Framework project is aimed at developing an evidence framework for the purposes of informing efficacious, effective, sustainable global health programs at the community and scale level.

  • Health Systems Evidence – (McMaster University, Health Information Research Unit CANADA)

    Health Systems Evidence is a continuously updated repository of syntheses of research evidence about governance, financial and delivery arrangements within health systems, and about implementation strategies that can support change in health systems.

  • Healthy People 2020 Evidence-Based Resources Tool – (Office of Disease Prevention and Health Promotion (ODPHP), HHS)

    Database of evidence-based resources to find interventions and resources that can be used to achieve targets set forth in Healthy People 2020.

  • Introduction to Evidence-Based Practice – (Duke University, Medical Center Library USA)

    This tutorial is intended for any health care practitioner or student who needs a basic introduction to the principles of Evidence-Based Practice.

  • National Registry of Evidence-based Programs and Practices (NREPP) – (Substance Abuse & Mental Health Services Administration (SAMHSA), HHS)

    NREPP is a searchable online registry of more than 350 substance use and mental health interventions. NREPP was developed to help the public learn more about evidence-based interventions that are available for implementation.

  • Patient-Centered Outcomes Research Clinical Decision Support – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    Includes access to the Patient-Centered Clinical Decision Support Learning Network; CDS Connect, an online repository of CDS artifacts; An Evaluation Project which will evaluate the overall initiative; and Funding Opportunities to translate evidence-based research findings into forms and CDS tools.

  • SR Tool Box

    The Systematic Review Toolbox is a searchable, web-based catalog of tools that support the systematic review process across multiple domains

  • Systematic Review Data Repository – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    To assist in the creation of systematic reviews or meta analyses, this tool is designed for the extraction and management of data, and a searchable archive of systematic reviews and their data.

  • The Employee Health Communication Toolkit – (American Institutes of Research (AIR) USA)

    Contains customizable materials to support consumers in identifying, understanding, and using health care information and evidence.

  • Why Not the Best? Comparative Health Care Performance Data – (Commonwealth Fund)

    Free resource for health care professionals interested in tracking performance on various measures of health care quality. It enables organizations to compare their performance against that of peer organizations, against a range of benchmarks, and over time. Case studies and improvement tools spotlight successful improvement strategies of the nation’s top performers.

Databases of Guidelines

  • Cochrane Collaboration Evidence Reviews – (Cochrane Collaboration)

    Cochrane Reviews are published in The Cochrane Library – an online collection of databases that brings together in one place rigorous and up-to-date research on the effectiveness of healthcare treatments and interventions, as well as methodology and diagnostic tests.

  • EPC Evidence Reports – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    AHRQ is developing scientific information for other agencies and organizations on which to base clinical guidelines, performance measures, and other quality improvement tools. Contractor institutions review all relevant scientific literature on assigned clinical care topics and produce evidence reports and technology assessments, conduct research on methodologies and the effectiveness of their implementation, and participate in technical assistance activities.

  • Knowledge Translation (KT+) – (Canadian Obesity Network CANADA, McMaster University, Health Information Research Unit CANADA)

    KT+ provides access to articles on the current evidence on knowledge translation including articles on quality improvement, continuing medical education, computerized clinical decision support, health services research and patient adherence. Its purpose is to inform those working in the knowledge translation area of current research as it is published.

  • Methodology: Evidence-based Reports – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    AHRQ’s Evidence-based Practice Centers have developed methodologies for conducting systematic reviews.

  • Strings Attached: CADTH’s Database Search Filters – (Canadian Agency for Drugs and Technologies in Health (CADTH) CANADA)

    Included are search filters for Pubmed, OVID Medline, Embase, PSYCInfo filters on: Systematic Reviews/Meta-Analysis/Health Technology Assessment, Randomized Controlled Trials, Guidelines, Economic Evaluations/Cost/Economic Models, Health Utilities/Quality of Life, Narrow Economic filter.

Guidelines, Journals, Other Publications

  • A Guide To Evidence-Based Practices (EBP) on The Web – (Substance Abuse & Mental Health Services Administration (SAMHSA), HHS)

    SAMHSA provides this Web Guide to assist the public with simple and direct connections to Web sites that contain information about interventions to prevent and/or treat mental and substance use disorders. The Web Guide provides a list of Web sites that contain information about specific evidence-based practices (EBPs) or provide comprehensive reviews of research findings. The Web Guide can be used by stakeholders throughout the behavioral health field to promote awareness of current intervention research and to increase the implementation and availability of EBPs.

  • Closing the Quality Gap Series – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    This series of reports focuses on improving the quality of health care through critical assessment of relevant evidence for selected settings, interventions, and clinical conditions.

  • Enabling Medication Management Through Health Information Technology (Health IT) – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    This report reviews the literature on the effects of health IT on medication management and synthesizes available evidence regarding the effectiveness and effects of health IT in all phases of medication management as well as reconciliation and education. Gaps are identified; recommendations are made.

  • Ethical Issues in Evidence-Based Medicine – (American Medical Association (AMA))

    This is a special issue of AMA Journal of Ethics from January 2013, which examines law and ethics regarding EBM. It discusses such areas as education, research, individualized care, and trials.

  • Implementation Research: A Synthesis of the Literature (2005) images/pdf.gif icon – (University of South Florida, Louis de la Parte Florida Mental Health Institute USA)

    This 2005 monograph summarizes findings from the review of the research literature on implementation. The review process began by identifying literature reporting any efforts to collect data on attempts to implement practices or programs in any domain, including agriculture, business, child welfare, engineering, health, juvenile justice, manufacturing, medicine, mental health, nursing and social services.

  • Medical Decision Making – (Sage USA)

    Journal offers rigorous and systematic approaches to decision making that are designed to improve the health and clinical care of individuals and to assist with health policy development. Articles may require a subscription to view.

  • Methods Guide for Comparative Effectiveness Reviews – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    Effectiveness and Comparative Effectiveness Reviews, systematic reviews of existing research on the effectiveness, comparative effectiveness, and comparative harms of different health care interventions, are intended to provide relevant evidence to inform real-world health care decisions for patients, providers, and policymakers. In an effort to improve the transparency, consistency, and scientific rigor of the work of the Effective Health Care (EHC) Program, through a collaborative effort, the Agency for Healthcare Research and Quality (AHRQ), the Scientific Resource Center, and the Evidence-based Practice Centers (EPCs) have developed a Methods Guide for Comparative Effectiveness Reviews. We intend that these documents will serve as a resource for our EPCs as well as for other investigators interested in conducting Comparative Effectiveness Reviews.

  • Patient Centered Medical Home Resource Center – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    The series is designed to “expand the toolbox” of methods used to evaluate and refine PCMH models and other health care interventions.

  • Quality/Equality Glossary – (Robert Wood Johnson Foundation (RWJF))

    A glossary of key terms in the fields of health care quality, disparities reduction and quality improvement.

  • Supported Education Evidence-Based Practices (EBP) Kit – (Substance Abuse & Mental Health Services Administration (SAMHSA), HHS)

    This kit of 5 modules, 2 brochures and a power-point presentation is aimed at mental health authorities and agency staff, to assist them in creating culturally sensitive evidence-based and promising practices activities.

Grants, Fellowship

  • AHRQ Conference Grants (R13) – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    HRQ seeks to support conferences that help to further its mission to produce evidence to make health care safer, higher quality, more accessible, equitable and affordable, and to work with HHS and other partners to make sure that the evidence is understood and used

Meetings, Conferences, Webinars

  • BIO International Convention – (Biotechnology Industry Organization (BIO))

    Held in June of each year, the annual meeting represents research and development of innovative healthcare, agricultural, industrial and environmental biotechnology products. Locations vary.

  • G-I-N 2018 Conference – (Guidelines International Network (GIN))

    September 12-14, 2018. Manchester UK

  • G-I-N North America Webinar Series – (Guidelines International Network (GIN))

    This series of webinars examines various aspects relevant to the North American guideline community.

  • Medicine: Mind the Gap Series – (National Institutes of Health (NIH), HHS)

    This seminar series examine issues that surround the areas of research, evidence, and clinical practice. The seminars are available in person at the NIH in Bethesda, MD or via free webcast.

Past Webinars & Meetings

  • Eisenberg Center Conference Series – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    Conference proceedings and white papers from past seminars are available. The conference discusses of state-of-the-art concepts in communication and medical decisionmaking.

  • The Limits of Evidence-based Medicine – (University of Washington)

    A video of Laboratory Medicine Grand Rounds, Dr. Mark Tonelli held on February 10, 2016, in which EBM, its strengths and weaknesses, and the relationship with clinical practice is discussed. The value of case-based medicine to the clinical process is also discussed.

Key Organizations

  • Accelerating Change and Transformation in Organizations and Networks II (ACTION II) – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    ACTION II is a model of field-based research designed to promote innovation in health care delivery by accelerating the diffusion of research into practice. The ACTION II network includes 17 large partnerships and more than 350 collaborating organizations that provide health care to an estimated 50 percent of the U.S. population. ACTION II promotes and accelerates the development, implementation, dissemination, and sustainability of innovations in health care delivery to increase understanding of how to incorporate evidence-based improvements into routine practice to improve quality of care.

  • Canadian Agency for Drugs and Technologies in Health

    National body that provides Canada’s federal, provincial and territorial health care decision makers with credible, impartial advice and evidence-based information about the effectiveness and efficiency of drugs and other health technologies. It was formerly known as the Canadian Coordinating Office for Health Technology Assessment (CCOHTA)

  • Center for Evidence-based Policy – (Oregon Health & Science University (OHSU) USA)

    The Center is a national leader in evidence-based decision making and policy design, working with federal, state and local policymakers in more than 20 states to use high-quality evidence to guide decisions, maximize resources and improve health outcomes.

  • Centre for Evidence-Based Medicine

    Aims to develop, teach and promote evidence-based health care and provide support and resources to doctors and health care professionals to help maintain the highest standards of medicine.

  • Centre for Reviews and Dissemination

    Part of the National Institute for Health Research, CRD undertakes high quality systematic reviews that evaluate the effects of health and social care interventions and the delivery and organisation of health care.

  • Cochrane Collaboration

    Improving healthcare decision-making globally, through systematic reviews of the effects of healthcare interventions.

  • ECRI Institute

    An independent, nonprofit health services research agency that works to improve the quality, safety, and cost-effectiveness of patient care. Provides a wide range of services dealing with healthcare technology, including research, evaluation, assessment, publications, and databases. Other areas of interest include: healthcare risk and quality management, and healthcare environmental management.

  • EUnetHTA (European Network for Health Technology Assessment)

    Focusing on scientific cooperation in HTA in Europe, thirty four government appointed organisations from the EU Member States, Accession Countries and EEA work together to help developing reliable, timely, transparent and transferable information to contribute to HTAs in European countries. The EUnetHTA Joint Action builds on the achievements of a number of the previous European initiatives including the EUnetHTA Project (2006-2008) and the Pharmaceutical Forum (on relative effectiveness).

  • Effective Health Care Program – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    The Effective Health Care Program is dedicated to facilitating decision making by providing findings from high-quality research in formats for different audiences.

  • Equator Network

    This initiative seeks to improve the reliability and value of published health research literature by promoting transparent and accurate reporting and wider use of robust reporting guidelines. The website contains a blog, a library for health research reporting, a toolkit to promote accurate publication of health research, and upcoming and past events and classes.

  • Evidence-Based Health Policy Project – (University of Wisconsin)

    The mission of the Institute is to translate public health and health policy research for policy and practice.

  • Evidence-based Practice Centers (EPC) Program – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    Under the Evidence-based Practice Centers (EPC) Program of five-year contracts are awarded to institutions in the United States and Canada to serve as EPCs. The EPCs review all relevant scientific literature on clinical, behavioral, and organization and financing topics to produce evidence reports and technology assessments. These reports are used for informing and developing coverage decisions, quality measures, educational materials and tools, guidelines, and research agendas. The EPCs also conduct research on methodology of systematic reviews.

  • Evidence-based Practice Centers (EPCs) – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    Evidence-based Practice Centers (EPCs) are top-ranking institutions where research reviews for the AHRQ Effective Health Care Program are made. EPCs are housed at 15 of the nation’s top medical schools, universities, or medical centers. Access research reviews, original research reports, and summary guides.

  • Evidence-based Synthesis Program – (Health Services Research and Development Service (HSR&D), VA)

    The Evidence-based Synthesis Program (ESP) was established to provide timely and accurate syntheses of targeted health care topics of particular importance to VA managers and policy makers and to disseminate these reports broadly throughout VA. Access published reports as well as reports in progress.

  • Health Information Research Unit, HIRU, McMaster University

    Conducts research in the field of health information science and is dedicated to the generation of new knowledge about the nature of health and clinical information problems, the development of new information resources to support evidence-based health care, and the evaluation of various innovations in overcoming health care information problems.

  • Health Technology Assessment – (Washington State Health Care Authority USA)

    The primary purpose of HTA is to ensure medical treatments and services paid for with state health care dollars are safe and proven to work. HTA serves as a resource for state agencies purchasing health care. HTA contracts for scientific, evidence-based reports about whether certain medical devices, procedures, and tests are safe and work as promoted. An independent clinical committee of health care practitioners then uses the reports to determine if programs should pay for the medical device, procedure, or test.

  • Health Technology Assessment International (HTAi)

    Focuses uniquely on health technology assessment (HTA) and provides the key forum for all those from the worlds of health care, academia and business interested in the science, development and application of HTA. Health technology assessment (HTA) offers “supporting evidence based decision making in health care policy and practice”.

  • Healthcare Delivery Research Program – (National Cancer Institute (NCI), NIH)

    NCI’s work related to quality of care research and the translation of this research into practice is available through the links on this website.

  • Insitute of Health Economics – (Institute of Health Economics CANADA)

    The IHE strives to assist decision makers in health policy and practice with the results from economic evaluations, costing and cost-effectiveness analyses, and with syntheses of findings from research in health technology assessment.

  • International Society for Pharmacoeconomics and Outcomes Research (ISPOR)

    ISPOR promotes the science of pharmacoeconomics (health economics) and outcomes research (the scientific discipline that evaluates the effect of health care interventions on patient well-being including clinical outcomes, economic outcomes, and patient-reported outcomes) and facilitates the translation of this research into useful information for healthcare decision-makers to ensure that society allocates scarce health care resources wisely, fairly and efficiently. ISPOR embraces all health technology assessors, government health technology regulators & payers of health care including governments, insurers, and other health care payers who use health care outcomes research information in their decisions.

  • Joanna Briggs Institute

    Based within the University of Adelaide, Australia, the JBI promotes the synthesis, transfer and utilization of evidence by identifying effective healthcare practices to assist in the improvement of healthcare outcomes globally.

  • NExT – Nursing Experts: Translating the Evidence – (University of Illinois at Chicago (UIC))

    The NExT project website is a tool for learning about evidence based public health practice and a portal to evidence based practice resources. The site was developed with a primary audience of public health nurses but will be of interest to everyone interested in learning more about evidence based public health. The site includes a free online course which offers 3 free CEUs to nurses.

  • NHS Health Technology Assessment Programme – (University of Southampton UNITED KINGDOM)

    The HTA programme is part of the National Institute for Health Research (NIHR). It produces independent research information about the effectiveness, costs and broader impact of healthcare treatments and tests for those who plan, provide or receive care in the NHS.

  • National Institute for Health and Clinical Excellence (NICE)

    NICE produces guidance in health technologies with guidance on the use of new and existing medicines, treatments and procedures within the NHS clinical practice; and guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

  • National Quality Forum (NQF)

    Not-for-profit membership organization created to develop and implement a national strategy for health care quality measurement and reporting.

  • Quality Enhancement Research Initiative (QUERI) – (Health Services Research and Development Service (HSR&D), VA)

    Works to improve the quality of healthcare for veterans by implementing research findings into routine clinical practice. The QUERI centers focus on nine high-risk and/or highly prevalent diseases or conditions among veterans.

  • SnowMed International

    Formerly the International Health Terminology Standards Development Organisation (IHTSDO), this organization is a not-for-profit association that develops and promotes use of SNOMED CT to support safe and effective health information exchange. SNOMED CT is a clinical terminology and is considered to be the most comprehensive, multilingual healthcare terminology in the world.

  • Swedish Council on Technology Assessment in Health Care (SBU)

    SBU presents the scientific evidence on the benefits, risks, and costs associated with different interventions. SBU identifies methods that offer the greatest benefits and the least risk, focusing on the most efficient ways to allocate healthcare resources. However, SBU also identifies methods currently in use that provide no benefits, have not been assessed, or are not cost effective.

  • Technology Assessment Program – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    This program provides technology assessments for the Centers for Medicare & Medicaid Services (CMS). AHRQ’s technology assessment program uses state-of-the-art methodologies for assessing the clinical utility of medical interventions. Technology assessments are based on a systematic review of the literature, along with appropriate qualitative and quantitative methods of synthesizing data from multiple studies.

  • The 6|18 Initiative: Accelerating Evidence into Action – (Centers for Disease Control and Prevention (CDC), HHS)

    This initiative from the CDC targets six common and costly health conditions – tobacco use, high blood pressure, healthcare-associated infections, asthma, unintended pregnancies, and diabetes – and 18 proven specific interventions that formed the starting point of discussions with purchasers, payers, and providers. Key actions of this initiative include bringing together health care purchasers, payers, and providers with CDC researchers, economists, and policy analysts to offer opportunities to improve health and control costs with the 6|18 interventions.

Health Technology Assessment

Health Technology Assessment items.

Data, Tools, and Statistics

  • AccessGUDID – (National Library of Medicine (NLM), NIH USA)

    Global Unique Device Identification Database (GUDID) contains key device identification information submitted to the FDA about medical devices that have Unique Device Identifiers (UDI).

  • Diffusion of Medical Procedures And Technology – (Dartmouth Institute for Health Policy & Clinical Practice USA)

    A publicly available source providing researchers, payers, regulators, and innovators with metrics quantifying the temporal and regional patterns of diffusion of medical interventions.

  • Equity-Oriented Toolkit for Health Technology Assessment (HTA) – (World Health Organization Centre for Knowledge Translation and Health Technology Assessment in Health Equity)

    The Equity-Oriented Toolkit is a needs-based health technology assessment model used to provide methods to match the identified health needs of a population, to the most appropriate interventions. It provides tools that explicitly consider health equity at the following steps of health technology assessment: Burden of illness, community effectiveness, economic evaluation, and knowledge translation and implementation.

  • Health Technology Assessment Database – (Cochrane Collaboration)

    Brings together details of completed and ongoing health technology assessments (studies of the medical, social, ethical, and economic implications of healthcare interventions) from around the world. The aim of the HTA Database is to improve the quality and cost-effectiveness of health care.

  • Horizon Scan – (Agency for Healthcare Research and Quality (AHRQ), HHS)

    Horizon Scan examines emerging health care technologies and innovations to better inform patient-centered outcomes research.

  • ISPOR International Digest of Databases – (International Society for Pharmacoeconomics and Outcomes Research (ISPOR) USA)

    Electronic index (Digest) of 400 databases from 45 countries. The Digest consists of key attributes of health care databases. It is grouped by country and allows both key word searches and searches by type of database.

Guidelines, Journals, Other Publications

  • Health Services/Technology Assessment Text (HSTAT) – (National Library of Medicine (NLM), NIH USA)

    Health Services/Technology Assessment Text is a searchable collection of large, full-text practice guidelines (including the Guide to Community Preventive Services), technology assessments and health information.

  • Health Technology Assessment of Medical Devices (2011) images/pdf.gif icon – (World Health Organization (WHO))

    WHO has developed a reference document to provide an introduction to the concept and programme of health technology assessment (HTA) around the world and to highlight the contribution that HTA can make to informed policy and decision-making, particularly in developing and emerging countries. It further aims to describe strategic actions that countries can take for introducing HTA into their health systems.

  • HTA Glossary – (Health Technology Assessment International (HTAi) CANADA)

    Provides a common vocabulary for work in HTA. Entries in this glossary have been created by selecting terms from existing glossaries (eg. Dr. Clifford Goodman’s guide HTA 101) and from terms and sources suggested by many individuals working in the field of HTA.

  • HTAI Global Policy Forum (free) – (Health Technology Assessment International (HTAi) CANADA)

    HTAI has created a subscription journal, which will allow non-members to access policy papers and news/events.

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