A. Types of Sources

Available information sources cover different, though often overlapping, sectors of health care information. Although some are devoted to health care topics, others cover the biomedical, social, and other sciences more broadly. Multiple sources should be searched to increase the likelihood of retrieving relevant reports. The types of sources that may be useful for HTA include:

  • Journal and other published literature databases
  • Clinical and administrative databases
  • Practice guideline databases
  • Government reports and monographs
  • Policy and research institute reports
  • Professional association reports and guidelines
  • Market research reports
  • Company reports and press releases
  • Reference lists in available studies and reviews
  • Special inventories/registers of reports
  • Health newsletters and newspapers
  • Colleagues and investigators

Some of these are traditional peer-reviewed, published sources; others are recognized as “grey” literature, as described below.

Across the hundreds of publicly available electronic databases of potential relevance to HTA are various general types. Among the major categories, bibliographic databases have indexed citations (or “records”) for journal articles and other publications. Factual databases provide substantive content in the form of, e.g., guidelines for diagnosis and treatment; compendia of information about pharmacologic properties, indications, contraindications, and other information about drugs; and other authoritative information. Referral databases provide information about organizations, services and other information sources.

The National Information Center on Health Services Research & Health Care Technology (NICHSR) of the US National Library of Medicine (NLM) provides an extensive, organized set of the many, evolving databases, publications, outreach and training, and other information resources for HTA. Various other useful listings of HTA information resources and related tools have been prepared, e.g., Health Technology Assessment on the Net International (Institute of Health Economics 2013), Grey Matters: A Practical Search Tool for Evidence-Based Medicine ] (CADTH 2014), and the HTAi Vortal.

The most widely used of these resources for HTA are the large bibliographic databases, particularly MEDLINE, produced by NLM, and Embase, produced by Elsevier. MEDLINE can be accessed at the NLM website using PubMed, which also includes new in-process citations (with basic citation information and abstracts before being indexed with MeSH terms and added to MEDLINE), citations from various life science journals, and certain other entries. In addition, there are certain specialized or more focused databases in such areas as ongoing clinical trials and their results (e.g., ClinicalTrials.gov of NLM) (Zarin 2011), ongoing health services research (e.g., HSRProj), and practice guidelines (e.g., the National Guideline Clearinghouse of AHRQ and the International Guideline Library of the Guidelines International Network).

The Cochrane Collaboration is an international organization that prepares, maintains and disseminates systematic reviews of RCTs (and other evidence when appropriate) of interventions for many diseases and conditions. Nearly 7,000 systematic reviews have been produced by more than 50 Cochrane review groups in such areas as acute respiratory infections; breast cancer; dementia and cognitive improvement; hypertension; infectious diseases; pregnancy and childbirth; and pain, palliative, and supportive care. These reviews are made available via the Cochrane Library, which also includes certain databases and registers produced by the Cochrane Collaboration as well as some produced by other organizations. The Cochrane Central Register of Controlled Trials includes more than 660,000 records. The Database of Abstracts of Reviews and Dissemination (DARE) and the NHS Economic Evaluation Database (NHS EED) are produced by the Centre for Reviews and Dissemination (CRD) at the University of York. The HTA Database is produced by CRD with information supplied by members of the International Network of Agencies for Health Technology Assessment (INAHTA) and other contributing HTA programs.

The selection of sources for literature searches should depend on the evidence questions and related matters of content of the HTA as well as pertinent time and resource constraints. Most searches are likely to involve one or more of the large bibliographic databases, which have their relative merits and can be complementary in some instances (Wilkins 2005). These sources can be supplemented by specialized bibliographic databases relevant to the topic, such as those devoted to mental health, allied health, or health economics. Further, there are strategies and search filters for identifying particular types of studies in such bibliographic databases, such for records on economic evaluations (Glanville, Lefebvre, Miles, Camosso-Stefinovic 2006). The selection of other databases is likely to differ by purpose of the inquiry, e.g., horizon scanning, ascertaining regulatory or payment status of technologies, comprehensive systematic review, or identifying literature in particular clinical areas. The yield from searching the more specialized sources in addition to the large, generic ones varies (Royle 2003).

Some of the most commonly used bibliographic and factual databases in HTA are listed in Box VII-1. Many additional bibliographic and factual databases that can be used in HTA, including additional generic ones and others that are more specialized, are listed in Box VII-2

Box VII-1. Some Core Sources: Bibliographic and Factual Databases for HTA

Among the most commonly used are the following:

  • PubMed (including MEDLINE): citations for life sciences journal articles and online books (NLM)
  • Embase: citations for biomedical journal articles (Elsevier)
  • Cochrane Database of Systematic Reviews: systematic reviews of controlled trials on hundreds of clinical topics
  • Cochrane Central Register of Controlled Trials: bibliography of controlled trials including sources outside peer-reviewed journal literature
  • Database of Abstracts of Reviews of Effectiveness (DARE): structured abstracts of systematic reviews from around the world, appraised by NHS Centre for Reviews and Dissemination (Cochrane Library)
  • Health Technology Assessment Database: records of completed and ongoing projects of members of INAHTA and other organizations (Cochrane Library)
  • NHS Economic Evaluation Database (NHS EED): abstracts and other information about published economic evaluations of health care interventions (Cochrane Library)

Box VII-2. Additional Sources: Bibliographic and Factual Databases for HTA

The variety of additional generic and more specific sources includes the following:

  • Other NLM sources:
    • Bookshelf: free full-text access to online biomedical books
    • ClinicalTrials.gov: registry of ongoing, and summary results of, clinical trials and observational studies funded by U.S. government and private sources conducted in the U.S. and around the world
    • HSRProj: ongoing health services research and public health projects
    • HSRR (Health Services and Sciences Research Resources): information about research datasets, instruments/indices, software
    • HSTAT: full text of US technology assessments, evidence reports, CER reports, clinical practice guidelines, consensus development reports, methods, reports, etc.
    • PubMed Health: systematic reviews of clinical trials, with related information for clinicians and patients
  • ACP Journal Club: selected studies and systematic reviews on clinical and economic topics for attention of clinicians, with “value added" abstracts and commentary
  • AMED (Allied and Complementary Medicine): citations to journals in physiotherapy, occupational therapy, rehabilitation, speech therapy, podiatry, complementary medicine, palliative care (British Library)
  • Bandolier: journal of summaries of evidence-based health care (University of Oxford, UK)
  • BIOSIS Previews: citations from life sciences journals and reports, reviews, meetings (Thomson Reuters)
  • Campbell Collaboration Library of Systematic Reviews: systematic reviews of the effects of social interventions, including education, crime and justice, and social welfare (Campbell Collaboration)
  • CEA Registry: database of standardized cost-utility analyses (Tufts Medical Center)
  • CINAHL: citations for nursing and allied health literature (Cinahl Information Systems)
  • CDC Wonder: gateway to epidemiological and public health reports, other information, and data (CDC, US)
  • Cochrane Methodology Register: bibliography of articles and books on research synthesis (Cochrane Library)
  • ERIC (Educational Resources Information Center): citations of education information, including in health, for journals, books, research syntheses, technical reports, conferences, policy papers, etc. (US Dept. Education)
  • Evidence Base: evidence briefing papers, reviews on state of existing evidence, research gaps; research recommendations (NICE, UK)
  • Evidence for Policy and Practice Information and Coordinating Centre (EPPI-Centre): databases of health promotion: Trials Register of Promoting Health Interventions (TRoPHI), Bibliomap, Database of Promoting Health Effectiveness Reviews (DoPHER) (Social Science Research Unit, UK)
  • EVIPNet Virtual Health Library: for evidence-informed policymaking, particularly in low- and middle-income countries (WHO)
  • Google Scholar: scholarly literature, with citation information
  • Health Economic Evaluations Database (HEED): records and bibliographies of economic evaluations of health care interventions, reviewed by health economists (Wiley InterScience)
  • Health Systems Evidence: syntheses of research evidence about governance, financial and delivery arrangements within health systems (McMaster University, Canada)
  • International Guideline Library: guidelines, evidence reports developed or endorsed by G-I-N member organizations (Guidelines International Network)
  • National Guideline Clearinghouse (NGC): evidence-based clinical practice guidelines (AHRQ, US)
  • NHS Evidence: portal to organizations and other sources providing health and social care evidence and best practices; most but not limited to UK (NICE, UK)
  • OTSeeker: abstracts of systematic reviews and RCTs (appraised and rated) on occupational therapy
  • PAIS International: citations of policy information, including for health and social conditions, demography, from journals, books, government documents, research reports, grey literature, conferences, etc. (ProQuest)
  • PEDro(Physiotherapy Evidence Database): citations for RCTs, systematic reviews, and clinical practice guidelines in physiotherapy (University of Sydney, Australia)
  • PsycINFO: citations of psychological literature (American Psychological Association)
  • _PROSPERO:_prospective registry of systematic reviews in health and social care (NHS Centre for Reviews and Dissemination)
  • _REHABDATA:_citations for reports, articles, other documents on disability and rehabilitation (US National Rehabilitation Information Center)
  • SciSearch: citations for journals in science, technology, biomedicine, and related disciplines, including all records of Science Citation Index (Dialog)
  • Scopus: citations for peer-reviewed journals, conference proceedings, books, patents in science, medicine, social sciences, other areas; also patent records (Elsevier)
  • SUMSearch 2: integrated search of original studies, systematic review, and practice guidelines from PubMED, DARE, and NGC (University of Kansas, US)
  • Systematic Review Data Repository (SRDR): archive of systematic reviews and their data, and data extraction tool (AHRQ, US)
  • TRIP Database: integrated search tool of multiple sites to identify clinical evidence for practice (TRIP Database, Ltd.)
  • UpToDate®: evidence-based, physician-authored clinical decision support resource (Wolters Kluwer)
  • Web of Science: citations for journals and conference proceedings in life sciences, social sciences, other fields (Thomson Reuters)

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