History and structure
AETS was founded in 1994 as one of the centers of the Instituto de Salud Carlos III, the Spanish National Public Health Research Institute, which provides with scientific and technical support to the Ministry of Health and to the National Health System (NHS).
The activities of AETS embrace three areas:

• Health technology assessment reports (elaborating reports assessing the impact of health technologies)
• Research projects (elaborating health services research projects)
• Coordination of evaluation services (participating in activities related with HTA advising NHS authorities)

Mission
Main objectives of AETS are:

• To assess the different health technologies as a basis for formulating policies on technology selection and implementation in the NHS
• To promote the appropriate use of existing technologies
• To improve NHS quality

AETS also participates in teaching and training programs. National and international cooperation is also a major mandate of AETS.

How AETS works
Most AETS reports are initiated by a request usually from a government or government- related office. These reports are reviewed by an independent panel of experts who endorse the conclusions. Whenever feasible, formal data is synthesized, including meta-analyses of empirical evidence. Social, economic, and ethical dimensions are often included in the AETS reports. Further expertise is obtained by collaboration with external health professionals.

Identification of specific issues to assess on a national scale was initiated in 1997 by Spain's main health policy coordinating body: The NHS Interritorial Council (NHSIC). Its decisions strongly influence the AETS work program.

AETS is working in coordination with the Spanish regional HTA agencies and units in the Plan for HTA lead by Spanish National Health Department. A web based platform has been developed to improve this coordination (aunets.iscii.es).

Dissemination activities
Diffusion and dissemination vary depending on the nature of the request that originated the report. For example, when an issue is raised by a certain institution, and deals with a very specific aspect, an internal report is produced for limited dissemination. The public reports by AETS are disseminated through selective mailing. The distribution list varies according to the topic addressed.
Active participation in meetings of scientific and professional societies, short-term training courses for healthcare managers and clinicians with managerial responsibilities are means of disseminating AETS results.

Current projects (a selection)

• Interventiones aimed towards reducing maternal mortality in developing countries
• Effectiveness and cost-effectiveness of FDG-PET in breast and ovarian cancers
• Definition and updating of covered benefits in countries with advanced health care systems
• Transitional elastography (Fibroscan) as a new non-invasive dignostic method in hepatic fibrosis
• Physical health care and health care in patients with schyzophrenia
• Health impact assessment
• Genetic testing and services
• Risk adjustement models
• Improving chronic desease conditions in primary care

Future plans

• To contribute to national cooperation in HTA
• To improve dissemination of findings (including increased use of the Internet)
• To foster institutional demands contributing to implementation of assessment results
• To foster commissioned research on HTA on a national scale
• To advise the NHSIC on the identification and approval of new technologies.