Experts highlight the need to reconsider the frameworks used in health technology assessment (HTA) in order to cover the particularities of digital health technologies (DHT). However, there is a large heterogeneity in the literature about terminologies and definitions. Our objective was to identify the methodological frameworks used worldwide for HTA of DHT and generate a proposal of domains to consider in the assessment through a thematic analysis, a qualitative data analysis method that consists of identifying, analysing and reporting patterns across the data.

Methodological frameworks were identified through a scoping review (ScR) in accordance with the PRISMA extension for ScR. We searched five different databases for peer-reviewed and grey literature published between 2011 and 2021. The retrieved references were screened using Rayyan by two authors in a single-blind manner. References included were analyzed thematically by three reviewers using ATLAS.ti.

The systematic search retrieved 3,061 references (2,238 unique), of which 26 were included. These, in turn, synthesized 102 frameworks designed for the assessment of DHT. The included documents contained a wide variety of items to consider in HTA of DHT and often used different wording to refer to similar concepts. Through the thematic analysis, we reduced this heterogeneity. Specifically, in the first analysis phase we established 176 provisional codes related to different assessment domains. In the second one, these codes were grouped in 86 descriptive themes that, in turn, were clustered in the third phase in 61 analytical themes. The latter were organized through a vertical hierarchy of three levels: level 1 (13 domains), level 2 (38 dimensions), and level 3 (11 sub-dimensions).

There is a need to reconsider the frameworks and assessment domains used for HTA of DHT. Our thematic analysis of 26 references led to the definition of 13 domains, 38 dimensions and 11 sub-dimensions to consider in HTA of DHT. From our perspective, thematic analysis is the most appropriate method to identify assessment items for HTA of DHT from literature.