> For the complete documentation index, see [llms.txt](https://docs.nested-knowledge.com/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.nested-knowledge.com/guides/guidance-by-review-type/evaluations-for-hta-submission.md).
# Evaluations for HTA submission
Learn how to set up your nest to support a HTA submission.
A health technology assessment (HTA) submission typically requires evidence across three distinct components: clinical effectiveness, economic evaluation, and epidemiology.
Choose this guide when your review needs to support a formal HTA submission or if you only need one part, for example an epidemiology-only burden-of-disease review.
For general methodology guidance independent of the software, see [HTA assessments best practices](/best-practices/best-practices-by-review-type/evaluations-for-hta-submissions.md).
### Start Shared, Then Split By Component
**Inputs:** a defined technology, comparator, and target population for each component your submission needs.
**Outputs:** three linked evidence bases in one nest ready for your submission dossier.
Run all three components' searches into one shared nest at the start, rather than three separate nests from day one. This allows you to avoid repeating steps and encourages data re-use.
1. Conduct a broad search
2. Extract preliminary data
Once that shared foundation is in place, use [**Nest Copy**](/your-nests/nest-settings.md#copy-rename-and-delete-a-nest) to split into three working nests, one per component, before you configure component-specific screening. Splitting after the shared search and broad screen means each copy gets its own properly-configured screening, tag hierarchy, and appraisal.
Filter each copy to its own component tag in [**Study Inspector**](/review-workflow/study-inspector.md) before starting that copy's dedicated screening pass, so you're not re-reading records.
Keep the original shared nest as your record of the full combined project.
### Clinical Effectiveness
This component answers whether the technology works, typically against a comparator, and is usually held to SLR-level rigor since HTA bodies scrutinize it closely.
| Stage | Recommended tools | Why |
| ---------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Search | [**Automatic Search**](/review-workflow/literature-search/add-search/automatic-search.md) across all relevant databases, added as its own search within the shared nest before splitting; [**Smart Search**](/review-workflow/literature-search/ai-tools-in-search/smart-search.md) or **Search Exploration** to build the query | HTA reviewers expect a comprehensive search. An incomplete search can omit evidence that affects the submission. |
| Screening | In your **Clinical effectiveness** working nest (after splitting): [**Dual Screening** and **Two Pass**](/review-workflow/screening/configure-screening.md), [**Criteria-Based Screening (CBS)**](/review-workflow/screening/criteria-based-screening.md) | Clinical eligibility criteria are usually defined in the protocol. **Criteria-Based Screening** applies those criteria consistently. A separate working nest lets you configure screening for clinical evidence without affecting the other components. |
| Tagging and extraction | [**Smart Config: Tagging**](/review-workflow/tagging/ai-tools-in-tagging/smart-config-tagging.md) and [**Adaptive Smart Tags**](/review-workflow/tagging/ai-tools-in-tagging/adaptive-smart-tags.md) to build this component's hierarchy in its working nest, covering comparators, outcomes, and effect estimates | HTA bodies need protocol-defined outcome data. A custom hierarchy captures the comparators, outcomes, and effect estimates that your submission reports. |
| Critical appraisal | A tool matched to your included study designs (for example, a randomized-trial tool for RCTs, an observational tool for real-world evidence) | Use an appraisal tool that fits each included study design. |
| Synthesis | [**Dashboards**](/review-workflow/synthesis/set-up-synthesis-outputs/dashboard-editor.md)**,** [**Smart Insights**](/review-workflow/synthesis/set-up-synthesis-outputs/smart-insights.md) and [**Synthesis Chat** ](/review-workflow/synthesis/navigate-synthesis-outputs/synthesis-chat.md) | Use Dashboards to show the study characteristics and outcomes from your tags. Use Smart Insights to summarize the main findings across the included studies. Use Synthesis Chat to ask questions about the included studies and get answers that cite the source studies. These tools help you make the clinical evidence clear for HTA reviewers, and each finding stays traceable to its source. |
### Economic Evaluation
This component answers whether the technology is cost-effective, and searches and extracts differently from clinical effectiveness — its unit of interest is cost and utility data, not clinical outcomes.
| Stage | Recommended tools | Why |
| ---------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| Search | [**Automatic Search**](/review-workflow/literature-search/add-search/automatic-search.md) targeted at economic-evaluation and cost-effectiveness literature, added as its own search within the shared nest before splitting, often a narrower set of databases and terms than the clinical effectiveness search | Economic evaluations are indexed differently from clinical trials. Use a separate query to avoid missing cost-effectiveness evidence. |
| Screening | In your **Economic evaluation** working nest: [**Single or Dual Screening**](/review-workflow/screening/configure-screening.md) depending on your submission's requirements, [**Criteria-Based Screening**](/review-workflow/screening/criteria-based-screening.md) | Economic eligibility criteria, such as model type, perspective, and comparator, are usually predefined. A separate working nest lets you choose the reviewer structure for this component. |
| Tagging and extraction | [**Smart Config: Tagging**](/review-workflow/tagging/ai-tools-in-tagging/smart-config-tagging.md) and [**Adaptive Smart Tags**](/review-workflow/tagging/ai-tools-in-tagging/adaptive-smart-tags.md) to build this component's hierarchy in its working nest, capturing cost inputs, utilities, and reported ICERs | Economic model inputs do not fit a standard PICO structure. Build a hierarchy for costs, utilities, and ICERs so the data stays usable in the submission. |
| Critical appraisal | An economic-evaluation-specific checklist | Clinical risk-of-bias tools do not assess model assumptions, data sources, or uncertainty analysis. Use a checklist designed for economic evaluations. |
| Synthesis | [**Dashboards**](/review-workflow/synthesis/set-up-synthesis-outputs/dashboard-editor.md)**,** [**Smart Insights**](/review-workflow/synthesis/set-up-synthesis-outputs/smart-insights.md) and [**Synthesis Chat** ](/review-workflow/synthesis/navigate-synthesis-outputs/synthesis-chat.md)summarizing cost-effectiveness findings across models | Economic models usually differ too much to pool statistically. A comparative summary shows how costs and outcomes vary across the relevant models. |
### Epidemiology
This component establishes disease burden — incidence, prevalence, and natural history — for the population your technology addresses.
| Stage | Recommended tools | Why |
| ---------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Search | [**Automatic Search**](/review-workflow/literature-search/add-search/automatic-search.md) targeted at burden-of-disease and epidemiological terms, added as its own search within the shared nest before splitting, typically including registry and surveillance sources under **Other Sources** | Epidemiological evidence often sits outside bibliographic databases. Add registry and surveillance sources deliberately so they are not missed. |
| Screening | In your **Epidemiology** working nest: [**Single or Dual Screening**](/review-workflow/screening/configure-screening.md), [**Exclusion Reasons**](/review-workflow/screening/exclusion-based-screening.md) | Screen for population and outcome relevance, such as whether a study reports incidence or prevalence for your population. **Exclusion Reasons** records why a study does not fit. |
| Tagging and extraction | [**Smart Config: Tagging**](/review-workflow/tagging/ai-tools-in-tagging/smart-config-tagging.md) and [**Adaptive Smart Tags**](/review-workflow/tagging/ai-tools-in-tagging/adaptive-smart-tags.md) to build this component's hierarchy in its working nest, capturing population demographics, incidence and prevalence rates, and subgroup breakdowns | Epidemiology needs population characteristics and rates rather than intervention outcomes. Build a hierarchy that captures demographics, incidence, prevalence, and subgroups. |
| Critical appraisal | An observational-study risk-of-bias tool | Epidemiological evidence often comes from observational or registry data. Use an appraisal tool designed for those study types. |
| Synthesis | [**Dashboards**](/review-workflow/synthesis/set-up-synthesis-outputs/dashboard-editor.md)**,** [**Smart Insights**](/review-workflow/synthesis/set-up-synthesis-outputs/smart-insights.md) and [**Synthesis Chat** ](/review-workflow/synthesis/navigate-synthesis-outputs/synthesis-chat.md) | Incidence and prevalence estimates can be pooled when studies are comparable. Otherwise, use descriptive summaries to show the evidence across populations and settings. |
### Next Steps
:scale-balanced: HTA Assessments Best Practices
Apply methodology guidance alongside this workflow.
---
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