Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Mar 6, 2024
Date Accepted: Apr 14, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Validation of a novel framework to assess clinical information in digital health technologies: structural equation modelling
ABSTRACT
Background:
Digital health is a critical driver of quality, safety, and efficiency in healthcare. However, poor quality of clinical information in Digital Health Technologies (DHTs) can compromise the quality and safety of care. The Clinical Information Quality (CLIQ) framework was developed as a pragmatic tool to assess the quality of clinical information in DHTs.
Objective:
The aim of this study is to assesses the applicability, internal consistency, and construct validity of the CLIQ framework.
Methods:
This study was conducted as a cross-sectional survey of healthcare professionals across the UK who regularly use SystmOne Electronic Health Records (EHRs). Participants were invited through emails and social media platforms. The CLIQ questionnaire, developed based on systemic review and international eDelphi study, was administered as an online survey. Spearman’s correlation coefficients were computed to investigate the linear relationship between the dimensions in the CLIQ framework. The Cronbach’s alpha coefficients were computed to assess the internal consistency of the global scale (i.e., CLIQ framework) and the sub-scales (i.e., the informativeness, availability and usability categories). Confirmatory factor analysis was used to assess the extent to which the survey data supported the construct validity of the CLIQ framework.
Results:
A total of 109 healthcare professionals completed the survey, of which two-third (n = 67; 61.5%) were doctors and a quarter (n = 26; 23.9%) were nurses or advance nurse practitioner. Overall, the CLIQ dimensions had good quality scores except for portability which had a modest score. The inter-item correlations were all positive and not likely due to chance. The Cronbach’s alpha coefficient for the overall CLIQ framework was 0.89 (95 CI%: 0.85 – 0.92). The confirmatory factor analysis provided a modest support for the construct validity of the CLIQ framework with the Comparative Fit Index (CFI) of 0.86 and Standardised Root Mean Square Residual (SRMR) of 0.08.
Conclusions:
The CLIQ framework demonstrated a high reliability and a modest construct validity. The CLIQ framework offers a pragmatic approach to assessing the quality of clinical information in DHTs and could be applied as part of information quality assurance systems in healthcare settings to improve quality of health information.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.