Quality and methodological challenges in Internet-based mental health trials.
OBJECTIVE
To review the quality of Internet-based mental health intervention studies and their methodological challenges.


METHODS
We searched multiple literature databases to identify relevant studies according to the Population, Interventions, Comparators, Outcomes, and Study Design framework. Two reviewers independently assessed selection bias, allocation bias, confounding bias, blinding, data collection methods, and withdrawals/dropouts, using the Quality Assessment Tool for Quantitative Studies. We rated each component as strong, moderate, or weak and assigned a global rating (strong, moderate, or weak) to each study. We discussed methodological issues related to the study quality.


RESULTS
Of 122 studies included, 31 (25%), 44 (36%), and 47 (39%) were rated strong, moderate, and weak, respectively. Only five studies were rated strong for all of the six quality components (three of them were published by the same group). Lack of blinding, selection bias, and low adherence were the top three challenges in Internet-based mental health intervention studies.


CONCLUSIONS
The overall quality of Internet-based mental health intervention needs to improve. In particular, studies need to improve sample selection, intervention allocation, and blinding.
1 Research and Evaluation Unit, Winnipeg Regional Health Authority , Winnipeg, Manitoba, Canada .
Xibiao
X
Ye
Sunita Bayyavarapu
SB
Bapuji
Shannon
S
Winters
Colleen
C
Metge
Mellissa
M
Raynard
D002986:Clinical Trials as Topic; D006801:Humans; D020407:Internet; D001523:Mental Disorders / Q000628:therapy*; D011613:Psychotherapy / Q000379:methods*; D011787:Quality of Health Care; D012107:Research Design
Internet-based research; mental health; methodology; quality