Appl Clin Inform 2017; 08(02): 470-490
DOI: 10.4338/ACI-2016-10-R-0170
Schattauer GmbH

Towards Usable E-Health

A Systematic Review of Usability Questionnaires
Vanessa E. C. Sousa
1  Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA
Karen Dunn Lopez
1  Department of Health Systems Science, University of Illinois at Chicago, Chicago, IL, USA
› Author Affiliations
Funding This study was supported in part by funding from The National Council for Scientific and Technological Development (CNPq), Brasilia, Brazil.
Further Information

Publication History

10 October 2017

26 February 2017

Publication Date:
21 December 2017 (online)


Background: The use of e-health can lead to several positive outcomes. However, the potential for e-health to improve healthcare is partially dependent on its ease of use. In order to determine the usability for any technology, rigorously developed and appropriate measures must be chosen.

Objectives: To identify psychometrically tested questionnaires that measure usability of e-health tools, and to appraise their generalizability, attributes coverage, and quality.

Methods: We conducted a systematic review of studies that measured usability of e-health tools using four databases (Scopus, PubMed, CINAHL, and HAPI). Non-primary research, studies that did not report measures, studies with children or people with cognitive limitations, and studies about assistive devices or medical equipment were systematically excluded. Two authors independently extracted information including: questionnaire name, number of questions, scoring method, item generation, and psychometrics using a data extraction tool with pre-established categories and a quality appraisal scoring table.

Results: Using a broad search strategy, 5,558 potentially relevant papers were identified. After removing duplicates and applying exclusion criteria, 35 articles remained that used 15 unique questionnaires. From the 15 questionnaires, only 5 were general enough to be used across studies. Usability attributes covered by the questionnaires were: learnability (15), efficiency (12), and satisfaction (11). Memorability (1) was the least covered attribute. Quality appraisal showed that face/content (14) and construct (7) validity were the most frequent types of validity assessed. All questionnaires reported reliability measurement. Some questionnaires scored low in the quality appraisal for the following reasons: limited validity testing (7), small sample size (3), no reporting of user centeredness (9) or feasibility estimates of time, effort, and expense (7).

Conclusions: Existing questionnaires provide a foundation for research on e-health usability. However, future research is needed to broaden the coverage of the usability attributes and psychometric properties of the available questionnaires.

Citation: Sousa VEC, Lopez KD. Towards usable e-health: A systematic review of usability questionnaires. Appl Clin Inform 2017; 8: 470–490

Human Subjects Protections

Human subjects were not included in the project.