Contents

What is the International HTA Database?

The International HTA Database is a freely available repository of bibliographic information about ongoing and completed health technology assessments (HTAs) commissioned or undertaken by members of the International Network of Agencies for Health Technology Assessment (INAHTA) and other HTA organizations. The International HTA database is a unique resource for locating HTA reports as these are typically not included in biomedical bibliographic databases. The International HTA database currently includes records to more than 24,000 HTA reports published by agencies throughout the world, from 1989 to date.

The database, formerly called the HTA Database, was initially established in 1996 by the Centre for Reviews and Dissemination (CRD), at the University of York. In March 2018, INAHTA assumed responsibility for producing the database, created a new database platform, and re-launched the new International HTA Database in June 2020. (The CRD's HTA Database is now an archive and has not been updated since 2018.)

The International HTA Database uses a decentralized approach to produce the content. Once the INAHTA Secretariat has set up a contributing agency profile in the platform, agencies can upload bibliographic information on their ongoing and completed HTA projects. The INAHTA content administrator then checks the record and applies Medical Subject Headings (MeSH) index terms. For more information see the "About" section of the International HTA Database.

Please note: Contributing agencies voluntarily add their records according to their own priorities and work schedules (some add records weekly, others monthly or only annually). Moreover, some agencies add only a subset of their various publications, and others do not currently contribute their HTA report records. Searchers are advised to bear this caution in mind and consider checking individual agency websites as well to ensure more comprehensive searches. (Tip: To check the most recent publications by a specific agency users can search by agency in the Source field and sort the results by year of publication.)

About INAHTA

The International Network of Agencies for Health Technology Assessment (INAHTA) is a non-profit global network of publicly funded health technology assessment (HTA) agencies. INAHTA was founded in 1993 with just a handful of members, and it has since grown to become the largest independent HTA network in the world, with over 50 member agencies.

INAHTA members serve an important role in health systems by providing evidence to support decision-making about health technologies throughout their lifecycle - including their introduction, reimbursement, implementation, optimization, and divestment. As the costs and complexity of health technologies continue to advance, there will be a greater need for HTA to support evidence-informed policy making for creating high-quality and sustainable health systems. The uniqueness of INAHTA can be best described by understanding its role, its relevance to INAHTA members, and its importance in the broader HTA ecosystem. Read more about this in the INAHTA Position Statement on the Uniqueness of INAHTA.

For more information about INAHTA visit: http://www.inahta.org

Contact the INAHTA Secretariat at INAHTA@ihe.ca

Does your organization produce HTAs? Become a contributor

If you are with an organization that produces HTA reports, please contact the INAHTA secretariat at HTAdatabase@ihe.ca for information on how to set up your contributor account and upload your HTA report records to the database.

Register to Use the International HTA Database

The International HTA Database can be accessed via the following link: https://database.inahta.org/.

While the International HTA Database is freely available, visitors are encouraged to register as users to save, view, and download their search histories.

Please note that the database was designed to be searched using Chrome, Edge, or Safari web browsers. Some features may not work on other browsers, such as Firefox.

Register as a User

There are two links where you may register as a user of the International HTA database. Both links lead to the same registration screen. The first 'Register' link is located in the top menu, the second is located below the Search History option on the left-hand side of the page.

To register as a user, please click either of the two ‘Register’ links (see Figure 1).

Figure 1 - International HTA database home page

You will be taken to a screen where you will be prompted to enter your username, email address, password, and confirm the password in the fields as shown in Figure 2 (see below); once you have entered information in these fields, click the 'Register' button.

Figure 2 - Registration fields for the International HTA database

You will then be taken to a screen requesting you check your email for a verification link (see Figure 3).

Figure 3 - Verify your email address to register as a user

Next, go to your email inbox where you should have received an email from INAHTA <noreply.inahta@gmail.com> and click the blue 'Verify Email Address' link provided in the email. If you do not see an email with this information (see Figure 4) please check your email spam filter.

Figure 4 - International HTA database verification email

Your browser window will now change to the International HTA database login window prompting you to enter your email address and password. Enter your username and password and click ‘Login.’

Once you have entered your login information, you are confirmed as a registered user and are logged into the International HTA database. You will notice that the top menu no longer displays ‘Login’ and ‘Register’ and instead displays your registered user profile name.

User Login

The International HTA Database can be accessed via the following link: https://database.inahta.org/.

To log in as a registered user, click the 'Login' link in the top menu of the International HTA database (see Figure 5). On the login screen, enter your account email address and password into the fields as requested and click the red 'Login' button. You are now logged into the database as a user.

Figure 5 - International HTA database home page

Once you have logged in, the ‘Login’ ‘Register’ options in the top menu will change to display your user account profile name.

Account Profile

Registered users of the International HTA database have an account profile where they may update their profile, change their password, or logout. To view the account profile, change a password, or logout, click your registered user account name in the top menu (see Figure 6).

Figure 6 - International HTA database registered user account name

A dropdown menu will appear with three options: ‘Profile,’ ‘Change Password,’ and ‘Logout.’

Profile

The account profile page displays three fields and is where a registered user may update their login name and view their account profile email address.

• Name
  • To edit the account profile name, type the updated name into the ‘Name’ field. Once you have changed the account profile name, click the red ‘Update’ button and the account profile name will be updated immediately.
• Email
  • This field displays the email address associated with the account profile. The email address may only be changed by the database administrator.
• Publisher
  • This field is only available for contributing agencies.

After updating the account profile information, click the red ‘Update’ button to save your changes and return to the database homepage. If you do not wish to make any changes, click the red ‘Cancel’ button and you will be returned to the database homepage without making any changes to your account profile.

Change Password

The ‘Change Password’ link is where a registered user may change their password. To change a password, click the ‘Change Password’ link, then enter your new password into the ‘New Password’ field, and retype it into the ‘Confirm Password’ field. Once you have typed the new password, click the red ‘Update’ button and your password will have been changed. If you make an error typing your password into either of the password fields and they do not match, an error message will appear and your password will not be changed. If you do not wish to make any changes, click the red ‘Cancel’ button and you will be returned to the database homepage.

Logout

The ‘Logout’ link allows registered users to safely exit the user function of the database.

Searching for Records in the International HTA Database

There are several tools to help you find records in the International HTA Database.

• Search bar with filters
• Advanced Search option
• MeSH Browser
• Filters

Search Bar

The search bar is located at the top of the International HTA database homepage (please see Figure 7). Use the pull-down menu on the left of the search box to limit your search to specific fields (e.g., all, keywords, author), then enter your search term(s) in the search box and click search or hit enter.

Figure 7 – International HTA database search bar

Use filters (located in the left-hand menu, see Figure 7 above) to refine your search results.

You can search words in other language than English, using the "All" default search option.

Search Bar Options and Filters

Search options in the pull down menu (to the left of the search bar) include: ‘All,’ ‘Title,’ ‘MeSH Search,’ ‘Author,’ ‘Language,’ ‘Keywords,’ ‘Abstracts,’ ‘Status,’ ‘Record ID,’ ‘Country,’ and ‘Source.’

The default search option is set to search records for ‘All.’

• All
  • This is the default search option. Selecting 'All' will allow you to search all fields (e.g., abstract, author recommendations, keywords, MeSH terms) for the term(s) you enter in the search bar. Use simple searches and the 'All' fields option for the most comprehensive results.
• Title
  • Title will limit your search to look for terms only in the title of the report. [title]
• MeSH Search
  • MeSH Search will search for records that are tagged with specific MeSH terms. Please note that MeSH subheadings and supplementary concepts are not used. MeSH terms are updated annually to include new terms added by the National Library of Medicine going forward, but, we do not retroactively re-index older records with new terms. [mh]
• Author
  • Author will limit your search to specific authors. [authors]
• Language
  • Language will limit your search to whichever language you select. [languages]
• Keywords
  • Keywords will limit your search to the keywords field. Please note that keywords are supplied by the HTA report authors/agency. Not all agencies add keywords to their records. [keywords]
• Abstracts
  • Abstracts will limit your search to records which contain the search term only in the abstract. [abs]
• Status
  • This is a dropdown menu that allows you to limit your search to either ongoing or completed HTA reports. Please note that not all agencies include records for their ongoing projects. [status]
• Record ID
  • This field allows you to search for a specific HTA report by using its associated International HTA database identification number. [record id]
• Country
  • This is a dropdown menu which allows you to limit items to publishers in a specific country.
• Source
  • This will limit your search to organizations that publish records. [source]

Using Boolean Operators and Other Search Tips

You may search the International HTA Database using Boolean search operators (AND, OR, and NOT) as well as parentheses, quotation marks, truncation, and proximity (or adjacency) searching:

• AND
  • If you combine terms using AND, you will only find documents containing both terms.
• OR
  • If you join the boxes using OR, you will find documents that contain either term.
• NOT
  • If you join words with NOT, you will find documents containing one of those words but not the other. Searching for ulcer NOT stomach will locate all documents containing the word ulcer, except for those which also contain the word stomach.
• Combining search lines
  • View your Search History to combine multiple search terms by selecting the check box for the search lines and the Combine Selections With (AND, OR, or NOT). (Please note: you need to be logged into the database as a user to see your Search History).
• Parenthesis / Brackets ()
  • Use parentheses to combine search concepts. for example, (breast OR colon OR lung) AND (immunotherapy OR radiotherapy OR chemotherapy)
  • Search concepts can also be combined using the Advanced search option.
• Phrase searching " "
  • Use double quotation marks to find documents that match the exact phrase contained in the quotes, for example, "negative pressure wound therapy".
  • Multiple word MeSH terms that include punctuation should also be enclosed in double quotation marks if the MeSH field is selected in the search line, for example, "technology assessment, biomedical"[mh]. MeSH terms without punctuation can be searched without quotation marks. (Parentheses can also be used when searching MeSH terms, for example, (technology assessment, biomedical)[mh] will also work.
  • Note that truncation (*) does not work when the phrase is enclosed in quotation marks.
  • Note that the quotation marks should be non-directional (i.e., they look the same at the start and end), and not the directional "smart" quotation marks used in Word documents. Something to be aware of if you are cutting and pasting in a search string rather than typing it into the database directly.
• Hyphenated terms
  • Hyphenated terms should be searched as phrase searches and enclosed in quotation marks (with or without the hyphen).
  • Please note that some agencies record drug combinations using hyphens, while other agencies use a forward slash (/). For example, ivacaftor/tezacaftor/elexacaftor also appears as ivacaftor-tezacaftor-elexacaftor. Enclosing either variation as a phrase in double quotes will capture both variations.
• Truncation *
  • Use an asterisk * at the end of a term to search for multiple endings. For example, nurs* will retrieve nurse, nurses, nursing, etc.
  • Please note that truncation (*) does not work for phrase searches enclosed in quotation marks
  • Please note that wildcard truncation cannot be used in the middle of search terms, for example, tumo*r, will not retrieve either tumor or tumour.
• Proximity (adjacency searching) ADJ#
  • ADJ# allows you to specify that the words you are searching are within a certain proximity of each other, regardless of the order. Substitute the number with the maximum number of words that you would like to have one term from the other, for example:
    • breast ADJ3 cancer will retrieve: breast and gynecological cancer
    • breast ADJ4 cancer will retrieve: breast and uterine cervix cancer
    • breast ADJ5 cancer will retrieve: cancer sites: colon/rectum, lung, breast
  • Please note that ADJ# cannot be used with groups of terms. If ADJ is used with groups of terms, the interface ignores the ADJ and uses AND instead. For example, ((stomach OR breast) ADJ3 cancer) = ((stomach OR breast) AND cancer).
  • ADJ# also cannot be used more than once in a search line, as zero result is returned.

Tip: If two or more search terms are entered in a single search box without any Boolean operator, the default operator is AND - you will retrieve documents that contain all those terms, but the terms are not necessarily adjacent to each other, or in that order. Use phrase searches in double quotation marks (see above) for more precise searching of multiple word search terms, for example, use "multiple sclerosis" rather than multiple sclerosis.

Please note: Search terms must be at least 3 characters long. For example, abbreviations such as MS or TB will show 0 results, but longer abbreviations, such as HTA, will retrieve results.

Filters

Filters are located in the left-hand menu of the International HTA database. These allow you to quickly filter all of the records that are displayed, both in the initial record display as well as in your search results.

Results may be filtered by ‘Year,’ ‘Publication Type’ (Full HTA, Rapid Review, Mini HTA, Not Assigned, and Other), ‘Language’ (customizable checkboxes), ‘Project Status’ (Completed or Ongoing), ‘Source,’ and ‘Country’ (customizable checkboxes). [NOTE: For more information about the publication type, please see the INAHTA Product Types].

Select the filter you wish to apply, and, if prompted, click ‘Apply.’ The record results will be updated to reflect the filter you have selected and applied.

Building searches

Searches that combine terms can be done in different ways.

On the advanced search page, pull down menus allow search boxes to be combined using Boolean search operators (AND, OR, NOT). See Figure 8, below.

On the Search History page (you must be registered and logged in as a user to access the Search History page), individual search lines can be combined by ticking the search lines of interest and then clicking the "Combine selections with" button (provides an option to combine selections using Boolean operators AND, OR, and NOT).

You may also combine terms by typing your search strings directly into the search box.

Tip: We recommend that searches are kept as simple as possible and that search queries are relatively short. The character limit for search queries on most browsers is approximately 2,000 characters, after which long search strings will be truncated and the search results will not be accurate.

Figure 8 – International HTA database advanced search history with Boolean operators shown

Managing Searches

To manage searches, you must first set up a user account via the “Register” link in the top right-hand corner. (Registration is simple and free.) To save, re-run, or delete searches you will have to be signed in.

Search History for Registered Users

Upon registering and signing into the International HTA database as a user, you will see your individual searches appear on the search history screen.

Deleting Lines

Individual lines can be deleted from the search history by checking the box located next to the search item you wish to delete. Other lines in the strategy will be automatically renumbered. You may delete a line that is referred to in a later line, but the later line (later search) will be re-written to include the deleted search term.

Saving Searches

To save searches, you must first set up a user account via the “Register” link in the top right-hand corner. From the search history screen, click the checkboxes of the search items you wish to save, then click on the “Save Selected” button.

Re-running a saved search

To re-run a saved search, ensure you are signed in. Click on the “Saved Search History” link on the left of the screen, then click the search you wish to re-run. The search will automatically re-run.

Exporting search strategies

Search strategies can be exported to a CSV file from the "Saved Search History" screen. To export a saved search, click the checkbox for the search lines you wish to export, then click the "Export Selected" button. A dropdown option of 'CSV' will appear. Click 'CSV' and the search will be downloaded as a CSV file to your computer. (Alternately, your search history can be copied and pasted from the search history screen into a Word document.)

Managing Search Results

You can export search result records from the International HTA database.

Export Records from the International HTA Database

Records can be exported from the results page as either CSV or RIS files. Either Select All (for all references in the search results) or Select the individual references you want to export and then press the "Export Selected" button. A dropdown option of 'CSV' or 'RIS' will appear. (CSV files are suitable for importing into Excel spreadsheets. RIS files are text (.txt) files that can be imported directly into EndNote, Zotero, or other reference manager programs).

Select and click the file type you prefer, and the search will be downloaded to your computer in that file format. If you wish to select all records from your search, click the "Select All" button before pressing the "Export Selected" button. All the records will be selected and will be downloaded in whichever format you choose (CSV or RIS).

Searching using MeSH terms

To search using MeSH terms, click on the ‘MeSH Browser’ link below the search bar. The ‘MeSH Browser’ link will take you to the MeSH explorer which is where you may search for records tagged with specific MeSH terms. Clicking the ‘MeSH Browser’ link will take you to the ‘MeSH Explorer’ screen with a search bar (please see Figure 9 below).

Figure 9 - MeSH Explorer

Enter your term into the search bar and click the red 'Search' button. Results will display a list of MeSH terms, and each term will have a 'Search,' 'Explode,' and 'Tree view of MeSH terms' options (please see Figure 10 below).

Figure 10 - MeSH Explorer (Search, Explode, MeSH Tree)

• The 'Search' function retrieves terms tagged with that specific term.
• The 'Explode' function in the MeSH Term Browser will retrieve records that are tagged with the specified MeSH heading (or subheading) and will also retrieve records that are tagged with any of the more specific MeSH headings (or subheadings) indented beneath it in the Tree structure.
  • If, for example, your search for Diabetes Mellitus, you will see that there are several subtypes of this disorder, such as Type 1, Type 2, and Gestational, listed in the tree as branches of Diabetes Mellitus. Choosing to 'explode' this MeSH term will display the records tagged with this MeSH term as well as all of the subtypes.
• The 'Go to MeSH Tree' function will show how that term fits into the overall hierarchy of MeSH terms.

Clicking 'Search' or 'Explode' in the MeSH Explorer will display those search results and the MeSH term search will be saved on your Search History page.

Tip: In some cases you may need to use older and newer MeSH terms, for example, Deprescriptions (introduced in 2015) and "Drug Prescriptions" (used from 2007-2015). (PubMed's MeSH browser shows the dates MeSH terms were introduced.)

Tip: As most records have only a limited number of MeSH terms, be sure to include search terms in other fields of the records, either by using the default "All", or by including additional fields (title, abstracts, keywords) as well.

Note: MeSH supplementary concepts and subheadings are not used in the database.

Note: The MeSH Browser is not supported in Internet Explorer.

If you have questions or feedback on this user manual, please contact HTAdatabase@ihe.ca