Indexers attempt to reflect the subject content of the article as it is written. Although bibliographic database managers such as NLM continue to work to narrow this gap, they have more control over the time between publication and citation entry than the time between assessment completion and publication. NLM continues to improve the efficiency of its indexing and related citation management processes. Further, NLM has taken steps to provide information about certain projects whose findings are not yet published. The new HSRProj database provides descriptions of ongoing projects in the related field of health services research, including certain health technology assessment efforts.
Tradeoffs are inherent in the process of gathering evidence for health technology assessments.
On the other hand, there are diminishing returns to literature searching. Beyond a certain critical mass of scientific information, it is unlikely that further searching will yield material of practical impact on assessment findings. That is, as more evidence is gathered, it becomes less likely at the margin that the next article will shift the weight of the evidence to render different assessment findings. Remain cognizant of the origins of HTA as well as its current practical connotation. Further, take account of the role of HTA with respect to health care policies and decision making, e.g., its use in formulating practice guidelines, developing disease management programs, and measuring quality of care.