When digital versions of self-report symptom scales are compared to pen and paper versions , most scales show high interformat reliability .
This supports the reliability of results obtained in psychotherapy research on the Internet and the comparability of the results to traditional psychotherapy research .
BACKGROUND Research on Internet-based interventions typically use digital versions of pen and paper self-report symptom scales .
However , adaptation into the digital format could affect the psychometric properties of established self-report scales .
Several studies have investigated differences between digital and pen and paper versions of instruments , but no systematic review of the results has yet been done .
OBJECTIVE This review aims to assess the interformat reliability of  self-report symptom  scales used in digital or online psychotherapy research .
A Comparison of Psychometric Properties Between Internet and Paper Versions of Two Depression Instruments (BDI-II and MADRS-S) Administered to Clinic Patients
Background Self-report measures can guide clinical decisions and are useful when evaluating treatment outcomes . However , many clinicians do not use self-report measures systematic ally in their clinical practice . Internet-based question naires could facilitate administration , but the psychometric properties of the online version of an instrument should be explored before implementation . The recommendation from the International Test Commission is to test the psychometric properties of each question naire separately . Objective Our objective was to compare the psychometric properties of paper- and -pencil versions and Internet versions of two question naires measuring depressive symptoms . Methods The 87 participating patients were recruited from primary care and psychiatric care within the public health care system in Sweden . Participants completed the  Beck Depression Inventory ( BDI-II )  and the  Montgomery-Åsberg Depression Rating Scale — Self-rated ( MADRS-S )  , both on paper and on the Internet . The order was r and omized to control for order effects . Symptom severity in the sample ranged from mild to severe depressive symptoms . Results Psychometric properties of the two administration formats were mostly equivalent . The internal consistency was similar for the Internet and paper versions , and significant correlations were found between the formats for both MADRS-S ( r = .84 ) and the BDI-II ( r = .89 ) . Differences between paper and Internet total scores were not statistically significant for either question naire nor for the MADRS-S question dealing with suicidality ( item 9 ) when analyzed separately . The score on the BDI-II question about suicidality ( item 9 ) was significantly lower when administered via the Internet compared with the paper score , but the difference was small ( effect size , Cohen ’s [ d ] = 0.14 ) . There were significant main effects for order of administration on both question naires and significant interaction effects between format and order . This should not , however , pose a problem in clinical use as long as the administration format is not changed when repeated measurements are made . Conclusions The MADRS-S can be transferred to online use without affecting the psychometric properties in a clinical ly meaningful way . The full BDI-II also seems to retain its properties when transferred ; however , the item measuring suicidality in the Internet version needs further investigation since it was associated with a lower score in this study . The use of online question naires offers clinicians a more practical way of measuring depressive symptoms and has the potential to save re sources
When digital versions of self-report symptom scales are compared to pen and paper versions , most scales show high interformat reliability .
This supports the reliability of results obtained in psychotherapy research on the Internet and the comparability of the results to traditional psychotherapy research .
BACKGROUND Research on Internet-based interventions typically use digital versions of pen and paper self-report symptom scales .
However , adaptation into the digital format could affect the psychometric properties of established self-report scales .
Several studies have investigated differences between digital and pen and paper versions of instruments , but no systematic review of the results has yet been done .
OBJECTIVE This review aims to assess the interformat reliability of  self-report symptom  scales used in digital or online psychotherapy research .