History and structure
AETMIS (the Quebec Agency for Health Services and Technology Assessment) was established by the Quebec government in June 2000, replacing the Conseil d'évaluation des technologies de la santé (CETS or Quebec Council for Health Technology Assessment), the first such organization in Quebec, created in 1988. AETMIS is an independent organization that reports to Québec's Minister of Health and Social services. The staff of AETMIS includes the President/CEO, the Scientific Director and a team of about 40 consultant researchers and assessment specialists as well as professional administrative and technical support.

Mission
To promote and sustain informed decision making concerning health technologies and care delivery methods. AETMIS mission is to support the Minister of Health and Social Services as well as public health decision makers by producing health technology and care delivery methods assessments. The reports it produces are chiefly designed to assess the efficacy, safety and efficiency of health technologies and to study the ethical, social, legal, economic and organizational implications related to their introduction, diffusion and use within Québec's public health system.

How AETMIS works
Assessments are generally produced in response to requests from different public health decision makers. A board of experts, appointed by the Quebec government Cabinet, determines the approaches to be applied, defines the contents of the assessments reports, and ensures that the assessments are appropriate, of high quality and methodologically rigorous. Upon the completion of a acceptable draft, the document is submitted to external reviewers, and then to the board formal approval of the final content and recommendations.

Dissemination activities
Owing to its decision-support mission, AETMIS has always been keenly interested in knowledge transfer. Although long considered the final step of dissemination, the Agency's vision of knowledge transfer has evolved in recent years. In fact, several AETMIS researchers involved in a working committee set up in 2003 came up with an innovative way of conceptualizing the knowledge transfer process. This concept is based on an iterative exchange with the different stakeholders throughout the evaluation process. With this exchange, AETMIS is better positioned to contextualize the results of the scientific assessments it undertakes while maintaining objectivity through specific measures.

Current projects (a selection)

• Comparative effectiveness of two reperfusion therapies for patients with ST elevation myocardial infarctus: thrombolysis and primary angioplasty
• Hyperbaric oxygen therapy in Québec: update on efficacy with special attention to cerebral palsy and autism
• Comparative evaluation of endorectal ultrasound, MRI and other diagnostic technologies used for rectal cancer staging
• Wound management technologies in burn care : effectiveness of Acticoattm wound dressing
• Assistive dogs for people with motor deficiencies
• Population-based genetic screening
• Telehealth: Clinical guidelines and technological standards for telepathology.

Future plans
For an assessment network - Health technology assessment (HTA) is one of the main missions of Québec's university hospitals. AETMIS promotes and supports the development of an HTA provincial network that brings together all of its players in the Québec health-care system, especially by chairing an HTA committee in the Integrated University Hospital Networks (RUIS) and facilitating the coordination of assessments at these institutions. This is strengthening the Québec health-care system's assessment resources and its ability to marshal evidence in decision making at all levels.