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Most clinicians and researchers have relied on patient or participant self-reported health information to overcome the constraints of eliciting these data in a clinic or laboratory setting. For example, time-dependent behaviours (eg, waking body temperature), or some sensitive or personal behaviour (eg, substance use or sexual behaviours) are difficult to directly observe in formal settings. 1 Additionally, clinic-based or lab-based data collection may fail to capture how an individual's own 'native' circumstances and subjective experiences determine or modify a health behaviour. 2 3 At the same time, it is important to safeguard the anonymity and confidentiality of self-reported information, as individuals may provide inaccurate data if they feel these elements have been breached. 3
The use of electronic diaries has become an increasingly common data collection approach to maximise the ecological validity and the security of self-reported health information. Considerable diversity has evolved over the past decade in how electronic diaries are structured, in how frequently they are completed, and in the health phenomena they are used to study. As evidenced by their use to understand sexual behaviour, 4 smoking cessation 5 and substance use, 6 asthma management 7 seizure prediction, 8 psychological state and disease symptomatology in old age, 9 paediatric arthritis pain, 10 and emotional regulation, 11 electronic diaries can be a flexible and powerful way to intimately connect to the health experiences of others.
In this issue, Stalgaitis and Glick's 12 systematic review of web-based diaries for understanding sexual risk behaviour serves as a useful illustration of some of the advantages and challenges associated with using any derivative of electronic diaries. As suggested here, researchers and clinicians need to carefully weigh expected gains in potential data quality with the time, personnel and financial investments needed to start and sustain an electronic diary-based project. A more in-depth review of several of these considerations is provided below.
Advantages of electronic diary platforms
The electronic diary platform provides programmatic benefits. 4-6 13-15 For example, the diary can be designed to function across multiple web-enabled devices, including tablets or cell phones. This modality accommodates mixed questions formats (eg, fixed choice and free text, dichotomous, categorical or continuous, check box or sliding 'rating' type scales), as well as varying frequency (eg, once/day or multiple times/day and...