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<!doctype html><html data-n-head-ssr lang="en" data-n-head="%7B%22lang%22:%7B%22ssr%22:%22en%22%7D%7D"><head ><meta data-n-head="ssr" charset="utf-8"><meta data-n-head="ssr" name="viewport" content="width=device-width, initial-scale=1"><meta data-n-head="ssr" name="msapplication-TileColor" content="#247CB3"><meta data-n-head="ssr" name="msapplication-TileImage" content="https://asset.jmir.pub/assets/static/images/mstile-144x144.png"><meta data-n-head="ssr" name="description" content="Background: Digital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, some of which result from poor information quality (IQ). Objective: This systematic review aims to synthesize an IQ framework that could be used to evaluate the extent to which digital health information is fit for clinical purposes. Methods: The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We searched Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, Global Health, ProQuest Dissertations and Theses Global, Scopus, and HMIC (the Health Management Information Consortium) from inception until October 2019. Multidimensional IQ frameworks for assessing DHTs used in the clinical context by health care professionals were included. A thematic synthesis approach was used to synthesize the Clinical Information Quality (CLIQ) framework for digital health. Results: We identified 10 existing IQ frameworks from which we developed the CLIQ framework for digital health with 13 unique dimensions: accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were categorized into 3 meaningful categories: availability, informativeness, and usability. Conclusions: This systematic review highlights the importance of the IQ of DHTs and its relevance to patient safety. The CLIQ framework for digital health will be useful in evaluating and conceptualizing IQ issues associated with digital health, thus forestalling potential patient safety problems. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42018097142; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=97142 "><meta data-n-head="ssr" name="keywords" content="digital health; information quality; patient safety"><meta data-n-head="ssr" name="DC.Title" content="Information Quality Frameworks for Digital Health Technologies: Systematic Review"><meta data-n-head="ssr" name="DC.Subject" content="digital health; information quality; patient safety"><meta data-n-head="ssr" name="DC.Description" content="Background: Digital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, some of which result from poor information quality (IQ). Objective: This systematic review aims to synthesize an IQ framework that could be used to evaluate the extent to which digital health information is fit for clinical purposes. Methods: The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We searched Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, Global Health, ProQuest Dissertations and Theses Global, Scopus, and HMIC (the Health Management Information Consortium) from inception until October 2019. Multidimensional IQ frameworks for assessing DHTs used in the clinical context by health care professionals were included. A thematic synthesis approach was used to synthesize the Clinical Information Quality (CLIQ) framework for digital health. Results: We identified 10 existing IQ frameworks from which we developed the CLIQ framework for digital health with 13 unique dimensions: accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were categorized into 3 meaningful categories: availability, informativeness, and usability. Conclusions: This systematic review highlights the importance of the IQ of DHTs and its relevance to patient safety. The CLIQ framework for digital health will be useful in evaluating and conceptualizing IQ issues associated with digital health, thus forestalling potential patient safety problems. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42018097142; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=97142 "><meta data-n-head="ssr" name="DC.Publisher" content="Journal of Medical Internet Research"><meta data-n-head="ssr" name="DC.Publisher.Address" content="JMIR Publications // 130 Queens Quay East, Unit 1100 // Toronto, ON, M5A 0P6"><meta data-n-head="ssr" name="DC.Date" scheme="ISO8601" content="2021-05-17"><meta data-n-head="ssr" name="DC.Type" content="Text.Serial.Journal"><meta data-n-head="ssr" name="DC.Format" scheme="IMT" content="text/xml"><meta data-n-head="ssr" name="DC.Identifier" content="doi:10.2196/23479"><meta data-n-head="ssr" name="DC.Language" scheme="ISO639-1" content="EN"><meta data-n-head="ssr" name="DC.Relation" content="World"><meta data-n-head="ssr" name="DC.Source" content="J Med Internet Res 2021;23(5):e23479 https://www.jmir.org/2021/5/e23479"><meta data-n-head="ssr" name="DC.Rights" content=""><meta data-n-head="ssr" property="og:title" content="Information Quality Frameworks for Digital Health Technologies: Systematic Review"><meta data-n-head="ssr" property="og:type" content="article"><meta data-n-head="ssr" property="og:url" content="https://www.jmir.org/2021/5/e23479"><meta data-n-head="ssr" property="og:image" content="https://asset.jmir.pub/assets/2514801cb40c0f99b8123c78a2cbf92d.png"><meta data-n-head="ssr" property="og:site_name" content="Journal of Medical Internet Research"><meta data-n-head="ssr" name="twitter:card" content="summary_large_image"><meta data-n-head="ssr" name="twitter:site" content="@jmirpub"><meta data-n-head="ssr" name="twitter:title" content="Information Quality Frameworks for Digital Health Technologies: Systematic Review"><meta data-n-head="ssr" name="twitter:description" content="Background: Digital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, some of which result from poor information quality (IQ). Objective: This systematic review aims to synthesize an IQ framework that could be used to evaluate the extent to which digital health information is fit for clinical purposes. Methods: The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We searched Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, Global Health, ProQuest Dissertations and Theses Global, Scopus, and HMIC (the Health Management Information Consortium) from inception until October 2019. Multidimensional IQ frameworks for assessing DHTs used in the clinical context by health care professionals were included. A thematic synthesis approach was used to synthesize the Clinical Information Quality (CLIQ) framework for digital health. Results: We identified 10 existing IQ frameworks from which we developed the CLIQ framework for digital health with 13 unique dimensions: accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were categorized into 3 meaningful categories: availability, informativeness, and usability. Conclusions: This systematic review highlights the importance of the IQ of DHTs and its relevance to patient safety. The CLIQ framework for digital health will be useful in evaluating and conceptualizing IQ issues associated with digital health, thus forestalling potential patient safety problems. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42018097142; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=97142 "><meta data-n-head="ssr" name="twitter:image" content="https://asset.jmir.pub/assets/2514801cb40c0f99b8123c78a2cbf92d.png"><meta data-n-head="ssr" name="citation_title" content="Information Quality Frameworks for Digital Health Technologies: Systematic Review"><meta data-n-head="ssr" name="citation_journal_title" content="Journal of Medical Internet Research"><meta data-n-head="ssr" name="citation_publisher" content="JMIR Publications Inc., Toronto, Canada"><meta data-n-head="ssr" name="citation_doi" content="10.2196/23479"><meta data-n-head="ssr" name="citation_issue" content="5"><meta data-n-head="ssr" name="citation_volume" content="23"><meta data-n-head="ssr" name="citation_firstpage" content="e23479"><meta data-n-head="ssr" name="citation_date" content="2021-05-17"><meta data-n-head="ssr" name="citation_abstract_html_url" content="https://www.jmir.org/2021/5/e23479"><meta data-n-head="ssr" name="citation_abstract_pdf_url" content="https://www.jmir.org/2021/5/e23479/PDF"><meta data-n-head="ssr" name="DC.Creator" content="Kayode Philip"><meta data-n-head="ssr" name="DC.Contributor" content="Kayode Philip Fadahunsi"><meta data-n-head="ssr" name="DC.Contributor" content="Siobhan O'Connor"><meta data-n-head="ssr" name="DC.Contributor" content="James Tosin Akinlua"><meta data-n-head="ssr" name="DC.Contributor" content="Petra A Wark"><meta data-n-head="ssr" name="DC.Contributor" content="Joseph Gallagher"><meta data-n-head="ssr" name="DC.Contributor" content="Christopher Carroll"><meta data-n-head="ssr" name="DC.Contributor" content="Josip Car"><meta data-n-head="ssr" name="DC.Contributor" content="Azeem Majeed"><meta data-n-head="ssr" name="DC.Contributor" content="John O'Donoghue"><meta data-n-head="ssr" name="citation_authors" content="Kayode Philip Fadahunsi"><meta data-n-head="ssr" name="citation_authors" content="Siobhan O'Connor"><meta data-n-head="ssr" name="citation_authors" content="James Tosin Akinlua"><meta data-n-head="ssr" name="citation_authors" content="Petra A Wark"><meta data-n-head="ssr" name="citation_authors" content="Joseph Gallagher"><meta data-n-head="ssr" name="citation_authors" content="Christopher Carroll"><meta data-n-head="ssr" name="citation_authors" content="Josip Car"><meta data-n-head="ssr" name="citation_authors" content="Azeem Majeed"><meta data-n-head="ssr" name="citation_authors" content="John O'Donoghue"><title>Journal of Medical Internet Research - Information Quality Frameworks for Digital Health Technologies: Systematic Review</title><link data-n-head="ssr" rel="apple-touch-icon" sizes="57x57" href="https://asset.jmir.pub/assets/static/images/apple-touch-icon-57x57.png"><link data-n-head="ssr" rel="apple-touch-icon" sizes="114x114" 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</time> in <span data-test="issue-info"><a href="/2021/5" class="nuxt-link-active"> Vol 23<span>, No 5</span> (2021)<span>: May</span></a></span></p> </div> <div class="preprints-version"><span aria-hidden="true" class="icon fas fa-thumbtack"></span> <div><span class="ml-2"> Preprints (earlier versions) of this paper are available at <a data-test="preprint-link" aria-label="'Preprints (earlier versions) of this paper are available at preprints.jmir.org/preprint/'23479" href="https://preprints.jmir.org/preprint/23479" target="_blank">https://preprints.jmir.org/preprint/23479</a>, first published <time datetime="August 13, 2020">August 13, 2020</time>. </span></div></div></div> <div class="info mt-3"><div class="info__article-img"><div data-v-10f10a3e><img data-srcset="https://asset.jmir.pub/assets/2514801cb40c0f99b8123c78a2cbf92d.png 480w,https://asset.jmir.pub/assets/2514801cb40c0f99b8123c78a2cbf92d.png 960w,https://asset.jmir.pub/assets/2514801cb40c0f99b8123c78a2cbf92d.png 1920w,https://asset.jmir.pub/assets/2514801cb40c0f99b8123c78a2cbf92d.png 2500w" alt="Information Quality Frameworks for Digital Health Technologies: Systematic Review" title="Information Quality Frameworks for Digital Health Technologies: Systematic Review" aria-label="Article Thumbnail Image" src="https://asset.jmir.pub/placeholder.svg" data-v-10f10a3e></div> <div data-test="article-img-info" class="info__article-img-info"><span aria-hidden="true" class="icon fas fa-search-plus"></span></div></div> <div class="info__title-authors"><h1 tabindex="0" aria-label="Information Quality Frameworks for Digital Health Technologies: Systematic Review" class="h3 mb-0 mt-0">Information Quality Frameworks for Digital Health Technologies: Systematic Review</h1> <h2 class="info__hidden-title"> Information Quality Frameworks for Digital Health Technologies: Systematic Review </h2> <div class="mt-3"><p tabindex="0" class="authors-for-screen-reader"> Authors of this article: </p> <span data-test="authors-info" class="info__authors"><a href="/search?term=Kayode%20Philip%20Fadahunsi&type=author&precise=true" aria-label="Kayode Philip Fadahunsi. Search more articles by this author."> Kayode Philip Fadahunsi<sup>1</sup> </a> <span><a aria-label="Visit this author on ORCID website" data-test="orcid-link" target="_blank" href="https://orcid.org/0000-0003-1470-5493"><img src="https://asset.jmir.pub/assets/static/images/Orcid-ID-Logo-Colour.png" alt="Author Orcid Image" aria-label="Author Orcid Image" class="info__orcid-img"></a></span> <span style="margin-left: -2px;"> ; </span></span><span data-test="authors-info" class="info__authors"><a href="/search?term=Siobhan%20O%27Connor&type=author&precise=true" aria-label="Siobhan O'Connor. Search more articles by this author."> Siobhan O'Connor<sup>2</sup> </a> <span><a aria-label="Visit this author on ORCID website" data-test="orcid-link" target="_blank" href="https://orcid.org/0000-0001-8579-1718"><img src="https://asset.jmir.pub/assets/static/images/Orcid-ID-Logo-Colour.png" alt="Author Orcid Image" aria-label="Author Orcid Image" class="info__orcid-img"></a></span> <span style="margin-left: -2px;"> ; </span></span><span data-test="authors-info" class="info__authors"><a href="/search?term=James%20Tosin%20Akinlua&type=author&precise=true" aria-label="James Tosin Akinlua. Search more articles by this author."> James Tosin Akinlua<sup>3</sup> </a> <span><a aria-label="Visit this author on ORCID website" data-test="orcid-link" target="_blank" href="https://orcid.org/0000-0002-9887-0033"><img src="https://asset.jmir.pub/assets/static/images/Orcid-ID-Logo-Colour.png" alt="Author Orcid Image" aria-label="Author Orcid Image" class="info__orcid-img"></a></span> <span style="margin-left: -2px;"> ; </span></span><span data-test="authors-info" class="info__authors"><a href="/search?term=Petra%20A%20Wark&type=author&precise=true" aria-label="Petra A Wark. Search more articles by this author."> Petra A Wark<sup>3, 4</sup> </a> <span><a aria-label="Visit this author on ORCID website" data-test="orcid-link" target="_blank" href="https://orcid.org/0000-0003-1020-4640"><img src="https://asset.jmir.pub/assets/static/images/Orcid-ID-Logo-Colour.png" alt="Author Orcid Image" aria-label="Author Orcid Image" class="info__orcid-img"></a></span> <span style="margin-left: -2px;"> ; </span></span><span data-test="authors-info" class="info__authors"><a href="/search?term=Joseph%20Gallagher&type=author&precise=true" aria-label="Joseph Gallagher. 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Search more articles by this author."> Josip Car<sup>1, 7</sup> </a> <span><a aria-label="Visit this author on ORCID website" data-test="orcid-link" target="_blank" href="https://orcid.org/0000-0001-8969-371X"><img src="https://asset.jmir.pub/assets/static/images/Orcid-ID-Logo-Colour.png" alt="Author Orcid Image" aria-label="Author Orcid Image" class="info__orcid-img"></a></span> <span style="margin-left: -2px;"> ; </span></span><span data-test="authors-info" class="info__authors"><a href="/search?term=Azeem%20Majeed&type=author&precise=true" aria-label="Azeem Majeed. Search more articles by this author."> Azeem Majeed<sup>1</sup> </a> <span><a aria-label="Visit this author on ORCID website" data-test="orcid-link" target="_blank" href="https://orcid.org/0000-0002-2357-9858"><img src="https://asset.jmir.pub/assets/static/images/Orcid-ID-Logo-Colour.png" alt="Author Orcid Image" aria-label="Author Orcid Image" class="info__orcid-img"></a></span> <span style="margin-left: -2px;"> ; </span></span><span data-test="authors-info" class="info__authors"><a href="/search?term=John%20O%27Donoghue&type=author&precise=true" aria-label="John O'Donoghue. Search more articles by this author."> John O'Donoghue<sup>8, 9</sup> </a> <span><a aria-label="Visit this author on ORCID website" data-test="orcid-link" target="_blank" href="https://orcid.org/0000-0001-6056-8640"><img src="https://asset.jmir.pub/assets/static/images/Orcid-ID-Logo-Colour.png" alt="Author Orcid Image" aria-label="Author Orcid Image" class="info__orcid-img"></a></span> </span></div> </div></div> <div role="tablist" aria-label="Article" class="tabs"><a href="/2021/5/e23479/" aria-current="page" role="tab" aria-label="Article" data-test="tabs" class="nuxt-link-exact-active nuxt-link-active active"> Article </a><a href="/2021/5/e23479/authors" role="tab" aria-label="Authors" data-test="tabs"> Authors </a><a href="/2021/5/e23479/citations" role="tab" aria-label="Cited by (44)" data-test="tabs"> Cited by (44) </a><a href="/2021/5/e23479/tweetations" role="tab" aria-label="Tweetations (18)" data-test="tabs"> Tweetations (18) </a><a href="/2021/5/e23479/metrics" role="tab" aria-label="Metrics" data-test="tabs"> Metrics </a></div> <div class="container"><div class="row"><div class="col-lg-3 mb-5 sidebar-sections"><div class="sidebar-nav"><div class="sidebar-nav-sticky"><ul></ul></div></div></div> <div data-test="keyword-links" class="col-lg-9 article"><main id="wrapper" class="wrapper ArticleMain clearfix"><section class="inner-wrapper clearfix"><section class="main-article-content clearfix"><article class="ajax-article-content"><h4 class="h4-original-paper"><span class="typcn typcn-document-text"/>Review</h4><div class="authors-container"><div class="authors clearfix"/></div><div class="authors-container"><div class="authors clearfix"/></div><div class="authors-container"><div class="authors clearfix"><ul class="clearfix"><li><a href="/search/searchResult?field%5B%5D=author&criteria%5B%5D=Kayode Philip+Fadahunsi" class="btn-view-author-options">Kayode Philip Fadahunsi<sup><small>1</small></sup>, MBBS, MPH</a><a class="author-orcid" href="https://orcid.org/0000-0003-1470-5493" target="_blank" title="ORCID"> </a>; </li><li><a href="/search/searchResult?field%5B%5D=author&criteria%5B%5D=Siobhan+O'Connor" class="btn-view-author-options">Siobhan O'Connor<sup><small>2</small></sup>, BSc, CIMA CBA, RN, FHEA, PhD</a><a class="author-orcid" href="https://orcid.org/0000-0001-8579-1718" target="_blank" title="ORCID"> </a>; </li><li><a href="/search/searchResult?field%5B%5D=author&criteria%5B%5D=James Tosin+Akinlua" class="btn-view-author-options">James Tosin Akinlua<sup><small>3</small></sup>, MBBS, MPH, PhD</a><a class="author-orcid" href="https://orcid.org/0000-0002-9887-0033" target="_blank" title="ORCID"> </a>; </li><li><a href="/search/searchResult?field%5B%5D=author&criteria%5B%5D=Petra A+Wark" class="btn-view-author-options">Petra A Wark<sup><small>3,</small></sup><sup><small>4</small></sup>, MSc, PhD, FHEA</a><a class="author-orcid" href="https://orcid.org/0000-0003-1020-4640" target="_blank" title="ORCID"> </a>; </li><li><a href="/search/searchResult?field%5B%5D=author&criteria%5B%5D=Joseph+Gallagher" class="btn-view-author-options">Joseph Gallagher<sup><small>5</small></sup>, BA, MD, MBChB, BAO, MRCPI, MICGP, FHFA</a><a class="author-orcid" href="https://orcid.org/0000-0002-5564-2890" target="_blank" title="ORCID"> </a>; </li><li><a href="/search/searchResult?field%5B%5D=author&criteria%5B%5D=Christopher+Carroll" class="btn-view-author-options">Christopher Carroll<sup><small>6</small></sup>, BA, MA, MSc, PhD</a><a class="author-orcid" href="https://orcid.org/0000-0002-6361-6182" target="_blank" title="ORCID"> </a>; </li><li><a href="/search/searchResult?field%5B%5D=author&criteria%5B%5D=Josip+Car" class="btn-view-author-options">Josip Car<sup><small>1,</small></sup><sup><small>7</small></sup>, FFPH, DIC, MSc, PhD, MD, FRCP</a><a class="author-orcid" href="https://orcid.org/0000-0001-8969-371X" target="_blank" title="ORCID"> </a>; </li><li><a href="/search/searchResult?field%5B%5D=author&criteria%5B%5D=Azeem+Majeed" class="btn-view-author-options">Azeem Majeed<sup><small>1</small></sup>, MD, FRCP, FRCGP, FFPH</a><a class="author-orcid" href="https://orcid.org/0000-0002-2357-9858" target="_blank" title="ORCID"> </a>; </li><li><a href="/search/searchResult?field%5B%5D=author&criteria%5B%5D=John+O'Donoghue" class="btn-view-author-options">John O'Donoghue<sup><small>8,</small></sup><sup><small>9</small></sup>, BSc, MSc, PhD, Cert(ICL), FHEA, FBCS</a><a class="author-orcid" href="https://orcid.org/0000-0001-6056-8640" target="_blank" title="ORCID"> </a></li></ul><div class="author-affiliation-details"><p><sup>1</sup>Department of Public Health and Primary Care, Imperial College London, London, United Kingdom</p><p><sup>2</sup>School of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom</p><p><sup>3</sup>Department of Primary Care and Population Health Sciences, University College London, London, United Kingdom</p><p><sup>4</sup>Centre for Intelligent Healthcare, Institute of Health and Wellbeing, Coventry University, Coventry, United Kingdom</p><p><sup>5</sup>gHealth Research Group, School of Medicine, University College Dublin, Dublin, Ireland</p><p><sup>6</sup>Health Economics and Decision Science, School of Health and Related Research, The University of Sheffield, Sheffield, United Kingdom</p><p><sup>7</sup>Centre for Population Health Sciences, LKC Medicine, Nayang Technological University, Sungapore, Singapore</p><p><sup>8</sup>Malawi eHealth Research Centre, University College Cork, Cork, Ireland</p><p><sup>9</sup>ASSERT Research Centre, University College Cork, Cork, Ireland</p></div></div><div class="corresponding-author-and-affiliations clearfix"><div class="corresponding-author-details"><h3>Corresponding Author:</h3><p>Kayode Philip Fadahunsi, MBBS, MPH</p><p/><p>Department of Public Health and Primary Care</p><p>Imperial College London</p><p>The Reynolds Building</p><p>St. Dunstan’s Road</p><p>London, W6 8RP</p><p>United Kingdom</p><p>Phone: 44 07477854209</p><p>Email: <a href="mailto:K.fadahunsi14@imperial.ac.uk">K.fadahunsi14@imperial.ac.uk</a></p><br/></div></div></div><section class="article-content clearfix"><article class="abstract"><h3 id="Abstract" class="navigation-heading" data-label="Abstract">Abstract</h3><p><span class="abstract-sub-heading">Background: </span>Digital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, some of which result from poor information quality (IQ).<br/></p><p><span class="abstract-sub-heading">Objective: </span>This systematic review aims to synthesize an IQ framework that could be used to evaluate the extent to which digital health information is fit for clinical purposes.<br/></p><p><span class="abstract-sub-heading">Methods: </span>The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We searched Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, Global Health, ProQuest Dissertations and Theses Global, Scopus, and HMIC (the Health Management Information Consortium) from inception until October 2019. Multidimensional IQ frameworks for assessing DHTs used in the clinical context by health care professionals were included. A thematic synthesis approach was used to synthesize the Clinical Information Quality (CLIQ) framework for digital health.<br/></p><p><span class="abstract-sub-heading">Results: </span>We identified 10 existing IQ frameworks from which we developed the CLIQ framework for digital health with 13 unique dimensions: accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were categorized into 3 meaningful categories: availability, informativeness, and usability.<br/></p><p><span class="abstract-sub-heading">Conclusions: </span>This systematic review highlights the importance of the IQ of DHTs and its relevance to patient safety. The CLIQ framework for digital health will be useful in evaluating and conceptualizing IQ issues associated with digital health, thus forestalling potential patient safety problems.<br/></p><p><span class="abstract-sub-heading">Trial Registration: </span>PROSPERO International Prospective Register of Systematic Reviews CRD42018097142; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=97142<br/></p><p><span class="abstract-sub-heading">International Registered Report Identifier (IRRID): </span>RR2-10.1136/bmjopen-2018-024722<br/></p><strong class="h4-article-volume-issue">J Med Internet Res 2021;23(5):e23479</strong><br/><br/><span class="article-doi"><a href="https://doi.org/10.2196/23479">doi:10.2196/23479</a></span><br/><br/><h3 class="h3-main-heading" id="Keywords">Keywords</h3><div class="keywords"><span><a href="/search?type=keyword&term=digital health">digital health</a>; </span><span><a href="/search?type=keyword&term=patient safety">patient safety</a>; </span><span><a href="/search?type=keyword&term=information quality">information quality</a> </span></div><div id="trendmd-suggestions"/></article><br/><article class="main-article clearfix"><br/><h3 class="navigation-heading h3-main-heading" id="Introduction" data-label="Introduction">Introduction</h3><h4>Background</h4><p class="abstract-paragraph">Digital health—the use of digital technologies for health—is increasingly recognized as a major driver of quality in health care [<span class="footers"><a class="citation-link" href="#ref1" rel="footnote">1</a></span>]. Digital health technologies (DHTs), such as telemedicine, electronic health records (EHRs), clinical decision support systems (CDSS), mobile health, computerized physician order entry, electronic prescribing systems, and web-based health services, can improve access and quality of health care services [<span class="footers"><a class="citation-link" href="#ref2" rel="footnote">2</a></span>,<span class="footers"><a class="citation-link" href="#ref3" rel="footnote">3</a></span>]. DHTs generate a copious amount of information used in health care for administrative, educational, research, and clinical purposes [<span class="footers"><a class="citation-link" href="#ref4" rel="footnote">4</a></span>,<span class="footers"><a class="citation-link" href="#ref5" rel="footnote">5</a></span>]. However, the clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, including significant harms and death, some of which result from poor information quality (IQ) [<span class="footers"><a class="citation-link" href="#ref6" rel="footnote">6</a></span>-<span class="footers"><a class="citation-link" href="#ref9" rel="footnote">9</a></span>]. For instance, a patient in the United Kingdom experienced a life-threatening allergic reaction following a medication error because of inaccessible allergy information in the EHR [<span class="footers"><a class="citation-link" href="#ref6" rel="footnote">6</a></span>].</p><p class="abstract-paragraph">IQ refers to the extent to which information is fit for a specific purpose [<span class="footers"><a class="citation-link" href="#ref10" rel="footnote">10</a></span>,<span class="footers"><a class="citation-link" href="#ref11" rel="footnote">11</a></span>]. IQ is multidimensional, with each dimension describing a unique aspect of information [<span class="footers"><a class="citation-link" href="#ref10" rel="footnote">10</a></span>,<span class="footers"><a class="citation-link" href="#ref12" rel="footnote">12</a></span>]. For example, accuracy describes the extent to which information is correct, and accessibility describes the extent to which information is easily obtainable [<span class="footers"><a class="citation-link" href="#ref12" rel="footnote">12</a></span>]. Dimensions relating to a specific context are traditionally integrated into a framework for evaluating IQ within the context [<span class="footers"><a class="citation-link" href="#ref10" rel="footnote">10</a></span>,<span class="footers"><a class="citation-link" href="#ref11" rel="footnote">11</a></span>]. One IQ framework for EHRs [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>] has 11 dimensions and 3 categories, as shown in <span class="footers"><a class="citation-link" href="#box1" rel="footnote">Textbox 1</a></span>. The framework depicts the relationship between the dimensions by categorizing statistically measurable dimensions as objectivity, security-related dimensions as integrity, and dimensions relating to the usefulness of information to intended users as utility [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>].</p><div class="textbox-container" id="box1"><h5>Dimensions and categories in an information quality framework for electronic health record.</h5><p class="abstract-paragraph">Objectivity</p><ul><li class="spacey">Accuracy</li><li class="spacey">Completeness</li><li class="spacey">Consistency</li><li class="spacey">Timeliness</li></ul><p class="abstract-paragraph">Utility</p><ul><li class="spacey">Provenance</li><li class="spacey">Interpretability</li><li class="spacey">Usability</li><li class="spacey">Relevance</li></ul><p class="abstract-paragraph">Integrity</p><ul><li class="spacey">Privacy</li><li class="spacey">Confidentiality</li><li class="spacey">Secure access</li></ul><figcaption><span class="typcn typcn-image"/>Textbox 1. Dimensions and categories in an information quality framework for electronic health record.</figcaption></div><h4>Research Problem and Objective</h4><p class="abstract-paragraph">Currently, there is no consensus on the definition of IQ dimensions in the context of the use of digital health information for clinical purposes. There is a lack of consistency in the terminology and definition of dimensions in existing IQ frameworks, limiting a common understanding of IQ requirements for DHTs [<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>]. Although previous literature reviews have attempted to define the IQ dimensions of digital health information, they focused on the use of digital health information for administrative and research purposes [<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref15" rel="footnote">15</a></span>]. Identifying and defining IQ dimensions in the context of the use of digital health information for clinical purposes is especially important considering the patient safety implications of poor IQ, as discussed earlier [<span class="footers"><a class="citation-link" href="#ref6" rel="footnote">6</a></span>-<span class="footers"><a class="citation-link" href="#ref8" rel="footnote">8</a></span>]. This study aims to use an evidence-based approach to integrate dimensions from existing IQ frameworks, thus promoting a common understanding of IQ requirements. In addition, safety concerns may discourage health care professionals from adopting DHTs. Although many general practitioners in the United Kingdom would support the deployment of more DHTs in primary care, they are concerned about the safety of digital health information [<span class="footers"><a class="citation-link" href="#ref16" rel="footnote">16</a></span>]. Thus, there is a need for a framework that can be used to evaluate the extent to which digital health information is suitable for clinical purposes. The aim of this systematic review is to identify and define dimensions within existing IQ frameworks for DHTs and synthesize an IQ framework that can be used to evaluate the extent to which digital health information is fit for clinical purposes, either diagnostic, therapeutic, or prognostic.</p><br/><h3 class="navigation-heading h3-main-heading" id="Methods" data-label="Methods">Methods</h3><h4>Review Checklist</h4><p class="abstract-paragraph">The systematic review is reported based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist [<span class="footers"><a class="citation-link" href="#ref17" rel="footnote">17</a></span>] presented in <span class="footers"><a class="citation-link" href="#app1" rel="footnote">Multimedia Appendix 1</a></span>.</p><h4>Review Questions</h4><p class="abstract-paragraph">The systematic review will address the following questions:</p><ol type="1"><li class="spacey">What IQ frameworks currently exist for evaluating DHTs?</li><li class="spacey">How are dimensions within these existing IQ frameworks defined?</li><li class="spacey">Which IQ dimensions indicate how well digital health information is fit for diagnostic, therapeutic, or prognostic purposes?</li><li class="spacey">How are these digital health IQ dimensions related to one another?</li></ol><h4>Eligibility Criteria</h4><p class="abstract-paragraph">The eligibility criteria of this review were based on a specific approach for identifying frameworks, theories, and models in a systematic review using behavior of phenomenon of interest, health context and model or theory [<span class="footers"><a class="citation-link" href="#ref18" rel="footnote">18</a></span>,<span class="footers"><a class="citation-link" href="#ref19" rel="footnote">19</a></span>]. The traditional population, intervention, comparator, and outcome approach was not suitable as we synthesized frameworks rather than interventions.</p><p class="abstract-paragraph">We included IQ frameworks for assessing DHTs used for clinical purposes but excluded frameworks for nonclinical or administrative purposes because they are less likely to affect patient safety. For example, an incidence reporting system within a hospital setting can be used for administrative purposes. Similarly, we excluded IQ frameworks for web-based health-related information and electronic learning because they are not directly used in the clinical management of patients at the point of care. We excluded self-management apps used by patients mainly for health education and disease tracking purposes, as their IQ requirements are probably different from those used for clinical purposes by health care professionals [<span class="footers"><a class="citation-link" href="#ref20" rel="footnote">20</a></span>]. We included multidimensional frameworks, but not individual IQ dimensions, as IQ is an interrelated multidimensional concept. Both published and gray literature were included. The included studies were not restricted based on publication date, and all eligible studies until October 2019 were included. Restrictions based on publication status, study type, and publication date may inadvertently lead to the exclusion of potentially relevant IQ frameworks. A summary of the eligibility criteria is presented in <span class="footers"><a class="citation-link" href="#table1" rel="footnote">Table 1</a></span>.</p><div class="figure-table"><figcaption><span class="typcn typcn-clipboard"/>Table 1. Inclusion and exclusion criteria.</figcaption><table width="1000" cellpadding="5" cellspacing="0" border="1" rules="groups" frame="hsides"><col width="320" span="1"></col><col width="330" span="1"></col><col width="350" span="1"></col><thead><tr valign="top"><td rowspan="1" colspan="1">Concept</td><td rowspan="1" colspan="1">Inclusion</td><td rowspan="1" colspan="1">Exclusion</td></tr></thead><tbody><tr valign="top"><td rowspan="1" colspan="1">Behavior of phenomenon of interest</td><td rowspan="1" colspan="1">Information quality or data quality</td><td rowspan="1" colspan="1">Information quality or data quality of administrative and nonclinical data</td></tr><tr valign="top"><td rowspan="1" colspan="1">Health context</td><td rowspan="1" colspan="1">Use of digital health information for clinical purposes (ie, diagnostic, therapeutic, or prognostic)</td><td rowspan="1" colspan="1">Web-based search for health-related information, electronic learning, and digital health apps for self-management</td></tr><tr valign="top"><td rowspan="1" colspan="1">Model or theory</td><td rowspan="1" colspan="1">Multidimensional framework</td><td rowspan="1" colspan="1">Individual dimension</td></tr><tr valign="top"><td rowspan="1" colspan="1">Language</td><td rowspan="1" colspan="1">English</td><td rowspan="1" colspan="1">Non-English</td></tr><tr valign="top"><td rowspan="1" colspan="1">Publication status</td><td rowspan="1" colspan="1">Published and gray literature</td><td rowspan="1" colspan="1">None</td></tr><tr valign="top"><td rowspan="1" colspan="1">Date of publication</td><td rowspan="1" colspan="1">Any</td><td rowspan="1" colspan="1">None</td></tr><tr valign="top"><td rowspan="1" colspan="1">Type of study</td><td rowspan="1" colspan="1">Any</td><td rowspan="1" colspan="1">None</td></tr></tbody></table></div><h4>Information Sources</h4><p class="abstract-paragraph">We searched bibliographic health care databases, including Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, and Global Health. We also searched Scopus to identify digital health publications in non–health care disciplines, such as engineering and computer science. In addition, we searched HMIC (the Health Management Information Consortium) and ProQuest Dissertations and Theses Global, which are regarded as good sources of gray literature [<span class="footers"><a class="citation-link" href="#ref21" rel="footnote">21</a></span>,<span class="footers"><a class="citation-link" href="#ref22" rel="footnote">22</a></span>]. We manually searched the references of the included studies and tracked their citations to identify other eligible studies using Scopus and Google Scholar.</p><h4>Search Strategy</h4><p class="abstract-paragraph">The search terms are related to 3 main concepts: (1) IQ (behavior of the phenomenon of interest), (2) digital health (health context), and (3) framework (model or theory) [<span class="footers"><a class="citation-link" href="#ref18" rel="footnote">18</a></span>,<span class="footers"><a class="citation-link" href="#ref19" rel="footnote">19</a></span>]. The search terms relating to each of these concepts were combined using the <i>OR</i> connector. The results of the 3 categories were then combined using the <i>AND</i> connector. A librarian was consulted for input on the search strategy. Medical Subject Headings and free-text terms were used. Truncation and adjacency searching were used to increase the sensitivity of the search, as appropriate. The search strategy is presented in <span class="footers"><a class="citation-link" href="#app2" rel="footnote">Multimedia Appendix 2</a></span>.</p><h4>Data Management</h4><p class="abstract-paragraph">We removed duplicates using Endnote Reference Management Software (Clarivate), and additional duplicates not identified by the Endnote function were removed manually. The deduplicated data were then imported into Covidence (Veritas Health Innovation Ltd), a review-management software program that operates in partnership with Cochrane Collaboration and allows multiple reviewers to work on study selection simultaneously and independently.</p><h4>Study Selection</h4><p class="abstract-paragraph">The eligible studies were identified in 2 stages: title and abstract screening and full-text review. Titles and abstracts of the studies were screened for eligibility by 2 independent reviewers (KPF and JTA) using the criteria outlined in <span class="footers"><a class="citation-link" href="#table1" rel="footnote">Table 1</a></span>. Conflicts were resolved by discussion between the 2 reviewers and adjudicated by a third independent reviewer (JOD) when necessary. The full-text review of all studies selected during the screening was independently conducted by 2 reviewers (KPF and SOC), with disagreement resolved as described previously.</p><h4>Data Extraction</h4><p class="abstract-paragraph">Overall, 2 reviewers (KPF and SOC) independently extracted data from each eligible study using a prepiloted Microsoft Excel data extraction form. Other reviewers (JOD, CC, PAW, JG, JC, and AM) reviewed the extracted data to ensure the accuracy and completeness of the data. We extracted the study details, including authors, year of publication, country, affiliation, study aim, study design, and publication status. We also extracted IQ framework–related data, including the method of framework development, method of framework validation (when available), type of DHT, IQ dimensions and their verbatim definition, categories of IQ dimensions (when available), and metrics of IQ dimension measurement (when available).</p><p class="abstract-paragraph">These data elements were defined as follows:</p><ul><li class="spacey">IQ frameworks for DHTs: A systematic integration of IQ dimensions to evaluate health information technologies used in the diagnosis, treatment, and prognosis of patients.</li><li class="spacey">IQ dimensions within the frameworks in digital health: These are the evaluation criteria within the IQ frameworks that specify the extent to which health information technologies are fit for clinical use.</li><li class="spacey">Definition of IQ dimensions in digital health: A clear description of what aspect of information each dimension assesses.</li><li class="spacey">Categories of dimensions within IQ frameworks in digital health: IQ dimensions are often categorized to depict the relationship between IQ dimensions in an IQ framework.</li><li class="spacey">Metrics of measurement of IQ dimensions in digital health: How each IQ dimension is measured, for example, questionnaire and mathematical formulas.</li></ul><h4>Quality Assessment</h4><p class="abstract-paragraph">We assessed the quality of the included studies using the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies [<span class="footers"><a class="citation-link" href="#ref23" rel="footnote">23</a></span>]. Selecting this tool was difficult, as the included papers comprised a range of methodologies, including ethnography study, literature review, practice brief, and framework development, with some of the papers not explicitly stating their methodology. Therefore, some of the questions on the checklist were not applicable. Scores were not assigned, as this was not recommended by the checklist [<span class="footers"><a class="citation-link" href="#ref23" rel="footnote">23</a></span>]. Studies were not excluded based on quality assessment outcome, as this was unlikely to have any major impact on the ultimate definition of the dimensions and the resulting IQ framework. However, the assessment provided a general idea about the quality of the development processes of the existing IQ frameworks and, therefore, the strength of the evidence [<span class="footers"><a class="citation-link" href="#ref24" rel="footnote">24</a></span>].</p><h4>Data Synthesis</h4><p class="abstract-paragraph">In this review, the IQ framework was developed using a thematic synthesis approach comprising 3 key stages: coding, descriptive synthesis, and analytical synthesis [<span class="footers"><a class="citation-link" href="#ref25" rel="footnote">25</a></span>]. Although codes and descriptive themes were generated directly from the extracted definition of IQ dimensions, analytical themes were interpretations that went beyond the original data.</p><p class="abstract-paragraph">In the first stage, we coded the verbatim definitions of IQ dimensions extracted from the existing IQ frameworks in the included papers. Coding was done by identifying the unique concepts from each definition of the IQ dimension and highlighting them using the text highlight function of Microsoft Word (Microsoft).</p><p class="abstract-paragraph">Second, we categorized the codes based on their similarities and differences and created a descriptive theme to capture the meaning of each category. Each descriptive theme was defined based on the meaning of the original code from which it was created. The descriptive themes created were regarded as the IQ dimensions of the new IQ framework for digital health. Coding and descriptive synthesis were performed by 2 independent reviewers (KPF and JTA) with adjudication by a third independent reviewer (JOD).</p><p class="abstract-paragraph">Finally, we conceptualized analytical themes by considering the interrelationship between the descriptive themes (IQ dimensions) based on their definitions. The conceptualization of the analytical themes from the descriptive themes in thematic synthesis has been described as controversial because it is influenced by the insight and judgment of the reviewers [<span class="footers"><a class="citation-link" href="#ref25" rel="footnote">25</a></span>]. This stage was quite challenging because of the subjective nature and varying perspectives of the reviewers. The following procedures were used to avoid bias and to achieve a consensus. The lead author (KPF) categorized the IQ dimensions without revealing his proposed categories to other reviewers. The other reviewers were then invited to categorize the IQ dimensions individually and email their suggested categories with rationale to the lead author without copying other members of the team. The reviewers were specifically asked to reflect on the suitability of digital health information for clinical purposes and its impact on patient safety while categorizing the IQ dimensions. Overall, 2 reviewers (KPF and JOD) then collated the inputs and carefully assigned a category to each of the dimensions based on the most popular suggestions considered along with the rationale. The framework was then shared with all the members of the team for further inputs and adaptation, if necessary.</p><p class="abstract-paragraph">Thus, a new digital health IQ framework was developed by synthesizing existing IQ frameworks for DHTs. The IQ dimensions in the new framework are descriptive themes that were generated directly from the definition of IQ dimensions within existing frameworks, whereas the IQ categories were generated from the higher-order analytical synthesis of the descriptive themes.</p><h4>Ethics</h4><p class="abstract-paragraph">Ethical approval was not required for this systematic review, as the primary data were not collected. The review was registered in PROSPERO [<span class="footers"><a class="citation-link" href="#ref26" rel="footnote">26</a></span>], and the protocol was published [<span class="footers"><a class="citation-link" href="#ref27" rel="footnote">27</a></span>] to promote transparency.</p><br/><h3 class="navigation-heading h3-main-heading" id="Results" data-label="Results">Results</h3><h4>Selection of Studies</h4><p class="abstract-paragraph">A total of 19,377 records were identified from the literature search. These were reduced to 338 after the removal of duplicates and screening of titles and abstracts. Only 10 papers were included in the study after a full-text review. Although 3 of these papers [<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref28" rel="footnote">28</a></span>,<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>] were in the context of secondary use of digital health data for research, they were included, as their IQ frameworks were relevant to the clinical context of digital health information. However, we performed a sensitivity analysis by conducting a thematic synthesis with and without these 3 papers [<span class="footers"><a class="citation-link" href="#ref30" rel="footnote">30</a></span>]. The sensitivity analysis revealed that the inclusion of the 3 papers did not affect the component dimensions in the resulting framework, but their inclusion produced a better understanding of the definition of the dimensions. The PRISMA flow diagram is shown in <span class="footers"><a class="citation-link" href="#figure1" rel="footnote">Figure 1</a></span>.</p><figure><a name="figure1">‎</a><a class="fancybox" title="Figure 1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flow diagram. IQ: information quality." href="https://asset.jmir.pub/assets/4206ec530b2c626dd6c59e98922a634b.png" id="figure1"><img class="figure-image" src="https://asset.jmir.pub/assets/4206ec530b2c626dd6c59e98922a634b.png"/></a><figcaption><span class="typcn typcn-image"/>Figure 1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flow diagram. IQ: information quality. </figcaption><a class="fancybox" href="https://asset.jmir.pub/assets/4206ec530b2c626dd6c59e98922a634b.png" title="Figure 1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flow diagram. IQ: information quality.">View this figure</a></figure><h4>Included Papers</h4><p class="abstract-paragraph">The 10 included papers were published between 2007 and 2017. Of the 10 papers, 5 (50%) were published in the United States [<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref28" rel="footnote">28</a></span>,<span class="footers"><a class="citation-link" href="#ref31" rel="footnote">31</a></span>-<span class="footers"><a class="citation-link" href="#ref33" rel="footnote">33</a></span>], 3 (30%) were published in the United Kingdom [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>,<span class="footers"><a class="citation-link" href="#ref34" rel="footnote">34</a></span>], and one each was published in Canada [<span class="footers"><a class="citation-link" href="#ref35" rel="footnote">35</a></span>] and Japan [<span class="footers"><a class="citation-link" href="#ref36" rel="footnote">36</a></span>]. One of the studies published in the United Kingdom was conducted in Saudi Arabia [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>]. Of the 10 papers, 4 (40%) were journal publications [<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref28" rel="footnote">28</a></span>,<span class="footers"><a class="citation-link" href="#ref32" rel="footnote">32</a></span>,<span class="footers"><a class="citation-link" href="#ref36" rel="footnote">36</a></span>], 3 (30%) were conference papers [<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>,<span class="footers"><a class="citation-link" href="#ref31" rel="footnote">31</a></span>,<span class="footers"><a class="citation-link" href="#ref34" rel="footnote">34</a></span>], 2 (20%) were institutional reports [<span class="footers"><a class="citation-link" href="#ref33" rel="footnote">33</a></span>,<span class="footers"><a class="citation-link" href="#ref35" rel="footnote">35</a></span>], and 1 (10%) was a PhD thesis [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>]. Of the 10 studies, 5 used qualitative methods, either alone [<span class="footers"><a class="citation-link" href="#ref31" rel="footnote">31</a></span>,<span class="footers"><a class="citation-link" href="#ref36" rel="footnote">36</a></span>] or in combination with other methods [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>]. Similarly, 40% (4/10) studies used literature review alone [<span class="footers"><a class="citation-link" href="#ref28" rel="footnote">28</a></span>,<span class="footers"><a class="citation-link" href="#ref34" rel="footnote">34</a></span>] or combined with other methods [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>]. Overall, 30% (3/10) studies modified the existing frameworks [<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>,<span class="footers"><a class="citation-link" href="#ref32" rel="footnote">32</a></span>,<span class="footers"><a class="citation-link" href="#ref36" rel="footnote">36</a></span>]. One study reported to have updated the previous framework [<span class="footers"><a class="citation-link" href="#ref33" rel="footnote">33</a></span>], but it was unclear how this was achieved. In addition, 10% (1/10) study [<span class="footers"><a class="citation-link" href="#ref35" rel="footnote">35</a></span>] did not state how the framework was developed. About 50% (5/10) of the frameworks were on EHRs [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref28" rel="footnote">28</a></span>,<span class="footers"><a class="citation-link" href="#ref32" rel="footnote">32</a></span>,<span class="footers"><a class="citation-link" href="#ref33" rel="footnote">33</a></span>], one each on electronic medical records [<span class="footers"><a class="citation-link" href="#ref35" rel="footnote">35</a></span>], primary care databases [<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>], CDSSs [<span class="footers"><a class="citation-link" href="#ref31" rel="footnote">31</a></span>], mobile and web-based apps for telemedicine [<span class="footers"><a class="citation-link" href="#ref36" rel="footnote">36</a></span>], and cloud-based health information systems [<span class="footers"><a class="citation-link" href="#ref34" rel="footnote">34</a></span>]. Thus, it appears that IQ framework research is unable to keep pace with the rapid evolution of DHTs with obvious underrepresentation of newer DHTs such as mobile health. The details of the included papers are presented in <span class="footers"><a class="citation-link" href="#app3" rel="footnote">Multimedia Appendix 3</a></span> [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref28" rel="footnote">28</a></span>,<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>,<span class="footers"><a class="citation-link" href="#ref31" rel="footnote">31</a></span>-<span class="footers"><a class="citation-link" href="#ref36" rel="footnote">36</a></span>].</p><h4>Quality of Included Studies</h4><p class="abstract-paragraph">The quality assessment indicated that most of the studies described an IQ framework for DHT without reporting a robust framework development process. The Critical Appraisal Skills Programme checklist is not applicable to 2 studies [<span class="footers"><a class="citation-link" href="#ref33" rel="footnote">33</a></span>,<span class="footers"><a class="citation-link" href="#ref35" rel="footnote">35</a></span>], which are institutional publications. Only 1 qualitative study [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>] reported on the recruitment strategy. Similarly, studies with literature reviews did not report on the search strategy or study selection process [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref28" rel="footnote">28</a></span>,<span class="footers"><a class="citation-link" href="#ref34" rel="footnote">34</a></span>]. Only 3 studies [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref31" rel="footnote">31</a></span>,<span class="footers"><a class="citation-link" href="#ref32" rel="footnote">32</a></span>] addressed ethical issues and reported sufficiently rigorous data analysis. These findings further justify the need for this study, which used a robust systematic review approach to develop a preliminary IQ framework for digital health. The quality assessment results are provided in <span class="footers"><a class="citation-link" href="#app4" rel="footnote">Multimedia Appendix 4</a></span> [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref28" rel="footnote">28</a></span>,<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>,<span class="footers"><a class="citation-link" href="#ref31" rel="footnote">31</a></span>-<span class="footers"><a class="citation-link" href="#ref36" rel="footnote">36</a></span>].</p><h4>Clinical Information Quality Framework for Digital Health</h4><p class="abstract-paragraph">A total of 38 IQ dimensions and 70 verbatim definitions were extracted from the 10 included frameworks. The list of dimensions and their definitions are provided in <span class="footers"><a class="citation-link" href="#app5" rel="footnote">Multimedia Appendix 5</a></span> [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref14" rel="footnote">14</a></span>,<span class="footers"><a class="citation-link" href="#ref28" rel="footnote">28</a></span>,<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>,<span class="footers"><a class="citation-link" href="#ref31" rel="footnote">31</a></span>-<span class="footers"><a class="citation-link" href="#ref36" rel="footnote">36</a></span>]. The coding of these definitions led to the identification of 160 codes. Aggregation of similar codes resulted in a total of 13 unique IQ dimensions that mirrored all the relevant dimensions in the existing IQ frameworks while eliminating related but redundant dimensions. The resulting dimensions include accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability. These dimensions were defined based on the codes from which they were generated and classified into higher categories of availability, informativeness, and usability during the analytical synthesis. It is worth noting that some of the dimensions fit into more than one category but were placed into the best-fit category after carefully considering the inputs of all reviewers. For example, completeness was considered fit for both the availability and informativeness categories but was placed in the informativeness category, as this was the most popular category suggested by the reviewers. Similarly, timeliness was considered more fit for the availability category compared with the usability category, and interpretability was placed in the informativeness category rather than the usability category. The resulting Clinical Information Quality (CLIQ) framework for digital health is shown in <span class="footers"><a class="citation-link" href="#figure2" rel="footnote">Figure 2</a></span>.</p><figure><a name="figure2">‎</a><a class="fancybox" title="Figure 2. Clinical Information Quality framework for digital health." href="https://asset.jmir.pub/assets/c925c975f7d1b3a8e0ab153f13dde022.png" id="figure2"><img class="figure-image" src="https://asset.jmir.pub/assets/c925c975f7d1b3a8e0ab153f13dde022.png"/></a><figcaption><span class="typcn typcn-image"/>Figure 2. Clinical Information Quality framework for digital health. </figcaption><a class="fancybox" href="https://asset.jmir.pub/assets/c925c975f7d1b3a8e0ab153f13dde022.png" title="Figure 2. Clinical Information Quality framework for digital health.">View this figure</a></figure><h4>Metrics of Measurement</h4><p class="abstract-paragraph">Metrics of measurement for the IQ dimensions were given in only 30% (3/10) of the included papers [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>,<span class="footers"><a class="citation-link" href="#ref35" rel="footnote">35</a></span>]. The remaining papers only conceptualize IQ without providing guidance on its measurement. Objective and subjective measures were used in these studies. Objective measures involved mathematical calculations, such as ratio, percentages, and fraction to quantify the IQ dimension [<span class="footers"><a class="citation-link" href="#ref37" rel="footnote">37</a></span>]. Subjective measures, on the other hand, rely on the perspectives of the information users, which are usually assessed using a Likert scale questionnaire or qualitative interviews [<span class="footers"><a class="citation-link" href="#ref10" rel="footnote">10</a></span>].</p><p class="abstract-paragraph">Objective measures were reported for accuracy, validity, timeliness, completeness and interpretability, comprehensibility, reliability, validity, timeliness, relevance, integrity completeness, concordance, informative sufficiency, consistency, consistency of capture, and consistency of form [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>,<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>,<span class="footers"><a class="citation-link" href="#ref35" rel="footnote">35</a></span>]. These dimensions were measured by determining whether a desired or undesired attribute was present or absent. For example, Almutiry [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>] identified quality problems (undesired attributes) related to accuracy as misspelling, out-of-range values, erroneous values, etc. The quality score for accuracy was then calculated by determining the proportion of the total data units without each quality problem. Similarly, Dungey et al [<span class="footers"><a class="citation-link" href="#ref29" rel="footnote">29</a></span>] measured accuracy by calculating the proportion of implausible values (undesired attributes). Bowen [<span class="footers"><a class="citation-link" href="#ref35" rel="footnote">35</a></span>], on the other hand, used the percentage of data units with the desired attribute. Correctness was measured by determining the positive predictive value, which is the proportion of true positives (desired attributes).</p><p class="abstract-paragraph">Subjective measures were reported for usability, relevance, provenance, secure access, confidentiality, and privacy [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>]. Each dimension was measured using multiple Likert scale questions. For example, relevance was assessed by the information users’ rating of how far the information was relevant, useful, applicable, and appropriate to the task at hand [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>]. The quality score for each dimension is the aggregate of all ratings for these different measures.</p><br/><h3 class="navigation-heading h3-main-heading" id="Discussion" data-label="Discussion">Discussion</h3><h4>Principal Findings</h4><p class="abstract-paragraph">We identified 10 existing IQ frameworks for DHTs, and from these, we developed the CLIQ framework for digital health with 13 unique dimensions, including accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were classified into 3 meaningful categories—availability, informativeness, and usability—based on our conceptualization of <i>fitness</i> of digital health information for clinical purposes.</p><p class="abstract-paragraph">The informativeness category directly concerns the usefulness of information for clinical purposes and has the greatest implications for patient safety. Problems with the dimensions in the category can directly lead to significant harm, as previously reported in the literature [<span class="footers"><a class="citation-link" href="#ref6" rel="footnote">6</a></span>,<span class="footers"><a class="citation-link" href="#ref8" rel="footnote">8</a></span>]. Accuracy is the most popular IQ dimension. However, this systematic review echoes the literature that IQ is not only about accuracy but also a multidimensional phenomenon [<span class="footers"><a class="citation-link" href="#ref38" rel="footnote">38</a></span>]. Provenance and plausibility are unique IQ dimensions that can be regarded as proxies for accuracy, especially in situations where immediate and objective determination of accuracy is impractical. Provenance and plausibility can be easily determined subjectively. For example, knowing that the source of digital health information is a reputable institution (provenance) such as the World Health Organization would be reassuring, and an implausible value, such as a body temperature of 100°C (plausibility), would raise a serious concern. Interpretability is critical to the clinical use of digital information, as an incorrect interpretation may lead to significant harm. Hence, the inclusion of reference values with most laboratory results enhances the safe interpretation of the values.</p><p class="abstract-paragraph">The availability category of IQ dimensions concerns the functionality of a system that holds clinical information. These dimensions are critical as they can affect the efficiency of service delivery and are regarded as important by users of digital health information. Inaccessible digital information offers no real value to health professionals, as it cannot be used in the clinical management of patients. In addition, accessibility of clinical information wherever it is required (portability) and whenever it is required (timeliness) could be lifesaving, especially in emergency situations when the knowledge of a patient’s medical history and current medications are essential. Timeliness, in the clinical context of digital health, also requires that health information is up to date. On the other hand, restriction of access to clinical information only to authorized users (security) protects the privacy and confidentiality of the patient and protects the information from corruption. Availability dimensions are illustrated by the UK’s Summary Care Records [<span class="footers"><a class="citation-link" href="#ref39" rel="footnote">39</a></span>], which contain up-to-date personal medical and medication history of patients and are accessible at the point of care (timeliness and accessibility) across different health care settings only to authorized health care professionals (security).</p><p class="abstract-paragraph">The usability category concerns the ease of use of health information. Consistency and conformance are akin to 2 sides of a coin, with consistency referring to the presentation of information in the same format within a system and conformance referring to the presentation of information in the desired format based on local guidelines or international standards. For example, it is important for an app to present blood glucose consistently using either gram per deciliter or millimoles per liter and conform with the recommended units in the local guidelines to avoid confusion, which may compromise patient safety. The last dimension in this category is maintainability. This refers to the extent to which the information can be maintained. Maintenance, in this context, covers a range of activities, including review, audit, update, and storage of clinical information to ensure that all other IQ requirements are met. For example, timeliness can be improved by updating the information in the DHTs, and accuracy can be improved through regular audits of the information generated by the DHTs.</p><h4>Strength and Limitations</h4><p class="abstract-paragraph">The main strength of our framework lies in the rigorous systematic review approach that was used to identify, define, and categorize IQ dimensions. In addition, our approach of synthesizing definitions rather than the traditional practice of simply cross-matching dimensions from different frameworks is more meaningful, as the definition expresses the real meaning of each dimension, and a dimension usually has heterogeneous definitions across different frameworks. In addition, focusing on the clinical context rather than the ever-changing DHTs, as in previous frameworks, we have developed a context-specific IQ framework that would be applicable or at least adaptable to a range of DHTs used in the clinical context, including novel ones that are currently underrepresented in IQ framework research. This approach differs from previous frameworks that focus on individual DHTs, such as EHR [<span class="footers"><a class="citation-link" href="#ref13" rel="footnote">13</a></span>] and CDSS [<span class="footers"><a class="citation-link" href="#ref31" rel="footnote">31</a></span>]. The consideration of the clinical purposes of DHTs is in consonance with the <i>fit-for-purpose</i> definition of IQ [<span class="footers"><a class="citation-link" href="#ref10" rel="footnote">10</a></span>]. Moreover, the traditional practice of using the same clinical information across different DHTs (eg, the use of EHR information for CDSS) further justifies the need for a common IQ framework for the clinical context of DHTs.</p><p class="abstract-paragraph">However, the lack of information about the relative relevance of the IQ dimensions in the CLIQ framework and the optimal means of their measurement are limitations. Although these dimensions could be considered as indices of fitness of digital information for clinical purposes, we acknowledge the need to consult with clinical information users, such as doctors, nurses, and health service managers, as recommended in the literature [<span class="footers"><a class="citation-link" href="#ref10" rel="footnote">10</a></span>,<span class="footers"><a class="citation-link" href="#ref12" rel="footnote">12</a></span>]. Thus, the current CLIQ framework for digital health could be regarded as a preliminary framework to be tested in primary research studies. To build on this preliminary research, an international eDelphi study is currently underway to obtain consensus among clinicians on the approach to assessing the quality of clinical information produced by DHTs. The eDelphi study addresses the prioritization of the dimensions and the metrics for measuring the dimension.</p><h4>Comparison With Validated IQ Frameworks</h4><p class="abstract-paragraph">The CLIQ framework for digital health shares several characteristics with validated IQ frameworks within and beyond the health care domain. One such validated IQ framework, developed by Wang and Strong [<span class="footers"><a class="citation-link" href="#ref38" rel="footnote">38</a></span>], has been used as a reference point in IQ research. Out of its 15 dimensions, 7 (accuracy, relevance, completeness, timeliness, interpretability, security, and accessibility) are also included in the CLIQ framework. The rest of its dimensions, such as believability and understandability, were assimilated by other dimensions in our framework during thematic synthesis. On the other hand, novel dimensions such as portability and maintainability are included in our framework but not in the framework developed by Wang and Strong [<span class="footers"><a class="citation-link" href="#ref38" rel="footnote">38</a></span>]. This reflects technological advances in the last three decades, with an increasing amount of digital information. In addition, our framework was developed for the clinical context, whereas Wang and Strong focused on the business domain [<span class="footers"><a class="citation-link" href="#ref38" rel="footnote">38</a></span>].</p><p class="abstract-paragraph">Similarly, the dimensions in our framework overlap with the product quality properties of the International Organization for Standardization/International Electrotechnical Commission (ISO/IEC 25010), which include 8 characteristics: functional suitability, reliability, performance efficiency, operability, security, compatibility, maintainability, and transferability [<span class="footers"><a class="citation-link" href="#ref40" rel="footnote">40</a></span>]. Of these characteristics, 2 (maintainability and security) were also included in the CLIQ framework. Other dimensions in the CLIQ framework (eg, availability, accuracy, and completeness) are included as subcharacteristics of product quality. This overlap is not unexpected, as DHTs are also software products, with IQ being a subset of product quality [<span class="footers"><a class="citation-link" href="#ref40" rel="footnote">40</a></span>]. However, ISO/IEC 25010 addresses Systems and Software Quality Requirements and Evaluation from a computer engineering perspective, whereas the CLIQ framework addresses IQ from a health care perspective with consideration of its impact on patient safety [<span class="footers"><a class="citation-link" href="#ref6" rel="footnote">6</a></span>-<span class="footers"><a class="citation-link" href="#ref8" rel="footnote">8</a></span>]. Although we recognize the importance of other aspects of product quality, such as user-interface esthetics, these are beyond the scope of this study, which is focused on IQ in the clinical context of DHTs.</p><h4>Conclusions</h4><p class="abstract-paragraph">This systematic review highlighted the importance of the IQ of DHTs and their relevance to patient safety. Future research is needed to determine the relative relevance of each dimension in the CLIQ framework and their metrics of measurement, with inputs from clinical information users. The CLIQ framework for digital health will be useful to health care organizations, health care professionals, digital health solution developers, and medical device regulators in conceptualizing and evaluating IQ issues associated with digital health, thus forestalling potential patient safety problems. This is more relevant than ever, as the health care community is increasingly turning to DHTs, and the need for and value of such systems in the context of health emergencies is becoming ever more apparent.</p></article><p><h4 class="h4-border-top">Acknowledgments</h4></p><p class="abstract-paragraph">The authors would like to thank Rebecca Jones, library manager and liaison librarian at the Charring Cross Library, Imperial College London, for useful advice on strategies for the literature search. This review is part of the PhD of the lead author (KPF) sponsored by the Federal Government of Nigeria. This review is an independent research supported in part by the National Institute for Health Research (NIHR) Applied Research Collaboration Northwest London. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.</p><h4 class="h4-border-top">Authors' Contributions</h4><p><p class="abstract-paragraph">KPF and JOD conceived the study. KPF drafted the manuscript. JTA, SOC, PAW, CC, AM, JC, JG, and JOD revised the manuscript for important intellectual content and contributed to the review, including search strategy, study selection, data extraction, and data analysis. AM is the clinical lead, and JOD is the guarantor of the review.</p></p><h4 class="h4-border-top">Conflicts of Interest</h4><p><p class="abstract-paragraph">None declared.</p></p> ‎ <div id="app1" name="app1">Multimedia Appendix 1<p class="abstract-paragraph">PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist.</p><a href="https://jmir.org/api/download?alt_name=jmir_v23i5e23479_app1.docx&filename=0aa85c448a67797f526b5ba7356e8f2e.docx" target="_blank">DOCX File , 18 KB</a></div><hr/> ‎ <div id="app2" name="app2">Multimedia Appendix 2<p class="abstract-paragraph">Search strategy.</p><a href="https://jmir.org/api/download?alt_name=jmir_v23i5e23479_app2.docx&filename=9b34c067299680987c678107cbc464b0.docx" target="_blank">DOCX File , 91 KB</a></div><hr/> ‎ <div id="app3" name="app3">Multimedia Appendix 3<p class="abstract-paragraph">Included papers.</p><a href="https://jmir.org/api/download?alt_name=jmir_v23i5e23479_app3.docx&filename=5fb55d3402260df8f3fd5efcab7a131a.docx" target="_blank">DOCX File , 18 KB</a></div><hr/> ‎ <div id="app4" name="app4">Multimedia Appendix 4<p class="abstract-paragraph">Quality assessment result.</p><a href="https://jmir.org/api/download?alt_name=jmir_v23i5e23479_app4.docx&filename=6bea79823732cfe7028b61ffed269048.docx" target="_blank">DOCX File , 15 KB</a></div><hr/> ‎ <div id="app5" name="app5">Multimedia Appendix 5<p class="abstract-paragraph">Definition of dimensions within the existing information quality frameworks for digital health technologies.</p><a href="https://jmir.org/api/download?alt_name=jmir_v23i5e23479_app5.docx&filename=5e319bb258868d41314581c3a800dc13.docx" target="_blank">DOCX File , 48 KB</a></div><hr/><div class="footnotes"><h4 class="h4-border-top" id="References">References</h4><ol><li><span id="ref1">World Health Organization. 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BS ISO/IEC 25010:2011. 2011.   URL: <a target="_blank" href="https://landingpage.bsigroup.com/LandingPage/Standard?UPI=000000000030215101">https://landingpage.bsigroup.com/LandingPage/Standard?UPI=000000000030215101</a> [accessed 2021-05-04] </span></li></ol></div><br/><hr/><a name="Abbreviations">‎</a><h4 class="navigation-heading" id="Abbreviations" data-label="Abbreviations">Abbreviations</h4><table width="80%" border="0" align="center"><tr><td><b>CDSS:</b> clinical decision support system</td></tr><tr><td><b>CLIQ:</b> Clinical Information Quality</td></tr><tr><td><b>DHT:</b> digital health technology</td></tr><tr><td><b>EHR:</b> electronic health record</td></tr><tr><td><b>IQ:</b> information quality</td></tr><tr><td><b>PRISMA:</b> Preferred Reporting Items for Systematic Reviews and Meta-Analysis</td></tr></table><br/><hr/><p style="font-style: italic">Edited by G Eysenbach; submitted 13.08.20; peer-reviewed by D Strong, M Kolotylo-Kulkarni, A Sharafoddini, MDG Pimentel, A Azzam, C Jones, N Mohammad Gholi Mezerji; comments to author 18.11.20; revised version received 28.11.20; accepted 03.04.21; published 17.05.21</p><a href="https://support.jmir.org/hc/en-us/articles/115002955531" id="Copyright" target="_blank" class="navigation-heading h4 d-block" aria-label="Copyright - what is a Creative Commons License?" data-label="Copyright">Copyright <span class="fas fa-question-circle"/></a><p class="article-copyright">©Kayode Philip Fadahunsi, Siobhan O'Connor, James Tosin Akinlua, Petra A Wark, Joseph Gallagher, Christopher Carroll, Josip Car, Azeem Majeed, John O'Donoghue. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 17.05.2021.</p><small class="article-license"><p class="abstract-paragraph">This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.</p></small><br/></section></article></section></section></main></div></div></div></div> <aside data-test="sidebar-exists" class="sidebar-citation col-lg-3 mb-5"><div style="margin-top: 25px;"><a target="_blank" href="https://doi.org/10.1136/bmjopen-2018-024722"><img src="https://www.jmir.org/ojs/styles/newDesign/images/rr2-main.png" style="width: 80px"></a> <br> <a target="_blank" href="https://support.jmir.org/hc/en-us/articles/360003450852">What is this?</a></div> <div><h2 class="h4 green-heading-underline width-fit-content"> Citation </h2> <p class="fw-bold"> Please cite as: </p> <p><span> Fadahunsi KP<span>,</span></span><span> O'Connor S<span>,</span></span><span> Akinlua JT<span>,</span></span><span> Wark PA<span>,</span></span><span> Gallagher J<span>,</span></span><span> Carroll C<span>,</span></span><span> Car J<span>,</span></span><span> Majeed A<span>,</span></span><span> O'Donoghue J</span> <br> <span>Information Quality Frameworks for Digital Health Technologies: Systematic Review</span> <br> <span>J Med Internet Res 2021;23(5):e23479</span> <br> <span>doi: <span><a aria-label="DOI number 10.2196/23479" data-test="article-doi" target="_blank" href="https://doi.org/10.2196/23479"> 10.2196/23479 </a></span></span> <span style="display: block"> PMID: <span><a data-test="article-pmid" aria-label="PMID 33835034" target="_blank" href="https://www.ncbi.nlm.nih.gov/pubmed/33835034">33835034</a></span></span> <span style="display: block"> PMCID: <span><a data-test="article-pmcid" aria-label="PMCID 8167621" target="_blank" href="https://www.ncbi.nlm.nih.gov/pmc/articles/8167621">8167621</a></span></span></p> <button title="Copy Citation" data-test="copy-to-clipboard-button" class="btn btn-small btn-grey"><span aria-hidden="true" class="icon fas fa-paste"></span> Copy Citation to Clipboard 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href=\"https:\u002F\u002Forcid.org\u002F0000-0001-8579-1718\" target=\"_blank\" title=\"ORCID\"\u003E \u003C\u002Fa\u003E; \u003C\u002Fli\u003E\u003Cli\u003E\u003Ca href=\"\u002Fsearch\u002FsearchResult?field%5B%5D=author&criteria%5B%5D=James Tosin+Akinlua\" class=\"btn-view-author-options\"\u003EJames Tosin Akinlua\u003Csup\u003E\u003Csmall\u003E3\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E, MBBS, MPH, PhD\u003C\u002Fa\u003E\u003Ca class=\"author-orcid\" href=\"https:\u002F\u002Forcid.org\u002F0000-0002-9887-0033\" target=\"_blank\" title=\"ORCID\"\u003E \u003C\u002Fa\u003E; \u003C\u002Fli\u003E\u003Cli\u003E\u003Ca href=\"\u002Fsearch\u002FsearchResult?field%5B%5D=author&criteria%5B%5D=Petra A+Wark\" class=\"btn-view-author-options\"\u003EPetra A Wark\u003Csup\u003E\u003Csmall\u003E3,\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E\u003Csup\u003E\u003Csmall\u003E4\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E, MSc, PhD, FHEA\u003C\u002Fa\u003E\u003Ca class=\"author-orcid\" href=\"https:\u002F\u002Forcid.org\u002F0000-0003-1020-4640\" target=\"_blank\" title=\"ORCID\"\u003E \u003C\u002Fa\u003E; \u003C\u002Fli\u003E\u003Cli\u003E\u003Ca href=\"\u002Fsearch\u002FsearchResult?field%5B%5D=author&criteria%5B%5D=Joseph+Gallagher\" class=\"btn-view-author-options\"\u003EJoseph Gallagher\u003Csup\u003E\u003Csmall\u003E5\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E, BA, MD, MBChB, BAO, MRCPI, MICGP, FHFA\u003C\u002Fa\u003E\u003Ca class=\"author-orcid\" href=\"https:\u002F\u002Forcid.org\u002F0000-0002-5564-2890\" target=\"_blank\" title=\"ORCID\"\u003E \u003C\u002Fa\u003E; \u003C\u002Fli\u003E\u003Cli\u003E\u003Ca href=\"\u002Fsearch\u002FsearchResult?field%5B%5D=author&criteria%5B%5D=Christopher+Carroll\" class=\"btn-view-author-options\"\u003EChristopher Carroll\u003Csup\u003E\u003Csmall\u003E6\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E, BA, MA, MSc, PhD\u003C\u002Fa\u003E\u003Ca class=\"author-orcid\" href=\"https:\u002F\u002Forcid.org\u002F0000-0002-6361-6182\" target=\"_blank\" title=\"ORCID\"\u003E \u003C\u002Fa\u003E; \u003C\u002Fli\u003E\u003Cli\u003E\u003Ca href=\"\u002Fsearch\u002FsearchResult?field%5B%5D=author&criteria%5B%5D=Josip+Car\" class=\"btn-view-author-options\"\u003EJosip Car\u003Csup\u003E\u003Csmall\u003E1,\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E\u003Csup\u003E\u003Csmall\u003E7\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E, FFPH, DIC, MSc, PhD, MD, FRCP\u003C\u002Fa\u003E\u003Ca class=\"author-orcid\" href=\"https:\u002F\u002Forcid.org\u002F0000-0001-8969-371X\" target=\"_blank\" title=\"ORCID\"\u003E \u003C\u002Fa\u003E; \u003C\u002Fli\u003E\u003Cli\u003E\u003Ca href=\"\u002Fsearch\u002FsearchResult?field%5B%5D=author&criteria%5B%5D=Azeem+Majeed\" class=\"btn-view-author-options\"\u003EAzeem Majeed\u003Csup\u003E\u003Csmall\u003E1\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E, MD, FRCP, FRCGP, FFPH\u003C\u002Fa\u003E\u003Ca class=\"author-orcid\" href=\"https:\u002F\u002Forcid.org\u002F0000-0002-2357-9858\" target=\"_blank\" title=\"ORCID\"\u003E \u003C\u002Fa\u003E; \u003C\u002Fli\u003E\u003Cli\u003E\u003Ca href=\"\u002Fsearch\u002FsearchResult?field%5B%5D=author&criteria%5B%5D=John+O'Donoghue\" class=\"btn-view-author-options\"\u003EJohn O'Donoghue\u003Csup\u003E\u003Csmall\u003E8,\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E\u003Csup\u003E\u003Csmall\u003E9\u003C\u002Fsmall\u003E\u003C\u002Fsup\u003E, BSc, MSc, PhD, Cert(ICL), FHEA, FBCS\u003C\u002Fa\u003E\u003Ca class=\"author-orcid\" href=\"https:\u002F\u002Forcid.org\u002F0000-0001-6056-8640\" target=\"_blank\" title=\"ORCID\"\u003E \u003C\u002Fa\u003E\u003C\u002Fli\u003E\u003C\u002Ful\u003E\u003Cdiv class=\"author-affiliation-details\"\u003E\u003Cp\u003E\u003Csup\u003E1\u003C\u002Fsup\u003EDepartment of Public Health and Primary Care, Imperial College London, London, United Kingdom\u003C\u002Fp\u003E\u003Cp\u003E\u003Csup\u003E2\u003C\u002Fsup\u003ESchool of Health in Social Science, The University of Edinburgh, Edinburgh, United Kingdom\u003C\u002Fp\u003E\u003Cp\u003E\u003Csup\u003E3\u003C\u002Fsup\u003EDepartment of Primary Care and Population Health Sciences, University College London, London, United Kingdom\u003C\u002Fp\u003E\u003Cp\u003E\u003Csup\u003E4\u003C\u002Fsup\u003ECentre for Intelligent Healthcare, Institute of Health and Wellbeing, Coventry University, Coventry, United Kingdom\u003C\u002Fp\u003E\u003Cp\u003E\u003Csup\u003E5\u003C\u002Fsup\u003EgHealth Research Group, School of Medicine, University College Dublin, Dublin, Ireland\u003C\u002Fp\u003E\u003Cp\u003E\u003Csup\u003E6\u003C\u002Fsup\u003EHealth Economics and Decision Science, School of Health and Related Research, The University of Sheffield, Sheffield, United Kingdom\u003C\u002Fp\u003E\u003Cp\u003E\u003Csup\u003E7\u003C\u002Fsup\u003ECentre for Population Health Sciences, LKC Medicine, Nayang Technological University, Sungapore, Singapore\u003C\u002Fp\u003E\u003Cp\u003E\u003Csup\u003E8\u003C\u002Fsup\u003EMalawi eHealth Research Centre, University College Cork, Cork, Ireland\u003C\u002Fp\u003E\u003Cp\u003E\u003Csup\u003E9\u003C\u002Fsup\u003EASSERT Research Centre, University College Cork, Cork, Ireland\u003C\u002Fp\u003E\u003C\u002Fdiv\u003E\u003C\u002Fdiv\u003E\u003Cdiv class=\"corresponding-author-and-affiliations clearfix\"\u003E\u003Cdiv class=\"corresponding-author-details\"\u003E\u003Ch3\u003ECorresponding Author:\u003C\u002Fh3\u003E\u003Cp\u003EKayode Philip Fadahunsi, MBBS, MPH\u003C\u002Fp\u003E\u003Cp\u002F\u003E\u003Cp\u003EDepartment of Public Health and Primary Care\u003C\u002Fp\u003E\u003Cp\u003EImperial College London\u003C\u002Fp\u003E\u003Cp\u003EThe Reynolds Building\u003C\u002Fp\u003E\u003Cp\u003ESt. Dunstan’s Road\u003C\u002Fp\u003E\u003Cp\u003ELondon, W6 8RP\u003C\u002Fp\u003E\u003Cp\u003EUnited Kingdom\u003C\u002Fp\u003E\u003Cp\u003EPhone: 44 07477854209\u003C\u002Fp\u003E\u003Cp\u003EEmail: \u003Ca href=\"mailto:K.fadahunsi14@imperial.ac.uk\"\u003EK.fadahunsi14@imperial.ac.uk\u003C\u002Fa\u003E\u003C\u002Fp\u003E\u003Cbr\u002F\u003E\u003C\u002Fdiv\u003E\u003C\u002Fdiv\u003E\u003C\u002Fdiv\u003E\u003Csection class=\"article-content clearfix\"\u003E\u003Carticle class=\"abstract\"\u003E\u003Ch3 id=\"Abstract\" class=\"navigation-heading\" data-label=\"Abstract\"\u003EAbstract\u003C\u002Fh3\u003E\u003Cp\u003E\u003Cspan class=\"abstract-sub-heading\"\u003EBackground: \u003C\u002Fspan\u003EDigital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, some of which result from poor information quality (IQ).\u003Cbr\u002F\u003E\u003C\u002Fp\u003E\u003Cp\u003E\u003Cspan class=\"abstract-sub-heading\"\u003EObjective: \u003C\u002Fspan\u003EThis systematic review aims to synthesize an IQ framework that could be used to evaluate the extent to which digital health information is fit for clinical purposes.\u003Cbr\u002F\u003E\u003C\u002Fp\u003E\u003Cp\u003E\u003Cspan class=\"abstract-sub-heading\"\u003EMethods: \u003C\u002Fspan\u003EThe review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We searched Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, Global Health, ProQuest Dissertations and Theses Global, Scopus, and HMIC (the Health Management Information Consortium) from inception until October 2019. Multidimensional IQ frameworks for assessing DHTs used in the clinical context by health care professionals were included. A thematic synthesis approach was used to synthesize the Clinical Information Quality (CLIQ) framework for digital health.\u003Cbr\u002F\u003E\u003C\u002Fp\u003E\u003Cp\u003E\u003Cspan class=\"abstract-sub-heading\"\u003EResults: \u003C\u002Fspan\u003EWe identified 10 existing IQ frameworks from which we developed the CLIQ framework for digital health with 13 unique dimensions: accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were categorized into 3 meaningful categories: availability, informativeness, and usability.\u003Cbr\u002F\u003E\u003C\u002Fp\u003E\u003Cp\u003E\u003Cspan class=\"abstract-sub-heading\"\u003EConclusions: \u003C\u002Fspan\u003EThis systematic review highlights the importance of the IQ of DHTs and its relevance to patient safety. The CLIQ framework for digital health will be useful in evaluating and conceptualizing IQ issues associated with digital health, thus forestalling potential patient safety problems.\u003Cbr\u002F\u003E\u003C\u002Fp\u003E\u003Cp\u003E\u003Cspan class=\"abstract-sub-heading\"\u003ETrial Registration: \u003C\u002Fspan\u003EPROSPERO International Prospective Register of Systematic Reviews CRD42018097142; https:\u002F\u002Fwww.crd.york.ac.uk\u002Fprospero\u002Fdisplay_record.php?RecordID=97142\u003Cbr\u002F\u003E\u003C\u002Fp\u003E\u003Cp\u003E\u003Cspan class=\"abstract-sub-heading\"\u003EInternational Registered Report Identifier (IRRID): \u003C\u002Fspan\u003ERR2-10.1136\u002Fbmjopen-2018-024722\u003Cbr\u002F\u003E\u003C\u002Fp\u003E\u003Cstrong class=\"h4-article-volume-issue\"\u003EJ Med Internet Res 2021;23(5):e23479\u003C\u002Fstrong\u003E\u003Cbr\u002F\u003E\u003Cbr\u002F\u003E\u003Cspan class=\"article-doi\"\u003E\u003Ca href=\"https:\u002F\u002Fdoi.org\u002F10.2196\u002F23479\"\u003Edoi:10.2196\u002F23479\u003C\u002Fa\u003E\u003C\u002Fspan\u003E\u003Cbr\u002F\u003E\u003Cbr\u002F\u003E\u003Ch3 class=\"h3-main-heading\" id=\"Keywords\"\u003EKeywords\u003C\u002Fh3\u003E\u003Cdiv class=\"keywords\"\u003E\u003Cspan\u003E\u003Ca href=\"\u002Fsearch?type=keyword&term=digital health\"\u003Edigital health\u003C\u002Fa\u003E; \u003C\u002Fspan\u003E\u003Cspan\u003E\u003Ca href=\"\u002Fsearch?type=keyword&term=patient safety\"\u003Epatient safety\u003C\u002Fa\u003E; \u003C\u002Fspan\u003E\u003Cspan\u003E\u003Ca href=\"\u002Fsearch?type=keyword&term=information quality\"\u003Einformation quality\u003C\u002Fa\u003E \u003C\u002Fspan\u003E\u003C\u002Fdiv\u003E\u003Cdiv id=\"trendmd-suggestions\"\u002F\u003E\u003C\u002Farticle\u003E\u003Cbr\u002F\u003E\u003Carticle class=\"main-article clearfix\"\u003E\u003Cbr\u002F\u003E\u003Ch3 class=\"navigation-heading h3-main-heading\" id=\"Introduction\" data-label=\"Introduction\"\u003EIntroduction\u003C\u002Fh3\u003E\u003Ch4\u003EBackground\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EDigital health—the use of digital technologies for health—is increasingly recognized as a major driver of quality in health care [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref1\" rel=\"footnote\"\u003E1\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Digital health technologies (DHTs), such as telemedicine, electronic health records (EHRs), clinical decision support systems (CDSS), mobile health, computerized physician order entry, electronic prescribing systems, and web-based health services, can improve access and quality of health care services [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref2\" rel=\"footnote\"\u003E2\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref3\" rel=\"footnote\"\u003E3\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. DHTs generate a copious amount of information used in health care for administrative, educational, research, and clinical purposes [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref4\" rel=\"footnote\"\u003E4\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref5\" rel=\"footnote\"\u003E5\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. However, the clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, including significant harms and death, some of which result from poor information quality (IQ) [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref6\" rel=\"footnote\"\u003E6\u003C\u002Fa\u003E\u003C\u002Fspan\u003E-\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref9\" rel=\"footnote\"\u003E9\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. For instance, a patient in the United Kingdom experienced a life-threatening allergic reaction following a medication error because of inaccessible allergy information in the EHR [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref6\" rel=\"footnote\"\u003E6\u003C\u002Fa\u003E\u003C\u002Fspan\u003E].\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EIQ refers to the extent to which information is fit for a specific purpose [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref10\" rel=\"footnote\"\u003E10\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref11\" rel=\"footnote\"\u003E11\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. IQ is multidimensional, with each dimension describing a unique aspect of information [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref10\" rel=\"footnote\"\u003E10\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref12\" rel=\"footnote\"\u003E12\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. For example, accuracy describes the extent to which information is correct, and accessibility describes the extent to which information is easily obtainable [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref12\" rel=\"footnote\"\u003E12\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Dimensions relating to a specific context are traditionally integrated into a framework for evaluating IQ within the context [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref10\" rel=\"footnote\"\u003E10\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref11\" rel=\"footnote\"\u003E11\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. One IQ framework for EHRs [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] has 11 dimensions and 3 categories, as shown in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#box1\" rel=\"footnote\"\u003ETextbox 1\u003C\u002Fa\u003E\u003C\u002Fspan\u003E. The framework depicts the relationship between the dimensions by categorizing statistically measurable dimensions as objectivity, security-related dimensions as integrity, and dimensions relating to the usefulness of information to intended users as utility [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E].\u003C\u002Fp\u003E\u003Cdiv class=\"textbox-container\" id=\"box1\"\u003E\u003Ch5\u003EDimensions and categories in an information quality framework for electronic health record.\u003C\u002Fh5\u003E\u003Cp class=\"abstract-paragraph\"\u003EObjectivity\u003C\u002Fp\u003E\u003Cul\u003E\u003Cli class=\"spacey\"\u003EAccuracy\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003ECompleteness\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EConsistency\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003ETimeliness\u003C\u002Fli\u003E\u003C\u002Ful\u003E\u003Cp class=\"abstract-paragraph\"\u003EUtility\u003C\u002Fp\u003E\u003Cul\u003E\u003Cli class=\"spacey\"\u003EProvenance\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EInterpretability\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EUsability\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003ERelevance\u003C\u002Fli\u003E\u003C\u002Ful\u003E\u003Cp class=\"abstract-paragraph\"\u003EIntegrity\u003C\u002Fp\u003E\u003Cul\u003E\u003Cli class=\"spacey\"\u003EPrivacy\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EConfidentiality\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003ESecure access\u003C\u002Fli\u003E\u003C\u002Ful\u003E\u003Cfigcaption\u003E\u003Cspan class=\"typcn typcn-image\"\u002F\u003ETextbox 1. Dimensions and categories in an information quality framework for electronic health record.\u003C\u002Ffigcaption\u003E\u003C\u002Fdiv\u003E\u003Ch4\u003EResearch Problem and Objective\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003ECurrently, there is no consensus on the definition of IQ dimensions in the context of the use of digital health information for clinical purposes. There is a lack of consistency in the terminology and definition of dimensions in existing IQ frameworks, limiting a common understanding of IQ requirements for DHTs [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Although previous literature reviews have attempted to define the IQ dimensions of digital health information, they focused on the use of digital health information for administrative and research purposes [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref15\" rel=\"footnote\"\u003E15\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Identifying and defining IQ dimensions in the context of the use of digital health information for clinical purposes is especially important considering the patient safety implications of poor IQ, as discussed earlier [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref6\" rel=\"footnote\"\u003E6\u003C\u002Fa\u003E\u003C\u002Fspan\u003E-\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref8\" rel=\"footnote\"\u003E8\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. This study aims to use an evidence-based approach to integrate dimensions from existing IQ frameworks, thus promoting a common understanding of IQ requirements. In addition, safety concerns may discourage health care professionals from adopting DHTs. Although many general practitioners in the United Kingdom would support the deployment of more DHTs in primary care, they are concerned about the safety of digital health information [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref16\" rel=\"footnote\"\u003E16\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Thus, there is a need for a framework that can be used to evaluate the extent to which digital health information is suitable for clinical purposes. The aim of this systematic review is to identify and define dimensions within existing IQ frameworks for DHTs and synthesize an IQ framework that can be used to evaluate the extent to which digital health information is fit for clinical purposes, either diagnostic, therapeutic, or prognostic.\u003C\u002Fp\u003E\u003Cbr\u002F\u003E\u003Ch3 class=\"navigation-heading h3-main-heading\" id=\"Methods\" data-label=\"Methods\"\u003EMethods\u003C\u002Fh3\u003E\u003Ch4\u003EReview Checklist\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe systematic review is reported based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref17\" rel=\"footnote\"\u003E17\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] presented in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#app1\" rel=\"footnote\"\u003EMultimedia Appendix 1\u003C\u002Fa\u003E\u003C\u002Fspan\u003E.\u003C\u002Fp\u003E\u003Ch4\u003EReview Questions\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe systematic review will address the following questions:\u003C\u002Fp\u003E\u003Col type=\"1\"\u003E\u003Cli class=\"spacey\"\u003EWhat IQ frameworks currently exist for evaluating DHTs?\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EHow are dimensions within these existing IQ frameworks defined?\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EWhich IQ dimensions indicate how well digital health information is fit for diagnostic, therapeutic, or prognostic purposes?\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EHow are these digital health IQ dimensions related to one another?\u003C\u002Fli\u003E\u003C\u002Fol\u003E\u003Ch4\u003EEligibility Criteria\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe eligibility criteria of this review were based on a specific approach for identifying frameworks, theories, and models in a systematic review using behavior of phenomenon of interest, health context and model or theory [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref18\" rel=\"footnote\"\u003E18\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref19\" rel=\"footnote\"\u003E19\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. The traditional population, intervention, comparator, and outcome approach was not suitable as we synthesized frameworks rather than interventions.\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EWe included IQ frameworks for assessing DHTs used for clinical purposes but excluded frameworks for nonclinical or administrative purposes because they are less likely to affect patient safety. For example, an incidence reporting system within a hospital setting can be used for administrative purposes. Similarly, we excluded IQ frameworks for web-based health-related information and electronic learning because they are not directly used in the clinical management of patients at the point of care. We excluded self-management apps used by patients mainly for health education and disease tracking purposes, as their IQ requirements are probably different from those used for clinical purposes by health care professionals [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref20\" rel=\"footnote\"\u003E20\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. We included multidimensional frameworks, but not individual IQ dimensions, as IQ is an interrelated multidimensional concept. Both published and gray literature were included. The included studies were not restricted based on publication date, and all eligible studies until October 2019 were included. Restrictions based on publication status, study type, and publication date may inadvertently lead to the exclusion of potentially relevant IQ frameworks. A summary of the eligibility criteria is presented in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#table1\" rel=\"footnote\"\u003ETable 1\u003C\u002Fa\u003E\u003C\u002Fspan\u003E.\u003C\u002Fp\u003E\u003Cdiv class=\"figure-table\"\u003E\u003Cfigcaption\u003E\u003Cspan class=\"typcn typcn-clipboard\"\u002F\u003ETable 1.\n Inclusion and exclusion criteria.\u003C\u002Ffigcaption\u003E\u003Ctable width=\"1000\" cellpadding=\"5\" cellspacing=\"0\" border=\"1\" rules=\"groups\" frame=\"hsides\"\u003E\u003Ccol width=\"320\" span=\"1\"\u003E\u003C\u002Fcol\u003E\u003Ccol width=\"330\" span=\"1\"\u003E\u003C\u002Fcol\u003E\u003Ccol width=\"350\" span=\"1\"\u003E\u003C\u002Fcol\u003E\u003Cthead\u003E\u003Ctr valign=\"top\"\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EConcept\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EInclusion\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EExclusion\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003C\u002Fthead\u003E\u003Ctbody\u003E\u003Ctr valign=\"top\"\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EBehavior of phenomenon of interest\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EInformation quality or data quality\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EInformation quality or data quality of administrative and nonclinical data\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr valign=\"top\"\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EHealth context\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EUse of digital health information for clinical purposes (ie, diagnostic, therapeutic, or prognostic)\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EWeb-based search for health-related information, electronic learning, and digital health apps for self-management\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr valign=\"top\"\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EModel or theory\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EMultidimensional framework\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EIndividual dimension\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr valign=\"top\"\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003ELanguage\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EEnglish\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003ENon-English\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr valign=\"top\"\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EPublication status\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EPublished and gray literature\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003ENone\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr valign=\"top\"\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EDate of publication\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EAny\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003ENone\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr valign=\"top\"\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EType of study\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003EAny\u003C\u002Ftd\u003E\u003Ctd rowspan=\"1\" colspan=\"1\"\u003ENone\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003C\u002Ftbody\u003E\u003C\u002Ftable\u003E\u003C\u002Fdiv\u003E\u003Ch4\u003EInformation Sources\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EWe searched bibliographic health care databases, including Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, and Global Health. We also searched Scopus to identify digital health publications in non–health care disciplines, such as engineering and computer science. In addition, we searched HMIC (the Health Management Information Consortium) and ProQuest Dissertations and Theses Global, which are regarded as good sources of gray literature [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref21\" rel=\"footnote\"\u003E21\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref22\" rel=\"footnote\"\u003E22\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. We manually searched the references of the included studies and tracked their citations to identify other eligible studies using Scopus and Google Scholar.\u003C\u002Fp\u003E\u003Ch4\u003ESearch Strategy\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe search terms are related to 3 main concepts: (1) IQ (behavior of the phenomenon of interest), (2) digital health (health context), and (3) framework (model or theory) [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref18\" rel=\"footnote\"\u003E18\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref19\" rel=\"footnote\"\u003E19\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. The search terms relating to each of these concepts were combined using the \u003Ci\u003EOR\u003C\u002Fi\u003E connector. The results of the 3 categories were then combined using the \u003Ci\u003EAND\u003C\u002Fi\u003E connector. A librarian was consulted for input on the search strategy. Medical Subject Headings and free-text terms were used. Truncation and adjacency searching were used to increase the sensitivity of the search, as appropriate. The search strategy is presented in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#app2\" rel=\"footnote\"\u003EMultimedia Appendix 2\u003C\u002Fa\u003E\u003C\u002Fspan\u003E.\u003C\u002Fp\u003E\u003Ch4\u003EData Management\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EWe removed duplicates using Endnote Reference Management Software (Clarivate), and additional duplicates not identified by the Endnote function were removed manually. The deduplicated data were then imported into Covidence (Veritas Health Innovation Ltd), a review-management software program that operates in partnership with Cochrane Collaboration and allows multiple reviewers to work on study selection simultaneously and independently.\u003C\u002Fp\u003E\u003Ch4\u003EStudy Selection\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe eligible studies were identified in 2 stages: title and abstract screening and full-text review. Titles and abstracts of the studies were screened for eligibility by 2 independent reviewers (KPF and JTA) using the criteria outlined in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#table1\" rel=\"footnote\"\u003ETable 1\u003C\u002Fa\u003E\u003C\u002Fspan\u003E. Conflicts were resolved by discussion between the 2 reviewers and adjudicated by a third independent reviewer (JOD) when necessary. The full-text review of all studies selected during the screening was independently conducted by 2 reviewers (KPF and SOC), with disagreement resolved as described previously.\u003C\u002Fp\u003E\u003Ch4\u003EData Extraction\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EOverall, 2 reviewers (KPF and SOC) independently extracted data from each eligible study using a prepiloted Microsoft Excel data extraction form. Other reviewers (JOD, CC, PAW, JG, JC, and AM) reviewed the extracted data to ensure the accuracy and completeness of the data. We extracted the study details, including authors, year of publication, country, affiliation, study aim, study design, and publication status. We also extracted IQ framework–related data, including the method of framework development, method of framework validation (when available), type of DHT, IQ dimensions and their verbatim definition, categories of IQ dimensions (when available), and metrics of IQ dimension measurement (when available).\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EThese data elements were defined as follows:\u003C\u002Fp\u003E\u003Cul\u003E\u003Cli class=\"spacey\"\u003EIQ frameworks for DHTs: A systematic integration of IQ dimensions to evaluate health information technologies used in the diagnosis, treatment, and prognosis of patients.\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EIQ dimensions within the frameworks in digital health: These are the evaluation criteria within the IQ frameworks that specify the extent to which health information technologies are fit for clinical use.\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EDefinition of IQ dimensions in digital health: A clear description of what aspect of information each dimension assesses.\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003ECategories of dimensions within IQ frameworks in digital health: IQ dimensions are often categorized to depict the relationship between IQ dimensions in an IQ framework.\u003C\u002Fli\u003E\u003Cli class=\"spacey\"\u003EMetrics of measurement of IQ dimensions in digital health: How each IQ dimension is measured, for example, questionnaire and mathematical formulas.\u003C\u002Fli\u003E\u003C\u002Ful\u003E\u003Ch4\u003EQuality Assessment\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EWe assessed the quality of the included studies using the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref23\" rel=\"footnote\"\u003E23\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Selecting this tool was difficult, as the included papers comprised a range of methodologies, including ethnography study, literature review, practice brief, and framework development, with some of the papers not explicitly stating their methodology. Therefore, some of the questions on the checklist were not applicable. Scores were not assigned, as this was not recommended by the checklist [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref23\" rel=\"footnote\"\u003E23\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Studies were not excluded based on quality assessment outcome, as this was unlikely to have any major impact on the ultimate definition of the dimensions and the resulting IQ framework. However, the assessment provided a general idea about the quality of the development processes of the existing IQ frameworks and, therefore, the strength of the evidence [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref24\" rel=\"footnote\"\u003E24\u003C\u002Fa\u003E\u003C\u002Fspan\u003E].\u003C\u002Fp\u003E\u003Ch4\u003EData Synthesis\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EIn this review, the IQ framework was developed using a thematic synthesis approach comprising 3 key stages: coding, descriptive synthesis, and analytical synthesis [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref25\" rel=\"footnote\"\u003E25\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Although codes and descriptive themes were generated directly from the extracted definition of IQ dimensions, analytical themes were interpretations that went beyond the original data.\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EIn the first stage, we coded the verbatim definitions of IQ dimensions extracted from the existing IQ frameworks in the included papers. Coding was done by identifying the unique concepts from each definition of the IQ dimension and highlighting them using the text highlight function of Microsoft Word (Microsoft).\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003ESecond, we categorized the codes based on their similarities and differences and created a descriptive theme to capture the meaning of each category. Each descriptive theme was defined based on the meaning of the original code from which it was created. The descriptive themes created were regarded as the IQ dimensions of the new IQ framework for digital health. Coding and descriptive synthesis were performed by 2 independent reviewers (KPF and JTA) with adjudication by a third independent reviewer (JOD).\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EFinally, we conceptualized analytical themes by considering the interrelationship between the descriptive themes (IQ dimensions) based on their definitions. The conceptualization of the analytical themes from the descriptive themes in thematic synthesis has been described as controversial because it is influenced by the insight and judgment of the reviewers [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref25\" rel=\"footnote\"\u003E25\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. This stage was quite challenging because of the subjective nature and varying perspectives of the reviewers. The following procedures were used to avoid bias and to achieve a consensus. The lead author (KPF) categorized the IQ dimensions without revealing his proposed categories to other reviewers. The other reviewers were then invited to categorize the IQ dimensions individually and email their suggested categories with rationale to the lead author without copying other members of the team. The reviewers were specifically asked to reflect on the suitability of digital health information for clinical purposes and its impact on patient safety while categorizing the IQ dimensions. Overall, 2 reviewers (KPF and JOD) then collated the inputs and carefully assigned a category to each of the dimensions based on the most popular suggestions considered along with the rationale. The framework was then shared with all the members of the team for further inputs and adaptation, if necessary.\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EThus, a new digital health IQ framework was developed by synthesizing existing IQ frameworks for DHTs. The IQ dimensions in the new framework are descriptive themes that were generated directly from the definition of IQ dimensions within existing frameworks, whereas the IQ categories were generated from the higher-order analytical synthesis of the descriptive themes.\u003C\u002Fp\u003E\u003Ch4\u003EEthics\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EEthical approval was not required for this systematic review, as the primary data were not collected. The review was registered in PROSPERO [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref26\" rel=\"footnote\"\u003E26\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], and the protocol was published [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref27\" rel=\"footnote\"\u003E27\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] to promote transparency.\u003C\u002Fp\u003E\u003Cbr\u002F\u003E\u003Ch3 class=\"navigation-heading h3-main-heading\" id=\"Results\" data-label=\"Results\"\u003EResults\u003C\u002Fh3\u003E\u003Ch4\u003ESelection of Studies\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EA total of 19,377 records were identified from the literature search. These were reduced to 338 after the removal of duplicates and screening of titles and abstracts. Only 10 papers were included in the study after a full-text review. Although 3 of these papers [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref28\" rel=\"footnote\"\u003E28\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] were in the context of secondary use of digital health data for research, they were included, as their IQ frameworks were relevant to the clinical context of digital health information. However, we performed a sensitivity analysis by conducting a thematic synthesis with and without these 3 papers [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref30\" rel=\"footnote\"\u003E30\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. The sensitivity analysis revealed that the inclusion of the 3 papers did not affect the component dimensions in the resulting framework, but their inclusion produced a better understanding of the definition of the dimensions. The PRISMA flow diagram is shown in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#figure1\" rel=\"footnote\"\u003EFigure 1\u003C\u002Fa\u003E\u003C\u002Fspan\u003E.\u003C\u002Fp\u003E\u003Cfigure\u003E\u003Ca name=\"figure1\"\u003E‎\u003C\u002Fa\u003E\u003Ca class=\"fancybox\" title=\"Figure 1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flow diagram. IQ: information quality.\" href=\"https:\u002F\u002Fasset.jmir.pub\u002Fassets\u002F4206ec530b2c626dd6c59e98922a634b.png\" id=\"figure1\"\u003E\u003Cimg class=\"figure-image\" src=\"https:\u002F\u002Fasset.jmir.pub\u002Fassets\u002F4206ec530b2c626dd6c59e98922a634b.png\"\u002F\u003E\u003C\u002Fa\u003E\u003Cfigcaption\u003E\u003Cspan class=\"typcn typcn-image\"\u002F\u003EFigure 1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flow diagram. IQ: information quality. \u003C\u002Ffigcaption\u003E\u003Ca class=\"fancybox\" href=\"https:\u002F\u002Fasset.jmir.pub\u002Fassets\u002F4206ec530b2c626dd6c59e98922a634b.png\" title=\"Figure 1. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flow diagram. IQ: information quality.\"\u003EView this figure\u003C\u002Fa\u003E\u003C\u002Ffigure\u003E\u003Ch4\u003EIncluded Papers\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe 10 included papers were published between 2007 and 2017. Of the 10 papers, 5 (50%) were published in the United States [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref28\" rel=\"footnote\"\u003E28\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref31\" rel=\"footnote\"\u003E31\u003C\u002Fa\u003E\u003C\u002Fspan\u003E-\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref33\" rel=\"footnote\"\u003E33\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], 3 (30%) were published in the United Kingdom [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref34\" rel=\"footnote\"\u003E34\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], and one each was published in Canada [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref35\" rel=\"footnote\"\u003E35\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] and Japan [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref36\" rel=\"footnote\"\u003E36\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. One of the studies published in the United Kingdom was conducted in Saudi Arabia [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Of the 10 papers, 4 (40%) were journal publications [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref28\" rel=\"footnote\"\u003E28\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref32\" rel=\"footnote\"\u003E32\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref36\" rel=\"footnote\"\u003E36\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], 3 (30%) were conference papers [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref31\" rel=\"footnote\"\u003E31\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref34\" rel=\"footnote\"\u003E34\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], 2 (20%) were institutional reports [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref33\" rel=\"footnote\"\u003E33\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref35\" rel=\"footnote\"\u003E35\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], and 1 (10%) was a PhD thesis [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Of the 10 studies, 5 used qualitative methods, either alone [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref31\" rel=\"footnote\"\u003E31\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref36\" rel=\"footnote\"\u003E36\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] or in combination with other methods [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Similarly, 40% (4\u002F10) studies used literature review alone [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref28\" rel=\"footnote\"\u003E28\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref34\" rel=\"footnote\"\u003E34\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] or combined with other methods [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Overall, 30% (3\u002F10) studies modified the existing frameworks [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref32\" rel=\"footnote\"\u003E32\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref36\" rel=\"footnote\"\u003E36\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. One study reported to have updated the previous framework [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref33\" rel=\"footnote\"\u003E33\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], but it was unclear how this was achieved. In addition, 10% (1\u002F10) study [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref35\" rel=\"footnote\"\u003E35\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] did not state how the framework was developed. About 50% (5\u002F10) of the frameworks were on EHRs [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref28\" rel=\"footnote\"\u003E28\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref32\" rel=\"footnote\"\u003E32\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref33\" rel=\"footnote\"\u003E33\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], one each on electronic medical records [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref35\" rel=\"footnote\"\u003E35\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], primary care databases [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], CDSSs [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref31\" rel=\"footnote\"\u003E31\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], mobile and web-based apps for telemedicine [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref36\" rel=\"footnote\"\u003E36\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], and cloud-based health information systems [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref34\" rel=\"footnote\"\u003E34\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Thus, it appears that IQ framework research is unable to keep pace with the rapid evolution of DHTs with obvious underrepresentation of newer DHTs such as mobile health. The details of the included papers are presented in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#app3\" rel=\"footnote\"\u003EMultimedia Appendix 3\u003C\u002Fa\u003E\u003C\u002Fspan\u003E [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref28\" rel=\"footnote\"\u003E28\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref31\" rel=\"footnote\"\u003E31\u003C\u002Fa\u003E\u003C\u002Fspan\u003E-\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref36\" rel=\"footnote\"\u003E36\u003C\u002Fa\u003E\u003C\u002Fspan\u003E].\u003C\u002Fp\u003E\u003Ch4\u003EQuality of Included Studies\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe quality assessment indicated that most of the studies described an IQ framework for DHT without reporting a robust framework development process. The Critical Appraisal Skills Programme checklist is not applicable to 2 studies [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref33\" rel=\"footnote\"\u003E33\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref35\" rel=\"footnote\"\u003E35\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], which are institutional publications. Only 1 qualitative study [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] reported on the recruitment strategy. Similarly, studies with literature reviews did not report on the search strategy or study selection process [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref28\" rel=\"footnote\"\u003E28\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref34\" rel=\"footnote\"\u003E34\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Only 3 studies [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref31\" rel=\"footnote\"\u003E31\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref32\" rel=\"footnote\"\u003E32\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] addressed ethical issues and reported sufficiently rigorous data analysis. These findings further justify the need for this study, which used a robust systematic review approach to develop a preliminary IQ framework for digital health. The quality assessment results are provided in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#app4\" rel=\"footnote\"\u003EMultimedia Appendix 4\u003C\u002Fa\u003E\u003C\u002Fspan\u003E [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref28\" rel=\"footnote\"\u003E28\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref31\" rel=\"footnote\"\u003E31\u003C\u002Fa\u003E\u003C\u002Fspan\u003E-\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref36\" rel=\"footnote\"\u003E36\u003C\u002Fa\u003E\u003C\u002Fspan\u003E].\u003C\u002Fp\u003E\u003Ch4\u003EClinical Information Quality Framework for Digital Health\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EA total of 38 IQ dimensions and 70 verbatim definitions were extracted from the 10 included frameworks. The list of dimensions and their definitions are provided in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#app5\" rel=\"footnote\"\u003EMultimedia Appendix 5\u003C\u002Fa\u003E\u003C\u002Fspan\u003E [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref14\" rel=\"footnote\"\u003E14\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref28\" rel=\"footnote\"\u003E28\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref31\" rel=\"footnote\"\u003E31\u003C\u002Fa\u003E\u003C\u002Fspan\u003E-\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref36\" rel=\"footnote\"\u003E36\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. The coding of these definitions led to the identification of 160 codes. Aggregation of similar codes resulted in a total of 13 unique IQ dimensions that mirrored all the relevant dimensions in the existing IQ frameworks while eliminating related but redundant dimensions. The resulting dimensions include accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability. These dimensions were defined based on the codes from which they were generated and classified into higher categories of availability, informativeness, and usability during the analytical synthesis. It is worth noting that some of the dimensions fit into more than one category but were placed into the best-fit category after carefully considering the inputs of all reviewers. For example, completeness was considered fit for both the availability and informativeness categories but was placed in the informativeness category, as this was the most popular category suggested by the reviewers. Similarly, timeliness was considered more fit for the availability category compared with the usability category, and interpretability was placed in the informativeness category rather than the usability category. The resulting Clinical Information Quality (CLIQ) framework for digital health is shown in \u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#figure2\" rel=\"footnote\"\u003EFigure 2\u003C\u002Fa\u003E\u003C\u002Fspan\u003E.\u003C\u002Fp\u003E\u003Cfigure\u003E\u003Ca name=\"figure2\"\u003E‎\u003C\u002Fa\u003E\u003Ca class=\"fancybox\" title=\"Figure 2. Clinical Information Quality framework for digital health.\" href=\"https:\u002F\u002Fasset.jmir.pub\u002Fassets\u002Fc925c975f7d1b3a8e0ab153f13dde022.png\" id=\"figure2\"\u003E\u003Cimg class=\"figure-image\" src=\"https:\u002F\u002Fasset.jmir.pub\u002Fassets\u002Fc925c975f7d1b3a8e0ab153f13dde022.png\"\u002F\u003E\u003C\u002Fa\u003E\u003Cfigcaption\u003E\u003Cspan class=\"typcn typcn-image\"\u002F\u003EFigure 2. Clinical Information Quality framework for digital health. \u003C\u002Ffigcaption\u003E\u003Ca class=\"fancybox\" href=\"https:\u002F\u002Fasset.jmir.pub\u002Fassets\u002Fc925c975f7d1b3a8e0ab153f13dde022.png\" title=\"Figure 2. Clinical Information Quality framework for digital health.\"\u003EView this figure\u003C\u002Fa\u003E\u003C\u002Ffigure\u003E\u003Ch4\u003EMetrics of Measurement\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EMetrics of measurement for the IQ dimensions were given in only 30% (3\u002F10) of the included papers [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref35\" rel=\"footnote\"\u003E35\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. The remaining papers only conceptualize IQ without providing guidance on its measurement. Objective and subjective measures were used in these studies. Objective measures involved mathematical calculations, such as ratio, percentages, and fraction to quantify the IQ dimension [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref37\" rel=\"footnote\"\u003E37\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Subjective measures, on the other hand, rely on the perspectives of the information users, which are usually assessed using a Likert scale questionnaire or qualitative interviews [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref10\" rel=\"footnote\"\u003E10\u003C\u002Fa\u003E\u003C\u002Fspan\u003E].\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EObjective measures were reported for accuracy, validity, timeliness, completeness and interpretability, comprehensibility, reliability, validity, timeliness, relevance, integrity completeness, concordance, informative sufficiency, consistency, consistency of capture, and consistency of form [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref35\" rel=\"footnote\"\u003E35\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. These dimensions were measured by determining whether a desired or undesired attribute was present or absent. For example, Almutiry [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] identified quality problems (undesired attributes) related to accuracy as misspelling, out-of-range values, erroneous values, etc. The quality score for accuracy was then calculated by determining the proportion of the total data units without each quality problem. Similarly, Dungey et al [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref29\" rel=\"footnote\"\u003E29\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] measured accuracy by calculating the proportion of implausible values (undesired attributes). Bowen [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref35\" rel=\"footnote\"\u003E35\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], on the other hand, used the percentage of data units with the desired attribute. Correctness was measured by determining the positive predictive value, which is the proportion of true positives (desired attributes).\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003ESubjective measures were reported for usability, relevance, provenance, secure access, confidentiality, and privacy [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Each dimension was measured using multiple Likert scale questions. For example, relevance was assessed by the information users’ rating of how far the information was relevant, useful, applicable, and appropriate to the task at hand [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. The quality score for each dimension is the aggregate of all ratings for these different measures.\u003C\u002Fp\u003E\u003Cbr\u002F\u003E\u003Ch3 class=\"navigation-heading h3-main-heading\" id=\"Discussion\" data-label=\"Discussion\"\u003EDiscussion\u003C\u002Fh3\u003E\u003Ch4\u003EPrincipal Findings\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EWe identified 10 existing IQ frameworks for DHTs, and from these, we developed the CLIQ framework for digital health with 13 unique dimensions, including accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were classified into 3 meaningful categories—availability, informativeness, and usability—based on our conceptualization of \u003Ci\u003Efitness\u003C\u002Fi\u003E of digital health information for clinical purposes.\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe informativeness category directly concerns the usefulness of information for clinical purposes and has the greatest implications for patient safety. Problems with the dimensions in the category can directly lead to significant harm, as previously reported in the literature [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref6\" rel=\"footnote\"\u003E6\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref8\" rel=\"footnote\"\u003E8\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Accuracy is the most popular IQ dimension. However, this systematic review echoes the literature that IQ is not only about accuracy but also a multidimensional phenomenon [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref38\" rel=\"footnote\"\u003E38\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Provenance and plausibility are unique IQ dimensions that can be regarded as proxies for accuracy, especially in situations where immediate and objective determination of accuracy is impractical. Provenance and plausibility can be easily determined subjectively. For example, knowing that the source of digital health information is a reputable institution (provenance) such as the World Health Organization would be reassuring, and an implausible value, such as a body temperature of 100°C (plausibility), would raise a serious concern. Interpretability is critical to the clinical use of digital information, as an incorrect interpretation may lead to significant harm. Hence, the inclusion of reference values with most laboratory results enhances the safe interpretation of the values.\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe availability category of IQ dimensions concerns the functionality of a system that holds clinical information. These dimensions are critical as they can affect the efficiency of service delivery and are regarded as important by users of digital health information. Inaccessible digital information offers no real value to health professionals, as it cannot be used in the clinical management of patients. In addition, accessibility of clinical information wherever it is required (portability) and whenever it is required (timeliness) could be lifesaving, especially in emergency situations when the knowledge of a patient’s medical history and current medications are essential. Timeliness, in the clinical context of digital health, also requires that health information is up to date. On the other hand, restriction of access to clinical information only to authorized users (security) protects the privacy and confidentiality of the patient and protects the information from corruption. Availability dimensions are illustrated by the UK’s Summary Care Records [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref39\" rel=\"footnote\"\u003E39\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], which contain up-to-date personal medical and medication history of patients and are accessible at the point of care (timeliness and accessibility) across different health care settings only to authorized health care professionals (security).\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe usability category concerns the ease of use of health information. Consistency and conformance are akin to 2 sides of a coin, with consistency referring to the presentation of information in the same format within a system and conformance referring to the presentation of information in the desired format based on local guidelines or international standards. For example, it is important for an app to present blood glucose consistently using either gram per deciliter or millimoles per liter and conform with the recommended units in the local guidelines to avoid confusion, which may compromise patient safety. The last dimension in this category is maintainability. This refers to the extent to which the information can be maintained. Maintenance, in this context, covers a range of activities, including review, audit, update, and storage of clinical information to ensure that all other IQ requirements are met. For example, timeliness can be improved by updating the information in the DHTs, and accuracy can be improved through regular audits of the information generated by the DHTs.\u003C\u002Fp\u003E\u003Ch4\u003EStrength and Limitations\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe main strength of our framework lies in the rigorous systematic review approach that was used to identify, define, and categorize IQ dimensions. In addition, our approach of synthesizing definitions rather than the traditional practice of simply cross-matching dimensions from different frameworks is more meaningful, as the definition expresses the real meaning of each dimension, and a dimension usually has heterogeneous definitions across different frameworks. In addition, focusing on the clinical context rather than the ever-changing DHTs, as in previous frameworks, we have developed a context-specific IQ framework that would be applicable or at least adaptable to a range of DHTs used in the clinical context, including novel ones that are currently underrepresented in IQ framework research. This approach differs from previous frameworks that focus on individual DHTs, such as EHR [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref13\" rel=\"footnote\"\u003E13\u003C\u002Fa\u003E\u003C\u002Fspan\u003E] and CDSS [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref31\" rel=\"footnote\"\u003E31\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. The consideration of the clinical purposes of DHTs is in consonance with the \u003Ci\u003Efit-for-purpose\u003C\u002Fi\u003E definition of IQ [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref10\" rel=\"footnote\"\u003E10\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Moreover, the traditional practice of using the same clinical information across different DHTs (eg, the use of EHR information for CDSS) further justifies the need for a common IQ framework for the clinical context of DHTs.\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EHowever, the lack of information about the relative relevance of the IQ dimensions in the CLIQ framework and the optimal means of their measurement are limitations. Although these dimensions could be considered as indices of fitness of digital information for clinical purposes, we acknowledge the need to consult with clinical information users, such as doctors, nurses, and health service managers, as recommended in the literature [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref10\" rel=\"footnote\"\u003E10\u003C\u002Fa\u003E\u003C\u002Fspan\u003E,\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref12\" rel=\"footnote\"\u003E12\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Thus, the current CLIQ framework for digital health could be regarded as a preliminary framework to be tested in primary research studies. To build on this preliminary research, an international eDelphi study is currently underway to obtain consensus among clinicians on the approach to assessing the quality of clinical information produced by DHTs. The eDelphi study addresses the prioritization of the dimensions and the metrics for measuring the dimension.\u003C\u002Fp\u003E\u003Ch4\u003EComparison With Validated IQ Frameworks\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe CLIQ framework for digital health shares several characteristics with validated IQ frameworks within and beyond the health care domain. One such validated IQ framework, developed by Wang and Strong [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref38\" rel=\"footnote\"\u003E38\u003C\u002Fa\u003E\u003C\u002Fspan\u003E], has been used as a reference point in IQ research. Out of its 15 dimensions, 7 (accuracy, relevance, completeness, timeliness, interpretability, security, and accessibility) are also included in the CLIQ framework. The rest of its dimensions, such as believability and understandability, were assimilated by other dimensions in our framework during thematic synthesis. On the other hand, novel dimensions such as portability and maintainability are included in our framework but not in the framework developed by Wang and Strong [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref38\" rel=\"footnote\"\u003E38\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. This reflects technological advances in the last three decades, with an increasing amount of digital information. In addition, our framework was developed for the clinical context, whereas Wang and Strong focused on the business domain [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref38\" rel=\"footnote\"\u003E38\u003C\u002Fa\u003E\u003C\u002Fspan\u003E].\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003ESimilarly, the dimensions in our framework overlap with the product quality properties of the International Organization for Standardization\u002FInternational Electrotechnical Commission (ISO\u002FIEC 25010), which include 8 characteristics: functional suitability, reliability, performance efficiency, operability, security, compatibility, maintainability, and transferability [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref40\" rel=\"footnote\"\u003E40\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Of these characteristics, 2 (maintainability and security) were also included in the CLIQ framework. Other dimensions in the CLIQ framework (eg, availability, accuracy, and completeness) are included as subcharacteristics of product quality. This overlap is not unexpected, as DHTs are also software products, with IQ being a subset of product quality [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref40\" rel=\"footnote\"\u003E40\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. However, ISO\u002FIEC 25010 addresses Systems and Software Quality Requirements and Evaluation from a computer engineering perspective, whereas the CLIQ framework addresses IQ from a health care perspective with consideration of its impact on patient safety [\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref6\" rel=\"footnote\"\u003E6\u003C\u002Fa\u003E\u003C\u002Fspan\u003E-\u003Cspan class=\"footers\"\u003E\u003Ca class=\"citation-link\" href=\"#ref8\" rel=\"footnote\"\u003E8\u003C\u002Fa\u003E\u003C\u002Fspan\u003E]. Although we recognize the importance of other aspects of product quality, such as user-interface esthetics, these are beyond the scope of this study, which is focused on IQ in the clinical context of DHTs.\u003C\u002Fp\u003E\u003Ch4\u003EConclusions\u003C\u002Fh4\u003E\u003Cp class=\"abstract-paragraph\"\u003EThis systematic review highlighted the importance of the IQ of DHTs and their relevance to patient safety. Future research is needed to determine the relative relevance of each dimension in the CLIQ framework and their metrics of measurement, with inputs from clinical information users. The CLIQ framework for digital health will be useful to health care organizations, health care professionals, digital health solution developers, and medical device regulators in conceptualizing and evaluating IQ issues associated with digital health, thus forestalling potential patient safety problems. This is more relevant than ever, as the health care community is increasingly turning to DHTs, and the need for and value of such systems in the context of health emergencies is becoming ever more apparent.\u003C\u002Fp\u003E\u003C\u002Farticle\u003E\u003Cp\u003E\u003Ch4 class=\"h4-border-top\"\u003EAcknowledgments\u003C\u002Fh4\u003E\u003C\u002Fp\u003E\u003Cp class=\"abstract-paragraph\"\u003EThe authors would like to thank Rebecca Jones, library manager and liaison librarian at the Charring Cross Library, Imperial College London, for useful advice on strategies for the literature search. This review is part of the PhD of the lead author (KPF) sponsored by the Federal Government of Nigeria. This review is an independent research supported in part by the National Institute for Health Research (NIHR) Applied Research Collaboration Northwest London. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.\u003C\u002Fp\u003E\u003Ch4 class=\"h4-border-top\"\u003EAuthors' Contributions\u003C\u002Fh4\u003E\u003Cp\u003E\u003Cp class=\"abstract-paragraph\"\u003EKPF and JOD conceived the study. KPF drafted the manuscript. JTA, SOC, PAW, CC, AM, JC, JG, and JOD revised the manuscript for important intellectual content and contributed to the review, including search strategy, study selection, data extraction, and data analysis. AM is the clinical lead, and JOD is the guarantor of the review.\u003C\u002Fp\u003E\u003C\u002Fp\u003E\u003Ch4 class=\"h4-border-top\"\u003EConflicts of Interest\u003C\u002Fh4\u003E\u003Cp\u003E\u003Cp class=\"abstract-paragraph\"\u003ENone declared.\u003C\u002Fp\u003E\u003C\u002Fp\u003E\n ‎\n \u003Cdiv id=\"app1\" name=\"app1\"\u003EMultimedia Appendix 1\u003Cp class=\"abstract-paragraph\"\u003EPRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist.\u003C\u002Fp\u003E\u003Ca href=\"https:\u002F\u002Fjmir.org\u002Fapi\u002Fdownload?alt_name=jmir_v23i5e23479_app1.docx&filename=0aa85c448a67797f526b5ba7356e8f2e.docx\" target=\"_blank\"\u003EDOCX File , 18 KB\u003C\u002Fa\u003E\u003C\u002Fdiv\u003E\u003Chr\u002F\u003E\n ‎\n \u003Cdiv id=\"app2\" name=\"app2\"\u003EMultimedia Appendix 2\u003Cp class=\"abstract-paragraph\"\u003ESearch strategy.\u003C\u002Fp\u003E\u003Ca href=\"https:\u002F\u002Fjmir.org\u002Fapi\u002Fdownload?alt_name=jmir_v23i5e23479_app2.docx&filename=9b34c067299680987c678107cbc464b0.docx\" target=\"_blank\"\u003EDOCX File , 91 KB\u003C\u002Fa\u003E\u003C\u002Fdiv\u003E\u003Chr\u002F\u003E\n ‎\n \u003Cdiv id=\"app3\" name=\"app3\"\u003EMultimedia Appendix 3\u003Cp class=\"abstract-paragraph\"\u003EIncluded papers.\u003C\u002Fp\u003E\u003Ca href=\"https:\u002F\u002Fjmir.org\u002Fapi\u002Fdownload?alt_name=jmir_v23i5e23479_app3.docx&filename=5fb55d3402260df8f3fd5efcab7a131a.docx\" target=\"_blank\"\u003EDOCX File , 18 KB\u003C\u002Fa\u003E\u003C\u002Fdiv\u003E\u003Chr\u002F\u003E\n ‎\n \u003Cdiv id=\"app4\" name=\"app4\"\u003EMultimedia Appendix 4\u003Cp class=\"abstract-paragraph\"\u003EQuality assessment result.\u003C\u002Fp\u003E\u003Ca href=\"https:\u002F\u002Fjmir.org\u002Fapi\u002Fdownload?alt_name=jmir_v23i5e23479_app4.docx&filename=6bea79823732cfe7028b61ffed269048.docx\" target=\"_blank\"\u003EDOCX File , 15 KB\u003C\u002Fa\u003E\u003C\u002Fdiv\u003E\u003Chr\u002F\u003E\n ‎\n \u003Cdiv id=\"app5\" name=\"app5\"\u003EMultimedia Appendix 5\u003Cp class=\"abstract-paragraph\"\u003EDefinition of dimensions within the existing information quality frameworks for digital health technologies.\u003C\u002Fp\u003E\u003Ca href=\"https:\u002F\u002Fjmir.org\u002Fapi\u002Fdownload?alt_name=jmir_v23i5e23479_app5.docx&filename=5e319bb258868d41314581c3a800dc13.docx\" target=\"_blank\"\u003EDOCX File , 48 KB\u003C\u002Fa\u003E\u003C\u002Fdiv\u003E\u003Chr\u002F\u003E\u003Cdiv class=\"footnotes\"\u003E\u003Ch4 class=\"h4-border-top\" id=\"References\"\u003EReferences\u003C\u002Fh4\u003E\u003Col\u003E\u003Cli\u003E\u003Cspan id=\"ref1\"\u003EWorld Health Organization. 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[\u003Ca target=\"_blank\" href=\"https:\u002F\u002Fdx.doi.org\u002F10.1145\u002F505248.506010\"\u003ECrossRef\u003C\u002Fa\u003E]\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli\u003E\u003Cspan id=\"ref38\"\u003EWang RY, Strong DM. Beyond accuracy: what data quality means to data consumers. J Manag Inform Syst 2015 Dec 11;12(4):5-33. [\u003Ca target=\"_blank\" href=\"https:\u002F\u002Fdx.doi.org\u002F10.1080\u002F07421222.1996.11518099\"\u003ECrossRef\u003C\u002Fa\u003E]\u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli\u003E\u003Cspan id=\"ref39\"\u003ESummary Care Records (SCR). NHS Digital. 2020. \n   URL: \u003Ca target=\"_blank\" href=\"https:\u002F\u002Fdigital.nhs.uk\u002Fservices\u002Fsummary-care-records-scr\"\u003Ehttps:\u002F\u002Fdigital.nhs.uk\u002Fservices\u002Fsummary-care-records-scr\u003C\u002Fa\u003E [accessed 2021-05-04]\n \u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003Cli\u003E\u003Cspan id=\"ref40\"\u003ESystems and software engineering. Systems and software quality requirements and evaluation (SQuaRE). System and software quality models. BS ISO\u002FIEC 25010:2011. 2011. \n   URL: \u003Ca target=\"_blank\" href=\"https:\u002F\u002Flandingpage.bsigroup.com\u002FLandingPage\u002FStandard?UPI=000000000030215101\"\u003Ehttps:\u002F\u002Flandingpage.bsigroup.com\u002FLandingPage\u002FStandard?UPI=000000000030215101\u003C\u002Fa\u003E [accessed 2021-05-04]\n \u003C\u002Fspan\u003E\u003C\u002Fli\u003E\u003C\u002Fol\u003E\u003C\u002Fdiv\u003E\u003Cbr\u002F\u003E\u003Chr\u002F\u003E\u003Ca name=\"Abbreviations\"\u003E‎\u003C\u002Fa\u003E\u003Ch4 class=\"navigation-heading\" id=\"Abbreviations\" data-label=\"Abbreviations\"\u003EAbbreviations\u003C\u002Fh4\u003E\u003Ctable width=\"80%\" border=\"0\" align=\"center\"\u003E\u003Ctr\u003E\u003Ctd\u003E\u003Cb\u003ECDSS:\u003C\u002Fb\u003E clinical decision support system\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr\u003E\u003Ctd\u003E\u003Cb\u003ECLIQ:\u003C\u002Fb\u003E Clinical Information Quality\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr\u003E\u003Ctd\u003E\u003Cb\u003EDHT:\u003C\u002Fb\u003E digital health technology\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr\u003E\u003Ctd\u003E\u003Cb\u003EEHR:\u003C\u002Fb\u003E electronic health record\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr\u003E\u003Ctd\u003E\u003Cb\u003EIQ:\u003C\u002Fb\u003E information quality\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003Ctr\u003E\u003Ctd\u003E\u003Cb\u003EPRISMA:\u003C\u002Fb\u003E Preferred Reporting Items for Systematic Reviews and Meta-Analysis\u003C\u002Ftd\u003E\u003C\u002Ftr\u003E\u003C\u002Ftable\u003E\u003Cbr\u002F\u003E\u003Chr\u002F\u003E\u003Cp style=\"font-style: italic\"\u003EEdited by G Eysenbach; submitted 13.08.20; peer-reviewed by D Strong, M Kolotylo-Kulkarni, A Sharafoddini, MDG Pimentel, A Azzam, C Jones, N Mohammad Gholi Mezerji; comments to author 18.11.20; revised version received 28.11.20; accepted 03.04.21; published 17.05.21\u003C\u002Fp\u003E\u003Ca href=\"https:\u002F\u002Fsupport.jmir.org\u002Fhc\u002Fen-us\u002Farticles\u002F115002955531\" id=\"Copyright\" target=\"_blank\" class=\"navigation-heading h4 d-block\" aria-label=\"Copyright - what is a Creative Commons License?\" data-label=\"Copyright\"\u003ECopyright \u003Cspan class=\"fas fa-question-circle\"\u002F\u003E\u003C\u002Fa\u003E\u003Cp class=\"article-copyright\"\u003E©Kayode Philip Fadahunsi, Siobhan O'Connor, James Tosin Akinlua, Petra A Wark, Joseph Gallagher, Christopher Carroll, Josip Car, Azeem Majeed, John O'Donoghue. Originally published in the Journal of Medical Internet Research (https:\u002F\u002Fwww.jmir.org), 17.05.2021.\u003C\u002Fp\u003E\u003Csmall class=\"article-license\"\u003E\u003Cp class=\"abstract-paragraph\"\u003EThis is an open-access article distributed under the terms of the Creative Commons Attribution License (https:\u002F\u002Fcreativecommons.org\u002Flicenses\u002Fby\u002F4.0\u002F), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https:\u002F\u002Fwww.jmir.org\u002F, as well as this copyright and license information must be included.\u003C\u002Fp\u003E\u003C\u002Fsmall\u003E\u003Cbr\u002F\u003E\u003C\u002Fsection\u003E\u003C\u002Farticle\u003E\u003C\u002Fsection\u003E\u003C\u002Fsection\u003E\u003C\u002Fmain\u003E"}],fetch:{},error:a,state:{host:a,environment:d,journalPath:k,keys:{},domains:{},screensize:"desktop",accessibility:{filter:"none","font-weight":"inherit","font-size":.625,"text-align":"initial"},announcements:{data:[{announcement_id:525,title:"JMIR Publications Integrates With Web of Science to Recognize Peer Reviewers",description_short:"\u003Cp\u003EJMIR Publications, a leading open access publisher of academic journals, is pleased to announce a new partnership with the Web of Science Reviewer Recognition Service (Web of Science RRS) to provide official recognition for the critical contributions of its peer reviewers.\u003C\u002Fp\u003E\u003Cp\u003E\u003Cbr\u003E\u003C\u002Fp\u003E",date_posted:"2024-11-14T16:33:25.000Z",journal_id:b},{announcement_id:517,title:"Webinar Announcement: Navigating Academic Promotion - Key Strategies for Junior Faculty Success",description_short:"\u003Cp\u003EJoin us for an insightful webinar inspired by the article “Advice for Junior Faculty Regarding Academic Promotion.” This session is designed to provide junior faculty with practical strategies to navigate the academic promotion process smoothly and effectively. Whether you're just beginning your academic journey or aiming for your next promotion, this webinar offers valuable advice from both senior and junior faculty members.\u003C\u002Fp\u003E\u003Cp\u003E\u003Cbr\u003E\u003C\u002Fp\u003E",date_posted:"2024-10-22T15:09:34.000Z",journal_id:b},{announcement_id:512,title:"JMIR Publications CEO and Executive Editor Gunther Eysenbach Achieves #1 Ranking as Most Cited Researcher in Medical Informatics for Fifth Consecutive Year",description_short:"\u003Cp\u003EJMIR Publications is proud to announce that Gunther Eysenbach, founder, CEO and executive editor, has once again been named the #1 most cited researcher in the subfield of medical informatics by Stanford\u002FElsevier’s Top 2% Scientists rankings\u003C\u002Fp\u003E",date_posted:"2024-10-11T17:08:49.000Z",journal_id:b},{announcement_id:509,title:"Call for Papers: Theme Issue: The Emergence of Medical Futures Studies",description_short:"\u003Cp\u003E\u003Cstrong\u003EThe \u003Cem\u003EJournal of Medical Internet Research\u003C\u002Fem\u003E is pleased to announce a call for papers for the theme issue The Emergence of Medical Futures Studies. This is the first ever call for papers on this topic.\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E",date_posted:"2024-10-08T12:00:52.000Z",journal_id:b},{announcement_id:493,title:"JMIR Publications + PREreview Live Review: Thursday, July 18- 12 pm ET",description_short:"\u003Cp\u003EJMIR Publications and PREreview are pleased to announce our next Preprint Live Review on Thursday, July 18\u003C\u002Fp\u003E",date_posted:"2024-07-04T13:05:37.000Z",journal_id:b},{announcement_id:476,title:"Journal of Medical Internet Research Receives a Journal Impact Factor of 5.8",description_short:"\u003Cp\u003EJMIR Publications announced today that its flagship journal, the \u003Cem\u003EJournal of Medical Internet Research\u003C\u002Fem\u003E, reported a Journal Impact Factor (JIF) of 5.8 as published in the 2024 Journal Citation Report (JCR) from Clarivate.\u003C\u002Fp\u003E",date_posted:"2024-06-26T16:13:36.000Z",journal_id:b},{announcement_id:475,title:"JMIR Publications Journals Shine in the 2024 Release of Journal Impact Factor by Clarivate",description_short:"\u003Cp\u003EJMIR Publications is pleased to announce the outstanding performance of its scholarly journals in the 2024 release of Journal Citation Reports (JCR) by Clarivate\u003C\u002Fp\u003E",date_posted:"2024-06-24T17:11:56.000Z",journal_id:b},{announcement_id:471,title:"New Scopus CiteScore Rankings Affirm JMIR Publications Journals are Leading in Their Respective Disciplines",description_short:"\u003Cp\u003E\u003Cstrong\u003EExciting News! JMIR Publications Achieves Impressive Results in the Latest Scopus CiteScore Release\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\u003Cp\u003EJMIR Publications is thrilled to announce an outstanding performance in the recently released Scopus CiteScore rankings. In all, 23 of its journals received a CiteScore this year, a testament to the high-quality research published across our diverse portfolio\u003C\u002Fp\u003E",date_posted:"2024-06-18T12:34:19.000Z",journal_id:b},{announcement_id:466,title:"JMIR Publications and Swedish Consortium Bibsam Join Forces in a Landmark Agreement to Advance Open Access",description_short:"\u003Cp\u003EOpen access publisher JMIR Publications, in partnership with Sweden's academic consortium Bibsam, with sales support by Accucoms, recently announced a landmark national agreement to eliminate the burden of article processing charges (APCs) for researchers in Sweden. \u003C\u002Fp\u003E\u003Cp\u003E\u003Cbr\u003E\u003C\u002Fp\u003E",date_posted:"2024-06-06T17:47:30.000Z",journal_id:b},{announcement_id:464,title:"JMIR Publications + PREreview Live Review: June 20, 2024 - 11 am ET",description_short:"\u003Cp\u003EJMIR Publications and PREreview are pleased to announce our next Preprint Live Review on Thursday, June 20\u003C\u002Fp\u003E",date_posted:"2024-05-31T08:51:19.000Z",journal_id:b}],pagination:{from:b,to:t,total:151,perPage:t,firstPage:b,lastPage:u}},article:{data:{article_id:23479,published_at:"2021-05-17T10:30:52.000Z",submitted_at:ac,section_id:ad,journal_id:b,year:ae,issue:af,volume:v,identifier:"23479",url:ag,pdf_url:"https:\u002F\u002Fwww.jmir.org\u002F2021\u002F5\u002Fe23479\u002FPDF",html_url:"https:\u002F\u002Fwww.jmir.org\u002F2021\u002F5\u002Fe23479",xml_url:"https:\u002F\u002Fwww.jmir.org\u002F2021\u002F5\u002Fe23479\u002FXML",title:"Information Quality Frameworks for Digital Health Technologies: Systematic Review",public_id:"J Med Internet Res 2021;23(5):e23479",thumbnail:"https:\u002F\u002Fasset.jmir.pub\u002Fassets\u002F2514801cb40c0f99b8123c78a2cbf92d.png",doi:"10.2196\u002F23479",pmid:33835034,pmcid:"8167621",issue_title:"May",pages:[],transfer:a,authors:[{first_name:ah,last_name:ai,degrees:aj,deceased:a,orcid:"0000-0003-1470-5493",equal_contrib:f,matchedAffiliations:[b]},{first_name:"Siobhan",last_name:"O'Connor",degrees:"BSc, CIMA CBA, RN, FHEA, PhD",deceased:a,orcid:"0000-0001-8579-1718",equal_contrib:f,matchedAffiliations:[e]},{first_name:"James Tosin",last_name:"Akinlua",degrees:"MBBS, MPH, PhD",deceased:a,orcid:"0000-0002-9887-0033",equal_contrib:f,matchedAffiliations:[l]},{first_name:"Petra A",last_name:"Wark",degrees:"MSc, PhD, FHEA",deceased:a,orcid:"0000-0003-1020-4640",equal_contrib:f,matchedAffiliations:[l,w]},{first_name:"Joseph",last_name:"Gallagher",degrees:"BA, MD, MBChB, BAO, MRCPI, MICGP, FHFA",deceased:a,orcid:"0000-0002-5564-2890",equal_contrib:f,matchedAffiliations:[m]},{first_name:"Christopher",last_name:"Carroll",degrees:"BA, MA, MSc, PhD",deceased:a,orcid:"0000-0002-6361-6182",equal_contrib:f,matchedAffiliations:[n]},{first_name:"Josip",last_name:"Car",degrees:"FFPH, DIC, MSc, PhD, MD, FRCP",deceased:a,orcid:"0000-0001-8969-371X",equal_contrib:f,matchedAffiliations:[b,o]},{first_name:"Azeem",last_name:"Majeed",degrees:"MD, FRCP, FRCGP, FFPH",deceased:a,orcid:"0000-0002-2357-9858",equal_contrib:f,matchedAffiliations:[b]},{first_name:"John",last_name:"O'Donoghue",degrees:"BSc, MSc, PhD, Cert(ICL), FHEA, FBCS",deceased:a,orcid:"0000-0001-6056-8640",equal_contrib:f,matchedAffiliations:[D,p]}],affiliations:[{aff_id:94932,author_id:212407,phone:ak,fax:c,corresp_aff:b,aff_type:a,seq:b,article_id:a,institution_line_1:al,institution_line_2:am,institution_line_3:c,address_line_1:an,address_line_2:ao,city:E,prov_state:a,postal_code:ap,country:i},{aff_id:94929,author_id:212410,phone:a,fax:c,corresp_aff:g,aff_type:a,seq:b,article_id:a,institution_line_1:"School of Health in Social Science",institution_line_2:"The University of Edinburgh",institution_line_3:c,address_line_1:a,address_line_2:a,city:"Edinburgh",prov_state:a,postal_code:a,country:i},{aff_id:94930,author_id:212411,phone:a,fax:c,corresp_aff:g,aff_type:a,seq:b,article_id:a,institution_line_1:"Department of Primary Care and Population Health Sciences",institution_line_2:"University College London",institution_line_3:c,address_line_1:a,address_line_2:a,city:E,prov_state:a,postal_code:a,country:i},{aff_id:94933,author_id:212414,phone:a,fax:c,corresp_aff:g,aff_type:a,seq:e,article_id:a,institution_line_1:"Centre for Intelligent Healthcare",institution_line_2:"Institute of Health and Wellbeing",institution_line_3:"Coventry University",address_line_1:a,address_line_2:a,city:"Coventry",prov_state:a,postal_code:a,country:i},{aff_id:94934,author_id:212416,phone:a,fax:c,corresp_aff:g,aff_type:a,seq:b,article_id:a,institution_line_1:"gHealth Research Group",institution_line_2:"School of Medicine",institution_line_3:"University College Dublin",address_line_1:a,address_line_2:a,city:"Dublin",prov_state:a,postal_code:a,country:F},{aff_id:94935,author_id:212417,phone:a,fax:c,corresp_aff:g,aff_type:a,seq:b,article_id:a,institution_line_1:"Health Economics and Decision Science",institution_line_2:"School of Health and Related Research",institution_line_3:"The University of Sheffield",address_line_1:a,address_line_2:a,city:"Sheffield",prov_state:a,postal_code:a,country:i},{aff_id:94936,author_id:212418,phone:a,fax:c,corresp_aff:g,aff_type:a,seq:e,article_id:a,institution_line_1:"Centre for Population Health Sciences",institution_line_2:"LKC Medicine",institution_line_3:"Nayang Technological University",address_line_1:a,address_line_2:a,city:"Sungapore",prov_state:a,postal_code:a,country:"Singapore"},{aff_id:94937,author_id:aq,phone:a,fax:c,corresp_aff:g,aff_type:a,seq:b,article_id:a,institution_line_1:"Malawi eHealth Research Centre",institution_line_2:ar,institution_line_3:c,address_line_1:a,address_line_2:a,city:as,prov_state:a,postal_code:a,country:F},{aff_id:94938,author_id:aq,phone:a,fax:c,corresp_aff:g,aff_type:a,seq:e,article_id:a,institution_line_1:"ASSERT Research Centre",institution_line_2:ar,institution_line_3:c,address_line_1:a,address_line_2:a,city:as,prov_state:a,postal_code:a,country:F}],primaryAuthor:{first_name:ah,last_name:ai,email:"K.fadahunsi14@imperial.ac.uk",degrees:aj,primaryAffiliation:{fax:c,phone:ak,country:i,postal_code:ap,prov_state:a,city:E,address_line_1:an,address_line_2:ao,institution_line_1:al,institution_line_2:am,institution_line_3:c}},abstract:"Background: Digital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, some of which result from poor information quality (IQ).\nObjective: This systematic review aims to synthesize an IQ framework that could be used to evaluate the extent to which digital health information is fit for clinical purposes.\nMethods: The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We searched Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, Global Health, ProQuest Dissertations and Theses Global, Scopus, and HMIC (the Health Management Information Consortium) from inception until October 2019. Multidimensional IQ frameworks for assessing DHTs used in the clinical context by health care professionals were included. A thematic synthesis approach was used to synthesize the Clinical Information Quality (CLIQ) framework for digital health.\nResults: We identified 10 existing IQ frameworks from which we developed the CLIQ framework for digital health with 13 unique dimensions: accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were categorized into 3 meaningful categories: availability, informativeness, and usability.\nConclusions: This systematic review highlights the importance of the IQ of DHTs and its relevance to patient safety. The CLIQ framework for digital health will be useful in evaluating and conceptualizing IQ issues associated with digital health, thus forestalling potential patient safety problems.\nTrial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42018097142; https:\u002F\u002Fwww.crd.york.ac.uk\u002Fprospero\u002Fdisplay_record.php?RecordID=97142\n",keywords:"digital health; information quality; patient safety",date_submitted:ac,title_html:a,sections:[{title:"Clinical Informatics",section_id:ad,journal_id:b,colour:x,count:1031},{title:"Registered Report",section_id:805,journal_id:b,colour:x,count:564},{title:"Quality Improvement",section_id:262,journal_id:o,colour:at,count:254},{title:"Health Care Quality and Health Services Research",section_id:389,journal_id:p,colour:au,count:273},{title:"Safety and Error Prevention in Health",section_id:195,journal_id:n,colour:av,count:205}],preprint:h,articleKD:aw,isOldOjphiMigrated:aw}},articles:{recent:[],openReview:[]},articleTypes:{},authentication:{data:a,jwt:a},countries:{data:[]},departments:{data:[]},help:{data:{}},journal:{data:{journal_id:b,title:ax,tag:ay,description:a,path:k,slug:k,seq:b,enabled:b,environment:d,url:az,batch:b,year:aA,colour:x,impact:G,order:b,published:aB,transfers:a,cite_score:aC,settings:{aboutJournal:"\u003Cp\u003EThe \u003Cem\u003EJournal of Medical Internet Research\u003C\u002Fem\u003E (JMIR) is the pioneer open access eHealth journal, and is the flagship journal of JMIR Publications. It is a leading health services and digital health journal globally in terms of quality\u002Fvisibility \u003Ca href=\"..\u002F..\u002F..\u002F..\u002F..\u002Fannouncements\u002F476\"\u003E(Journal Impact Factor™ 5.8 (Clarivate, 2024))\u003C\u002Fa\u003E, ranking Q1 in both the 'Medical Informatics' and 'Health Care Sciences & Services' categories, and is also the largest journal in the field. The journal is \u003Ca href=\"https:\u002F\u002Fscholar.google.com\u002Fcitations?view_op=top_venues&hl=en&vq=eng_medicalinformatics\" rel=\"noopener\" target=\"_blank\"\u003Eranked #1 on Google Scholar\u003C\u002Fa\u003E in the 'Medical Informatics' discipline. The journal focuses on emerging technologies, medical devices, apps, engineering, telehealth and informatics applications for patient education, prevention, population health and clinical care.\u003C\u002Fp\u003E\r\n\u003Cp\u003EJMIR is indexed in all major literature indices including \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fnlmcatalog\u002F100959882\"\u003ENational Library of Medicine(NLM)\u002FMEDLINE\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fv2.sherpa.ac.uk\u002Fid\u002Fpublisher\u002F2600\"\u003ESherpa\u002FRomeo,\u003C\u002Fa\u003E \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F?term=%22Journal+of+medical+Internet+research%22%5BJournal%5D&sort=\"\u003EPubMed,\u003C\u002Fa\u003E \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Fjournals\u002F224\u002F\"\u003EPMC\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fwww.scopus.com\u002Fsourceid\u002F23709\"\u003EScopus\u003C\u002Fa\u003E, Psycinfo, \u003Ca href=\"https:\u002F\u002Fmjl.clarivate.com\u002Fjournal-profile\"\u003EClarivate (which includes Web of Science (WoS)\u002FESCI\u002FSCIE)\u003C\u002Fa\u003E, EBSCO\u002FEBSCO Essentials, \u003Ca href=\"https:\u002F\u002Fdoaj.org\u002Ftoc\u002F1438-8871?source=%7B%22query%22%3A%7B%22bool%22%3A%7B%22must%22%3A%5B%7B%22terms%22%3A%7B%22index.issn.exact%22%3A%5B%221438-8871%22%5D%7D%7D%5D%7D%7D%2C%22size%22%3A100%2C%22sort%22%3A%5B%7B%22created_date%22%3A%7B%22order%22%3A%22desc%22%7D%7D%5D%2C%22_source%22%3A%7B%7D%2C%22track_total_hits%22%3Atrue%7D\"\u003EDOAJ\u003C\u002Fa\u003E, GoOA and others. The \u003Cem\u003EJournal of Medical Internet Research\u003C\u002Fem\u003E received a CiteScore of \u003Ca href=\"..\u002F..\u002F..\u002F..\u002F..\u002Fannouncements\u002F471\"\u003E14.4\u003C\u002Fa\u003E, placing it in the 95th percentile (#7 of 138) as a Q1 journal in the field of Health Informatics. It is a selective journal complemented by almost \u003Ca href=\"https:\u002F\u002Fjmir.zendesk.com\u002Fhc\u002Fen-us\u002Farticles\u002F115001442707\" target=\"_blank\"\u003E30 specialty JMIR sister journals\u003C\u002Fa\u003E, which have a broader scope, and which together receive over 10,000 submissions a year. \u003C\u002Fp\u003E\r\n\u003Cp\u003EAs an open access journal, we are read by clinicians, allied health professionals, informal caregivers, and patients alike, and have (as with all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies. We publish original research, viewpoints, and reviews (both literature reviews and medical device\u002Ftechnology\u002Fapp reviews). Peer-review reports are \u003Ca href=\"https:\u002F\u002Fjmir.zendesk.com\u002Fhc\u002Fen-us\u002Farticles\u002F115001714547-How-do-I-request-a-manuscript-transfer-to-another-journal-\" target=\"_blank\"\u003Eportable\u003C\u002Fa\u003E across JMIR journals and papers can be transferred, so authors save time by not having to resubmit a paper to a different journal but can simply transfer it between journals. \u003C\u002Fp\u003E\r\n\u003Cp\u003EWe are also a leader in participatory and open science approaches, and offer the option to publish new submissions immediately as \u003Ca href=\"http:\u002F\u002Fpreprints.jmir.org\"\u003Epreprints\u003C\u002Fa\u003E, which receive DOIs for immediate citation (eg, in grant proposals), and for open peer-review purposes. We also invite patients to participate (eg, as peer-reviewers) and have patient representatives on editorial boards.\u003C\u002Fp\u003E\r\n\u003Cp\u003EAs all JMIR journals, the journal encourages Open Science principles and strongly encourages publication of a protocol before data collection. Authors who have published a protocol in \u003Ca href=\"https:\u002F\u002Fresearchprotocols.org\u002F\"\u003EJMIR Research Protocols\u003C\u002Fa\u003E get a discount of 20% on the Article Processing Fee when publishing a subsequent results paper in any JMIR journal.\u003C\u002Fp\u003E\r\n\u003Cp\u003EBe a widely cited leader in the digital health revolution and \u003Ca href=\"..\u002F..\u002F..\u002F..\u002F..\u002Fauthor\" target=\"_blank\"\u003Esubmit your paper today\u003C\u002Fa\u003E!\u003C\u002Fp\u003E",announcementLink:"https:\u002F\u002Fwww.jmir.org\u002Fannouncements\u002F476",copyrightNotice:c,focusScopeDesc:"\u003Cp\u003EThe \"\u003Cem\u003EJournal of Medical Internet Research\u003C\u002Fem\u003E\" (JMIR; ISSN 1438-8871, Medline-abbreviation: \u003Cem\u003EJ Med Internet Res\u003C\u002Fem\u003E) \u003Ca href=\"..\u002F..\u002F2019\u002F12\u002Fe17578\u002F\"\u003E(founded in 1999, now in its 25th year!\u003C\u002Fa\u003E\u003Cspan\u003E)\u003C\u002Fspan\u003E is a leading health informatics and health services\u002Fhealth policy journal (ranking in the first quartile Q1 by Impact Factor in these disciplines) focusing on digital health, data science, health informatics and emerging technologies for health, medicine, and biomedical research. The journal is \u003Ca href=\"https:\u002F\u002Fscholar.google.com\u002Fcitations?view_op=top_venues&hl=en&vq=eng_medicalinformatics\" target=\"_blank\" rel=\"noopener\"\u003Eranked #1 on Google Scholar\u003C\u002Fa\u003E\u003Cspan\u003E in the 'Medical Informatics' discipline. \u003C\u002Fspan\u003E\u003C\u002Fp\u003E\r\n\u003Cp\u003EJMIR was the first open access journal covering health informatics, and the first international scientific peer-reviewed journal on all aspects of research, information and communication in the healthcare field using Internet and Internet-related technologies; a broad field, which is known as \"eHealth\" [see also \u003Ca href=\"..\u002F..\u002F2001\u002F2\u002Fe20\u002F\"\u003EWhat is eHealth\u003C\u002Fa\u003E and \u003Ca href=\"..\u002F..\u002F2001\u002F2\u002Fe22\u002F\"\u003EWhat is eHealth (2)\u003C\u002Fa\u003E], or now also \"\u003Cstrong\u003Edigital health\u003C\u002Fstrong\u003E\", which includes mHealth (mobile health). This field also has significant overlaps with what is called \"consumer health informatics\", health 2.0\u002Fmedicine 2.0, or participatory medicine. This focus makes JMIR unique among other medical or medical informatics journals, which tend to focus on clinical informatics or clinical applications. As eHealth\u002FmHealth is a highly interdisciplinary field we are not only inviting research papers from the medical sciences, but also from the computer, behavioral, social and communication sciences, psychology, library sciences, informatics, human-computer interaction studies, and related fields.\u003C\u002Fp\u003E\r\n\u003Cp\u003EThe term \"Internet\" is used in its broadest sense, so we are also interested in high impact studies and applications of digital medicine, mobile technologies, social media, novel wearable devices and sensors, connected home appliances, domotics etc.\u003C\u002Fp\u003E\r\n\u003Cp\u003EThe journal invites manuscripts that deal with the following topics (\u003Ca href=\"..\u002F..\u002Fthemes\"\u003Ethe main themes\u002Ftopics covered by this journal and sample papers can also be found here\u003C\u002Fa\u003E):\u003C\u002Fp\u003E\r\n\u003Cul\u003E\r\n\u003Cli\u003Enovel digital health approaches, methods, and devices\u003C\u002Fli\u003E\r\n\u003Cli\u003Elarge digital medicine \u002F digital therapeutics trials with clinical impact\u003C\u002Fli\u003E\r\n\u003Cli\u003Edata science, open data\u003C\u002Fli\u003E\r\n\u003Cli\u003Estudies evaluating the impact of Internet\u002Fsocial media use or specific eHealth\u002FmHealth interventions on individual health-related or social outcomes\u003C\u002Fli\u003E\r\n\u003Cli\u003Eevaluations and implementations of innovative mhealth (mobile health) applications, social media apps, ubiquitous computing, or innovative and emerging technologies in health\u003C\u002Fli\u003E\r\n\u003Cli\u003Edescriptions of the design and impact of Internet and mobile applications and websites or social media for consumers\u002Fpatients or medical professionals\u003C\u002Fli\u003E\r\n\u003Cli\u003Euse of the Internet, social media and mhealth in the context of clinical information and communication, including telemedicine\u003C\u002Fli\u003E\r\n\u003Cli\u003Euse of the Internet, social media, and mhealth in medical research and the basic sciences such as molecular biology or chemistry (e.g. bioinformatics, online factual databases)\u003C\u002Fli\u003E\r\n\u003Cli\u003Emedical information management and librarian sciences\u003C\u002Fli\u003E\r\n\u003Cli\u003Ee-learning and knowledge translation, online-courses, social media, web-based and mobile programs for undergraduate and continuing education,\u003C\u002Fli\u003E\r\n\u003Cli\u003EeHealth\u002FmHealth and social media applications for public health and population health technology (disease monitoring, teleprevention, teleepidemiology)\u003C\u002Fli\u003E\r\n\u003Cli\u003Eevidence-based medicine and the Internet and mhealth (e.g. online development or dissemination of clinical guidelines, measuring agreement about management of a given clinical problem among physicians, etc.)\u003C\u002Fli\u003E\r\n\u003Cli\u003Ethe impact of eHealth\u002FmHealth\u002FpHealth\u002FiHealth, social media, the Internet, or health care technologies on public health, the health care system and policy\u003C\u002Fli\u003E\r\n\u003Cli\u003Emethodological aspects of doing Internet\u002Fmhealth\u002Fsocial media research, e.g. methodology of web-based surveys\u003C\u002Fli\u003E\r\n\u003Cli\u003Edesign and validation of novel web-based instruments\u003C\u002Fli\u003E\r\n\u003Cli\u003Eecological momentary assessment, sensors, mobile technologies for gathering and analyzing data in real-time\u003C\u002Fli\u003E\r\n\u003Cli\u003Eanalysis of e-communities, social media communities, or virtual social networks\u003C\u002Fli\u003E\r\n\u003Cli\u003Ecomparisons of effectiveness of health communication and information on the Internet\u002FmHealth\u002Fsocial media compared with other methods of health communication,\u003C\u002Fli\u003E\r\n\u003Cli\u003Eeffects of the Internet\u002Fmhealth\u002Fsocial media and information\u002Fcommunication technology on the patient-physician relationship and impact on public health, e.g. the studies investigating how the patient-physician relationship changes as a result of the new ways of getting medical information\u003C\u002Fli\u003E\r\n\u003Cli\u003Eethical and legal problems as well as cross-border and cross-cultural issues of eHealth\u002FmHealth\u003C\u002Fli\u003E\r\n\u003Cli\u003Esystematic studies examining the quality of medical information available in various online venues\u003C\u002Fli\u003E\r\n\u003Cli\u003Emethods of evaluation, quality assessment and improvement of Internet information or eHealth applications\u003C\u002Fli\u003E\r\n\u003Cli\u003Eproposals for standards in the field of medical publishing on the Internet, including self-regulation issues, policies and guidelines to provide reliable healthcare information\u003C\u002Fli\u003E\r\n\u003Cli\u003Eresults and methodological aspects of Internet-based and social media studies, including medical surveys, psychological tests, quality-of-life studies, gathering and\u002For disseminating epidemiological data, use of the Internet\u002Fmobile apps\u002Fsocial media for clinical studies (e-trials), drug reaction reporting and surveillance systems etc.\u003C\u002Fli\u003E\r\n\u003Cli\u003Eelectronic medical publishing, Open Access publishing, altmetrics, and use of the Internet or social media for scholarly publishing (e.g. collaborative peer review)\u003C\u002Fli\u003E\r\n\u003Cli\u003Einformation needs of patients, consumers and health professionals, including studies evaluating search and retrieval behavior of patients\u003C\u002Fli\u003E\r\n\u003Cli\u003Eweb-based studies, e.g. online psychological experiments\u003C\u002Fli\u003E\r\n\u003Cli\u003Eevaluations of mhealth (mobile) applications, as well as ambient \u002F ubiquitous computing approaches, sensors, domotics, and other cutting edge technologies\u003C\u002Fli\u003E\r\n\u003Cli\u003Epersonal health records, patient portals, consumer health informatics applications\u003C\u002Fli\u003E\r\n\u003Cli\u003Ebehavior change technologies\u003C\u002Fli\u003E\r\n\u003Cli\u003EReviews, viewpoint papers and commentaries touching on the issues and themes listed above are also welcome, but should be grounded in data and\u002For a thorough literature review\u003C\u002Fli\u003E\r\n\u003C\u002Ful\u003E\r\n\u003Cp\u003EIn addition, the Journal will occasionally publish original research, reviews and tutorials on more generic, related topics such as:\u003C\u002Fp\u003E\r\n\u003Cul\u003E\r\n\u003Cli\u003EInternet standards\u003C\u002Fli\u003E\r\n\u003Cli\u003Ecybermetrics\u003C\u002Fli\u003E\r\n\u003Cli\u003Esecurity and confidentiality issues\u003C\u002Fli\u003E\r\n\u003Cli\u003EInternet demographics\u003C\u002Fli\u003E\r\n\u003Cli\u003Esocial impact of the Internet\u003C\u002Fli\u003E\r\n\u003Cli\u003Edigital imaging and multimedia\u003C\u002Fli\u003E\r\n\u003Cli\u003Ehealth care records\u003C\u002Fli\u003E\r\n\u003Cli\u003Ehigh-speed networks\u003C\u002Fli\u003E\r\n\u003Cli\u003Etelecommunication\u003C\u002Fli\u003E\r\n\u003Cli\u003Eelectronic publishing\u003C\u002Fli\u003E\r\n\u003Cli\u003Esoftware development\u003C\u002Fli\u003E\r\n\u003C\u002Ful\u003E\r\n\u003Cp\u003EThe \u003Cem\u003EJournal of Medical Internet Research\u003C\u002Fem\u003E is one of the flagship journals of \u003Ca href=\"https:\u002F\u002Fjmirpublications.com\u002F\"\u003EJMIR Publications\u003C\u002Fa\u003E and is \u003Cem\u003Ehighly selective\u003C\u002Fem\u003E. We are not a megajournal that publishes everything regardless of impact. To ensure a rapid turnaround time, we encourage that authors consider \u003Ca href=\"https:\u002F\u002Fsupport.jmir.org\u002Fhc\u002Fen-us\u002Farticles\u002F115001442707-Which-journal-titles-are-JMIR-Publications-currently-publishing-Journal-Portfolio-\"\u003Eother JMIR journal titles\u003C\u002Fa\u003E as well. While it is possible to transfer submissions from one journal to another before, during or after the review process (based on editorial suggestions), authors can avoid delays in decision-making by submitting to the right journal.\u003C\u002Fp\u003E\r\n\u003Cp style=\"padding-left: 40px;\"\u003EIn order to be considered for\u003Cem\u003E J Med Internet Res\u003C\u002Fem\u003E, \u003Cstrong\u003Eclinical informatics\u003C\u002Fstrong\u003E papers should have a clear connections to the major themes in this journal of consumer\u002Fpatient empowerment and participatory healthcare, and\u002For evaluate the use of mobile\u002FInternet-based\u002Femerging technologies such as patient portals. Other clinical informatics studies with no relationship to consumer health informatics, or more technical papers are best submitted to \u003Ca href=\"https:\u002F\u002Fsupport.jmir.org\u002Fhc\u002Fen-us\u002Farticles\u002F115001442707-Which-journal-titles-are-JMIR-Publications-currently-publishing-Journal-Portfolio-\"\u003Eother JMIR journal titles\u003C\u002Fa\u003E, such as \u003Ca href=\"http:\u002F\u002Fi-jmr.org\u002F\"\u003EInteractive Journal of Medical Research (i-JMR, a general medical journal with focus on innovation)\u003C\u002Fa\u003E, \u003Ca href=\"http:\u002F\u002Fmhealth.jmir.org\u002F\"\u003EJMIR mHealth and uHealth\u003C\u002Fa\u003E, \u003Ca href=\"http:\u002F\u002Fmedinform.jmir.org\u002F\"\u003EJMIR Medical Informatics\u003C\u002Fa\u003E, or \u003Ca href=\"https:\u002F\u002Fhumanfactors.jmir.org\"\u003EJMIR Human Factors\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\r\n\u003Cp style=\"padding-left: 40px;\"\u003E\u003Cstrong\u003EMachine-learning papers\u003C\u002Fstrong\u003E: Machine learning papers are now mostly published in JMIR Medical Informatics (see e-collection \u003Ca href=\"https:\u002F\u002Fmedinform.jmir.org\u002Fthemes\u002F500-machine-learning\"\u003EMachine Learning\u003C\u002Fa\u003E), JMIR Formative Research or JMIR AI, or another sister journal, unless they have reached clinical maturity and are being used and validated in routine clinical use. Our flagship journal J Med Internet Res no longer publishes ML papers unless 1) they show a direct clinical effect or impact on care, 2) are validated using an independent dataset not used for training, 3) are written in a language that can be understood by a healthcare professional, and provide open source or a publicly available tool that can be used by others to validate or apply the findings. We also request that 4) reporting strictly adheres to the \"\u003Ca href=\"..\u002F..\u002F2016\u002F12\u002Fe323\u002F\"\u003EGuidelines for Developing and Reporting Machine Learning Predictive Models in Biomedical Research\u003C\u002Fa\u003E\". Highly technical papers (with mathematical formulas) are unsuitable for J Med Internet Res or this information needs to be provided in a Multimedia Appendix. \u003C\u002Fp\u003E\r\n\u003Cp style=\"padding-left: 40px;\"\u003E\u003Cstrong\u003EDigital psychiatry and digital mental health\u003C\u002Fstrong\u003E papers are best suited for \u003Ca href=\"http:\u002F\u002Fmental.jmir.org\u002F\"\u003EJMIR Mental Health\u003C\u002Fa\u003E if they are impactful, otherwise JMIR Formative Research publishes early stage work.\u003C\u002Fp\u003E\r\n\u003Cp style=\"padding-left: 40px;\"\u003EStudies related to public health informatics and surveillance systems should preferably be submitted to \u003Ca href=\"https:\u002F\u002Fpublichealth.jmir.org\"\u003EJMIR Public Health & Surveillance\u003C\u002Fa\u003E. JPHS is also highly selective.\u003C\u002Fp\u003E\r\n\u003Cp style=\"padding-left: 40px;\"\u003EPapers with focus on \u003Cstrong\u003Egames in health or gamification aspects of apps\u003C\u002Fstrong\u003E and theoretical issues\u002Fcommentary on gaming are now primarily published in \u002F transferred to \u003Ca href=\"http:\u002F\u002Fgames.jmir.org\u002F\"\u003EJMIR Serious Games\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\r\n\u003Cp style=\"padding-left: 40px;\"\u003EStudies evaluating systematically the \u003Cstrong\u003Equality of health information\u003C\u002Fstrong\u003E or present tools for social listening may be best suited for \u003Ca href=\"https:\u002F\u002Finfodemiology.jmir.org\"\u003EJMIR Infodemiology\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\r\n\u003Cp style=\"padding-left: 40px;\"\u003E\u003Cstrong\u003EFormative work such as usability studies, pilot studies, and feasibility studies\u003C\u002Fstrong\u003E are no longer published in our flagship journals and should be submitted to \u003Ca href=\"http:\u002F\u002Fformative.jmir.org\u002F\"\u003EJMIR Formative Research\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\r\n\u003Cp style=\"padding-left: 40px;\"\u003EProtocols and proposals can be submitted to \u003Ca href=\"https:\u002F\u002Fwww.researchprotocols.org\u002F\"\u003EJMIR Research Protocols\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\r\n\u003Cp\u003ESubmitted manuscripts are subject to a rigorous \u003Cstrong\u003Ebut speedy peer review \u003C\u002Fstrong\u003Eprocess. We aim for a standard review time of less than 2 months, and a \u003Ca href=\"https:\u002F\u002Fsupport.jmir.org\u002Fhc\u002Fen-us\u002Farticles\u002F115001310127-How-to-fast-track-expedite-a-paper-and-what-are-the-benefits-\"\u003Ereview time of 4 weeks for submission to initial decision for fast-tracked papers\u003C\u002Fa\u003E).\u003C\u002Fp\u003E\r\n\u003Cp\u003EThe \u003Ca href=\"https:\u002F\u002Fsupport.jmir.org\u002Fhc\u002Fen-us\u002Farticles\u002F115004367848-What-does-the-peer-review-process-at-JMIR-journals-look-like-\"\u003Ereview process\u003C\u002Fa\u003E is designed to help authors to improve their manuscripts by giving them constructive comments on how to improve their paper, and to publish only those articles which comply to general quality criteria of a scholarly paper, especially originality, clarity, references to related work and validity of results and conclusions.\u003C\u002Fp\u003E",googleAnalyticsId:"UA-186918-1",impactFactor:G,journalDescription:"\u003Cp\u003E\u003Cstrong\u003EThe leading peer-reviewed journal for digital medicine and health and health care in the internet age. \u003C\u002Fstrong\u003E\u003C\u002Fp\u003E",journalInitials:"JMIR",footer:"\u003Cul style=\"display: flex; flex-wrap: wrap; justify-content: center; list-style: none;\"\u003E\r\n\u003Cli style=\"margin-bottom: 10px; margin-right: 10px; margin-top: 10px;\"\u003E\r\n\u003Cp style=\"text-align: center;\"\u003E\u003Ca target=\"_blank\" rel=\"noopener\"\u003E\u003Cimg src=\"https:\u002F\u002Fasset.jmir.pub\u002Fresources\u002Fimages\u002Fpartners\u002Fcrossref.jpg\" alt=\"Crossref Member\" \u002F\u003E\u003C\u002Fa\u003E\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n\u003Cli style=\"margin-bottom: 10px; margin-right: 10px; margin-top: 10px;\"\u003E\r\n\u003Cp style=\"text-align: center;\"\u003E\u003Ca target=\"_blank\" rel=\"noopener\"\u003E\u003Cimg src=\"https:\u002F\u002Fasset.jmir.pub\u002Fresources\u002Fimages\u002Fpartners\u002Fcope.jpg\" alt=\"Committee on Publication Ethics\" \u002F\u003E\u003C\u002Fa\u003E\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n\u003Cli style=\"margin-bottom: 10px; margin-right: 10px; margin-top: 10px;\"\u003E\r\n\u003Cp style=\"text-align: center;\"\u003E\u003Cimg src=\"https:\u002F\u002Fasset.jmir.pub\u002Fresources\u002Fimages\u002Fpartners\u002Fopen-access.jpg\" alt=\"Open Access\" \u002F\u003E\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n\u003Cli style=\"margin-bottom: 10px; margin-right: 10px; margin-top: 10px;\"\u003E\r\n\u003Cp style=\"text-align: center;\"\u003E\u003Ca target=\"_blank\" rel=\"noopener\"\u003E\u003Cimg src=\"https:\u002F\u002Fasset.jmir.pub\u002Fresources\u002Fimages\u002Fpartners\u002Foaspa.jpg\" alt=\"Open Access Scholarly Publishers Association\" \u002F\u003E\u003C\u002Fa\u003E\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n\u003Cli style=\"margin-bottom: 10px; margin-right: 10px; margin-top: 10px;\"\u003E \u003C\u002Fli\u003E\r\n\u003Cli style=\"margin-bottom: 10px; margin-right: 10px; margin-top: 10px;\"\u003E \u003C\u002Fli\u003E\r\n\u003Cli style=\"margin-bottom: 10px; margin-right: 10px; margin-top: 10px;\"\u003E\r\n\u003Cp style=\"text-align: center;\"\u003E\u003Ca target=\"_blank\" rel=\"noopener\"\u003E\u003Cimg src=\"https:\u002F\u002Fasset.jmir.pub\u002Fresources\u002Fimages\u002Fpartners\u002Ftrend-MD.jpg\" alt=\"TrendMD Member\" \u002F\u003E\u003Cimg src=\"https:\u002F\u002Fasset.jmir.pub\u002Fresources\u002Fimages\u002Fpartners\u002FORCID.jpg\" alt=\"ORCID Member\" \u002F\u003E\u003C\u002Fa\u003E\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n\u003Cli style=\"margin-bottom: 10px; margin-right: 10px; margin-top: 10px;\"\u003E \u003C\u002Fli\u003E\r\n\u003C\u002Ful\u003E\r\n\u003Cdiv data-v-d2fa5e4c=\"\" data-v-44a23348=\"\"\u003E\r\n\u003Csection class=\"partners-wrapper\" data-test=\"partnerships-section\" data-v-d2fa5e4c=\"\"\u003E\r\n\u003Ch2 class=\"text-center\" style=\"text-align: center;\" aria-label=\"Indexed in\" data-v-d2fa5e4c=\"\" tabindex=\"0\"\u003E \u003C\u002Fh2\u003E\r\n\u003Ch2 class=\"text-center\" style=\"text-align: center;\" aria-label=\"Indexed in\" data-v-d2fa5e4c=\"\" tabindex=\"0\"\u003EThis journal is indexed in\u003C\u002Fh2\u003E\r\n\u003Cdiv class=\"green-underline\" style=\"background-color: #367c3a; height: 3px; margin: 0 auto 40px; width: 100px;\" data-v-30c6e183=\"\"\u003E \u003C\u002Fdiv\u003E\r\n\u003Cul style=\"display: flex; flex-wrap: wrap; justify-content: center; list-style: none;\"\u003E\r\n\u003Cli style=\"margin-bottom: 10px; margin-right: 10px; margin-top: 10px;\"\u003E\r\n\u003Cp style=\"text-align: center;\"\u003E\u003Ca target=\"_blank\" rel=\"noopener\"\u003E\u003Cimg src=\"https:\u002F\u002F19668141.fs1.hubspotusercontent-na1.net\u002Fhubfs\u002F19668141\u002F00%20Marketing\u002FLogos\u002FExternal%20logos%20for%20journal%20pages\u002FPubMed.jpg\" alt=\"PubMed\" \u002F\u003E\u003C\u002Fa\u003E\u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n\u003Cli style=\"margin-bottom: 10px; 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margin-right: 10px; margin-top: 10px;\"\u003E\r\n\u003Cp style=\"text-align: center;\"\u003E \u003C\u002Fp\u003E\r\n\u003C\u002Fli\u003E\r\n\u003Cli\u003E \u003C\u002Fli\u003E\r\n\u003Cli\u003E\u003Ca target=\"_blank\" rel=\"noopener\"\u003E \u003C\u002Fa\u003E\u003C\u002Fli\u003E\r\n\u003C\u002Ful\u003E\r\n\u003Cp\u003E \u003C\u002Fp\u003E\r\n\u003C\u002Fsection\u003E\r\n\u003C\u002Fdiv\u003E",onlineIssn:"1438-8871",searchDescription:"Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet",searchKeywords:"Medical, Medicine, Internet, Research, Journal, ehealth, JMIR, open access publishing, medical research, medical informatics",articlesWidget:{enabled:h,count:y,label:"Recent Articles"},openReviewWidget:{enabled:h,count:y,label:"\u003Ca href=\"https:\u002F\u002Fpreprints.jmir.org\"\u003EPreprints\u003C\u002Fa\u003E Open for Peer-Review"},searchWidget:{enabled:h},partnershipsWidget:{enabled:h},submitButton:{enabled:h,label:"Submit Article"},editorInChief:"\u003Cp\u003EGunther Eysenbach, MD, MPH, FACMI, Founding Editor and Publisher; \u003Cspan\u003EAdjunct Professor, School of Health Information Science, University of Victoria, Canada\u003C\u002Fspan\u003E\u003C\u002Fp\u003E"}}},journals:{data:[{journal_id:b,title:ax,tag:ay,description:a,path:k,slug:k,seq:b,enabled:b,environment:d,url:az,batch:b,year:aA,colour:x,impact:G,order:b,published:aB,transfers:a,cite_score:aC},{journal_id:m,title:"JMIR Research Protocols",tag:"Ongoing trials, grant proposals, formative research, methods, early results. June 2024 - Journal Impact Factor: 1.4 (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:"JMIR Res Protoc publishes research protocols, current and ongoing trials, and grant proposals in all areas of medicine (with an initial focus on ehealth\u002Fmhealth). Publish your work in this journal to let others know what you are working on, to facilitate collaboration and\u002For recruitment, to avoid duplication of efforts, to create a citable record of a research design idea, and to aid systematic reviewers in compiling evidence. Research protocols or grant proposals that are funded and have undergone peer-review will receive an expedited review if you upload peer-review reports as supplementary files.",path:"resprot",slug:"researchprotocols",seq:e,enabled:b,environment:d,url:"https:\u002F\u002Fwww.researchprotocols.org",batch:b,year:H,colour:"#837a7a",impact:"1.4",order:u,published:4315,transfers:a,cite_score:"2.4"},{journal_id:aD,title:"JMIR Formative Research",tag:"Process evaluations, early results and feasibility\u002Fpilot studies of digital and non-digital interventions. June 2024 - Journal Impact Factor: 2.0 (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:c,path:aE,slug:aE,seq:z,enabled:b,environment:d,url:"https:\u002F\u002Fformative.jmir.org",batch:e,year:I,colour:"#605959",impact:"2.0",order:J,published:3046,transfers:a,cite_score:"2.7"},{journal_id:J,title:"JMIR mHealth and uHealth",tag:"Focused on health and biomedical applications in mobile and tablet computing, pervasive and ubiquitous computing, wearable computing and domotics. June 2024 - Journal Impact Factor: 5.4. Q1 journal in \"Health Care Sciences & Services\" and \"Medical Informatics\" categories. (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:"JMIR mhealth and uhealth is a new journal focussing on mobile and ubiquitous health technologies, including smartphones, augmented reality (Google Glasses), intelligent domestic devices, implantable devices, and other technologies designed to maintain health and improve life.",path:aF,slug:aF,seq:l,enabled:b,environment:d,url:"https:\u002F\u002Fmhealth.jmir.org",batch:e,year:K,colour:aG,impact:"5.4",order:e,published:2728,transfers:a,cite_score:"12.6"},{journal_id:45,title:"Online Journal of Public Health Informatics",tag:"A leading peer-reviewed, open access journal dedicated to the dissemination of high-quality research and innovation in the field of public health informatics.",description:a,path:aH,slug:aH,seq:L,enabled:b,environment:d,url:"https:\u002F\u002Fojphi.jmir.org",batch:a,year:aI,colour:"#3399FF",impact:c,order:L,published:1717,transfers:a,cite_score:a},{journal_id:p,title:"JMIR Public Health and Surveillance",tag:"A multidisciplinary journal that focuses on the intersection of public health and technology, public health informatics, mass media campaigns, surveillance, participatory epidemiology, and innovation in public health practice and research. June 2024 - Journal Impact Factor: 3.5. Q1 journal in \"Public, Environmental & Occupational Health\" category (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:"Innovations in Public Health practice and research",path:aJ,slug:aJ,seq:n,enabled:b,environment:d,url:"https:\u002F\u002Fpublichealth.jmir.org",batch:b,year:q,colour:au,impact:M,order:n,published:1634,transfers:a,cite_score:"13.7"},{journal_id:o,title:"JMIR Medical Informatics",tag:"Clinical informatics, decision support for health professionals, electronic health records, and eHealth infrastructures. June 2024 - Journal Impact Factor: 3.1 (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:"Clinical informatics",path:aK,slug:aK,seq:m,enabled:b,environment:d,url:"https:\u002F\u002Fmedinform.jmir.org",batch:e,year:K,colour:at,impact:"3.1",order:t,published:1400,transfers:a,cite_score:"7.9"},{journal_id:N,title:"JMIR Mental Health",tag:"A journal focused on Internet interventions, technologies, and digital innovations for mental health and behavior change. Official journal of the Society for Digital Psychiatry. June 2024 - Journal Impact Factor: 4.8. Q1 journal in \"Psychiatry\" category. (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:c,path:aL,slug:aL,seq:o,enabled:b,environment:d,url:"https:\u002F\u002Fmental.jmir.org",batch:b,year:O,colour:"#45936C",impact:aM,order:w,published:1072,transfers:a,cite_score:"10.8"},{journal_id:n,title:"JMIR Human Factors",tag:"Making health care interventions and technologies usable, safe, and effective. June 2024 - Journal Impact Factor: 2.6 (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:"Usability Studies and Ergonomics",path:aN,slug:aN,seq:D,enabled:b,environment:d,url:"https:\u002F\u002Fhumanfactors.jmir.org",batch:e,year:O,colour:av,impact:"2.6",order:aO,published:797,transfers:a,cite_score:"3.4"},{journal_id:u,title:"JMIR Serious Games",tag:"A multidisciplinary journal on gaming and gamification including simulation and immersive virtual reality for health education\u002Fpromotion, teaching, medicine, rehabilitation, and social change. June 2024 - Journal Impact Factor: 3.8. Q1 journal in \"Health Care Sciences & Services\" category. (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:"Serious games for health and social change",path:aP,slug:aP,seq:p,enabled:b,environment:d,url:"https:\u002F\u002Fgames.jmir.org",batch:b,year:K,colour:"#4A5A67",impact:"3.8",order:m,published:629,transfers:a,cite_score:"7.3"},{journal_id:P,title:"JMIR Medical Education",tag:"Technology, innovation and openess in medical education in the information age. June 2024 - Journal Impact Factor: 3.2. Q1 journal in \"Education, Scientific Disciplines\" category. (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:c,path:aQ,slug:aQ,seq:aO,enabled:b,environment:d,url:"https:\u002F\u002Fmededu.jmir.org",batch:e,year:q,colour:"#6678A6",impact:aR,order:p,published:552,transfers:a,cite_score:"6.9"},{journal_id:w,title:"Iproceedings",tag:"Electronic Proceedings, Presentations and Posters of Leading Conferences",description:c,path:aS,slug:aS,seq:J,enabled:b,environment:d,url:"https:\u002F\u002Fwww.iproc.org",batch:e,year:q,colour:"#6F7D80",impact:a,order:Q,published:510,transfers:a,cite_score:a},{journal_id:l,title:"Interactive Journal of Medical Research",tag:"A new general medical journal for the 21st centrury, focusing on innovation in health and medical research. June 2024 - Journal Impact Factor: 1.9 (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:c,path:"ijmr",slug:"i-jmr",seq:w,enabled:b,environment:d,url:"https:\u002F\u002Fwww.i-jmr.org",batch:e,year:H,colour:"#22B2C1",impact:"1.9",order:aT,published:427,transfers:a,cite_score:a},{journal_id:R,title:"JMIR Aging",tag:"Digital health technologies, apps, and informatics for patient education, medicine and nursing, preventative interventions, and clinical care \u002F home care for elderly populations. June 2024 - Journal Impact Factor: 5.0. Q1 journal in \"Geriatrics & Gerontology\", \"Gerontology\" and \"Medical Informatics\" categories. (Source: Journal Citation Reports™ 2024 from Clarivate™)",description:c,path:aU,slug:aU,seq:Q,enabled:b,environment:d,url:"https:\u002F\u002Faging.jmir.org",batch:e,year:r,colour:"#979bc4",impact:"5.0",order:l,published:424,transfers:a,cite_score:"6.5"},{journal_id:aV,title:"JMIRx Med",tag:aW,description:a,path:aX,slug:aX,seq:S,enabled:b,environment:d,url:"https:\u002F\u002Fxmed.jmir.org",batch:a,year:T,colour:"#3187df",impact:c,order:N,published:420,transfers:a,cite_score:a},{journal_id:Q,title:"JMIR Pediatrics and Parenting",tag:"Improving pediatric and adolescent health outcomes and empowering and educating parents. June 2024 - Journal Impact Factor: 2.1. Q1 journal in \"Pediatrics\" category. 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