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Brown ArrowEvidence-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.

Evidence-Based Practice (Domestic)

Data, Tools, and Statistics

  • Cancer Care Outcomes Research & Surveillance Consortium - (National Cancer Institute, NIH (NCI))  - Supports prospective cohort studies on 10,000 patients with newly diagnosed lung or colorectal cancers recruited in geographically diverse populations and health care systems.
  • Evidence Database on Aging Care (EDAC) - (New York Academy of Medicine)  - An online database to help scholars, policy analysts, and advocates stay on top of the latest research in aging care, including social services, and care coordination. The database is maintained by The Social Work leadership Academy at The New York Academy of Medicine.
  • Evidence-Based Health Care Resources - (New York University Libraries US)  - Developed by the New York University Libraries, this page provides access to evidence-based health care resources and searching tools. Please note that not all of the resources can be accessed by those outside of the NYU system.
  • Evidence-Based Medicine (EBM) Tutorial - (Duke University Medical Center Library US, University of North Carolina at Chapel Hill Health Science Library US)  - Intended for any health care practitioner or student who needs a basic introduction to the principles of Evidence-Based Medicine.
  • HSRR (Health Services and Sciences Research Resources) - (National Library of Medicine, National Information Center on Health Services Research and Health Care Technology)  - HSRR is a searchable database of information about research datasets, instruments/indices and software. Users may examine and compare characteristics of some of the resources 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. It also includes URLs of providers for additional information or access to the resources. HSRR is not a repository of the actual resources.
  • RAND 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.
  • 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.

Guidelines, Journals, Other Publications/Tutorials

  • ACP Journal Club - (American College of Physicians (ACP) USA)  - This website comprises a 10-year archive (from 2000 to the present) of the cumulative electronic contents of ACP Journal Club, with recurrent weeding of out-of-date articles. The content is carefully selected from over 100 clinical journals through reliable application of explicit criteria for scientific merit, followed by assessment of relevance to medical practice by clinical specialists.
  • Best Practices Series - (Centers for Disease Control and Prevention (CDC))  - CDC's Best Practices User Guide: Coalitions-State and Community Interventions focuses on the critical role coalitions play in a comprehensive tobacco control program. According to Best Practices, communities need to work toward transforming the knowledge, attitudes, and practices of users and nonusers by changing the way tobacco is promoted, sold, and used.
  • The Cochrane Collaboration Top 50 Reviews - (The 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.
  • Enabling Medication Management Through Health Information Technology (Health IT) - (Agency for Healthcare Research and Quality (AHRQ))  - 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.
  • EPC Evidence Reports - (Agency for Healthcare Research and Quality (AHRQ))  - 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.
  • Evidence Syntheses and Systematic Evidence Reviews - (Agency for Healthcare Research and Quality (AHRQ))  - This series was formerly known as Systematic Evidence Reviews (SERs). These are comprehensive reviews of the scientific evidence on the effectiveness of particular clinical preventive services.
  • Evidence-Based Health Care Resources - (New York University Libraries US)  - Developed by the New York University Libraries, this page provides access to evidence-based health care resources and searching tools. Please note that not all of the resources can be accessed by those outside of the NYU system.
  • Evidence-Based Nursing Tutorial - (University of Illinois at Chicago, Library of the Health Sciences-Chicago)  - 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: Introduction to Evidence-Based Nursing; structure of literature; research design; searching the literature; and evaluating the quality of research.
  • Evidence-based Synthesis Program - (Health Services Research and Development Service, Veterans Administration (HSR&D))  - 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.
  • Glossary of Health Care Quality Terms - (Robert Wood Johnson Foundation (RWJF))  - A glossary of key terms in the fields of health care quality, disparities reduction and quality improvement.
  • A Guide To Evidence-Based Practices (EBP) on The Web - (Substance Abuse & Mental Health Services Administration (SAMHSA))  - 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.
  • Implementation Research: A Synthesis of the Literature images/pdf.gif icon - (Louis de la Parte Florida Mental Health Institute, University of South Florida US)  - 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.
  • Introduction to Evidence-Based Practice - (Duke University Medical Center Library US)  - This tutorial is intended for any health care practitioner or student who needs a basic introduction to the principles of Evidence-Based Practice.
  • Methods Guide for Comparative Effectiveness Reviews - (Agency for Healthcare Research and Quality (AHRQ))  - 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.

Key Organizations/Programs

  • Accelerating Change and Transformation in Organizations and Networks II (ACTION II) - (Agency for Healthcare Research and Quality (AHRQ))  - 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.
  • AHRQ Effective Healthcare - (Agency for Healthcare Research and Quality (AHRQ))  - The Effective Health Care Program is dedicated to facilitating decision making by providing findings from high-quality research in formats for different audiences.
  • AHRQ: Evidence-Based Practice Program - (Agency for Healthcare Research and Quality (AHRQ))  - 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.
  • Blue Cross Blue Shield Association Technology Evaluation Center - (Blue Cross Blue Shield Association (BCBSA) US)  - Recognized for its leadership in evidence-based healthcare technology assessment. Its mission is to provide healthcare decision makers with timely, objective and scientifically rigorous assessments that synthesize the available evidence on the diagnosis, treatment, management and prevention of disease.
  • Cancer Quality of Care Measures Project - (National Cancer Institute, NIH (NCI))  - In this project, NCI is collaborating with other agencies and organizations to identify evidence-based quality measures for diagnosing and treating certain major types of cancer
  • Cochrane Collaboration - Improving healthcare decision-making globally, through systematic reviews of the effects of healthcare interventions.
  • Effective Healthcare Program - (Agency for Healthcare Research and Quality (AHRQ))  - Funds individual researchers, research centers, and academic organizations to work together with AHRQ to produce effectiveness and comparative effectiveness research for clinicians, consumers, and policymakers.
  • Evidence-based Practice Centers (EPCs) - (Agency for Healthcare Research and Quality (AHRQ))  - 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, Veterans Administration (HSR&D))  - 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.
  • 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, Veterans Administration (HSR&D))  - 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.

Meetings/Conferences/Webcasts

Evidence-Based Practice (International)

  • 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.

Data, Tools, and Statistics

  • Webliography of Resources for Evidence-based Health Care - (The Cochrane Collaboration)  - This webliography presents an overview of various print and online resources for evidence-based health care and medicine. The recommendations for books, articles and online resources are browseable by speciality, such as epidemiology, statistics, literature appraisal, reporting guidelines, and more. The other resources, such as databases and journals, are listed alphabetically.

Guidelines, Journals, Other Publications

  • Bandolier - (Pain Research Group UK)  - The first issue of Bandolier, an independent journal about evidence-based healthcare, written by Oxford scientists, (RAM AND HJM) was printed in February 1994. It has appeared monthly ever since and has become the premier source of evidence based healthcare information in the UK and worldwide for both healthcare professionals and consumers.
  • CMA Infobase - (Canadian Medical Association (CMA) Canada)  - Clinical practice guidelines produced or endorsed in Canada.
  • Integrative Approaches to Qualitative and Quantitative Evidence - (National Institute for Health and Clinical Excellence (NICE))  - This 2004 report is an informal review of the literature on integrating qualitative and quantitative forms of evidence. The report seeks to address five related questions: 1. What is the role of qualitative approaches in traditional trials and experimental studies? 2. At what point in the development of a field of knowledge is it appropriate to pull qualitative and quantitative learning together? 3. What constitutes good evidence from qualitative studies? 4. Are there hierarchies of evidence within the different types of qualitative investigation? 5. How may the findings of qualitative and quantitative research be synthesised?
  • 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.

Key Organizations/Programs

  • 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)
  • 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.
  • 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.
  • National Institute for Clinical Excellence (NICE) - Set up as a Special Health Authority for England and Wales on 1 April 1999. It is part of the National Health Service (NHS), and its role is to provide patients, health professionals and the public with authoritative, robust and reliable guidance on current "best practice".

Health Technology Assessment

Data, Tools, and Statistics

  • Equity-Oriented Toolkit for Health Technology Assessment (HTA) - (World Health Organization Centre for Knowledge Translation and Health Technology Assessment in Health Equity CA)  - The Equity -Oriented Toolkit is based on a needs-based model of HTA. 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 - (The 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.
  • ISPOR International Digest of Databases - (International Society for Pharmacoeconomics and Outcomes Research (ISPOR) US)  - Electronic index (Digest) of key attributes of health care databases around the world available at the ISPOR website, which is accessible to the public. The Digest is a compendium of 194 databases. These databases list key attributes of health care data from around the world.

Guidelines, Journals, Other Publications

  • Capturing the real value of medical technology to society - (European Health Technology Institute (EHTI) US)  - The European Health Technology Institute for Socio-Economic Research (EHTI) has received a grant from the Institute for Health Technology Studies (InHealth) to provide evidence on the value of medical technology in improving health-related quality of life. Link to more information on this study.
  • Health Services/Technology Assessment Text (HSTAT) - (National Library of Medicine (NLM) U.S.)  - 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 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.
  • NZHTA Clearing House - New Zealand Health Technology Assessment (NZHTA) was a clearing house for health outcomes and health technology assessment, operating from 1997-June 2007. NZHTA is no longer active but publications can still be accessed from this site.

Key Organizations/Programs

  • ECRI Institute - Horizon Scanning - (ECRI Institute US, Lewin Group US, Mathematica Policy Research, Inc.)  - ECRI was awarded a multi-year AHRQ contract (Nov. 2010) to establish the first national Healthcare Horizon Scanning System. The goal of horizon scanning is to provide a comprehensive, systematic, transparent process for identifying, tracking, and monitoring new healthcare technologies, including drugs, medical devices, procedures, services, and care delivery innovations that could signal important changes in patient care, health outcomes, or the healthcare system.
  • 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).
  • 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 US)  - 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".
  • 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.
  • 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.
  • NHS Health Technology Assessment Programme - (University of Southampton UK)  - 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.
  • 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 Assessments - (Agency for Healthcare Research and Quality (AHRQ))  - 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.