Assessing health technology assessment
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* Alison Sinclair

Health technology assessment (HTA) involves the evaluation of everything from pharmaceuticals and procedures to health systems. The evidence-based assessment considers 4 factors: safety, efficacy, effectiveness and economics. 

The Canadian Coordinating Office of Health Technology Assessment ([www.ccohta.ca](http://www.ccohta.ca)), which was founded in 1989, issues technology reports and overviews and discusses emerging issues, technology diffusion and method guidelines. The site contains executive summaries of reports, lists current and planned projects, and provides a link to EuroScan, a collaborative network of European HTA offices.

Another Canadian HTA site is the Therapeutics Initiative ([www.ti.ubc.ca](http://www.ti.ubc.ca)), which has operated from the University of British Columbia since 1994. The site, which focuses on evidence-based drug therapy, offers a bimonthly *Therapeutics Letter*. Recent issues have looked at the effectiveness of influenza prophylaxis and the safety of COX-2 inhibitors.

In the United Kingdom, the NHS Health Technology Assessment Program site ([www.hta.nhsweb.nhs.uk](http://www.hta.nhsweb.nhs.uk)) offers a list of projects, a monthly email bulletin and online executive summaries. It also acts as a liaison between review groups and the National Institute for Clinical Excellence (NICE, [www.nice.org.uk](http://www.nice.org.uk)), which took over the technology-assessment roles of several groups in 1999. The turbulent early days of NICE have been well documented in the *BMJ* ([www.bmj.com/cgi/content/full/321/7273/1363](http://www.bmj.com/cgi/content/full/321/7273/1363)).

In the US, the Clinical Information Directory maintained by the Agency for Health Care Research and Quality ([www.ahcpr.gov/clinic](http://www.ahcpr.gov/clinic)) contains evidence reports, information on outcomes and effectiveness, technology assessments and reviews, and clinical practice guidelines.

The US and UK both maintain national research registers. In the US, the National Institutes of Health and the National Library of Medicine host a clinical trials site ([www.clinicaltrials.gov](http://www.clinicaltrials.gov)) that allows doctors and patients to conduct text searches or browse. In the UK, the National Research Register is at [www.update-software.com/National/](http://www.update-software.com/National/).

The author thanks Dr. David Moher for his help.

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/164/13/1881.2/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/164/13/1881.2/F1)

Figure.