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To assess our collective understanding of how consumers use patient portals, we conducted a systematic literature review focusing on understanding patients and caregivers' perceptions, needs, requirements, and use of patient portals with the goal of informing the design of effective patient portals. Through multiple rounds of screening, we identified 56 relevant publications for analysis. The preliminary analysis suggested that patient portals are implemented in a wide range of health care settings, ranging from large medical centers to small primary care facilities. Patient portals primarily target patients with chronic conditions. Many aspects of the use of patient portals were covered in the literature, including users' use of specific portal functions (such as managing medications and accessing imaging results), their attitudes toward patient portals, and barriers to patient portal use. Our findings call for more attention from information science researchers to contribute to this important area.

This paper reports quantitative and qualitative findings from a systematic literature review of user studies of patient portals. A deductive content analysis was performed using six human values identified in a prior study: privacy, confidentiality, security, trust, transparency and agency. Each of the 52 articles in the corpus included invocations of at least one of these human values, supporting their salience for understanding the user experience of patient portals. The paper concludes with a discussion of the implications of this analysis for value-sensitive design of patient portals, including indicating potential future research directions.

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Background: Symptom clusters have not been previously explored in acute pain patients (APPs) and chronic pain patients (CPPs) with non-cancer pain. Objectives: The objectives of this study were to determine in CPPs and APPs which somatic and non-somatic symptoms cluster with each other, the number of clusters, and if cluster number and cluster symptom makeup differ by pain level. Study Design: Study sample was 326 APPs and 341 CPPs who had completed a pool of questions that had included current symptom questions other than pain. Symptom cluster analyses were performed on 15 somatic and non-somatic symptoms for APPs and CPPs and for 2 CPP subgroups with moderate and severe pain. Setting: APPs and CPPs were from rehabilitation facilities located in 30 states in all geographical regions of the United States. Results: APPs had 4 symptom clusters and CPPs had 5. For CPPs, the clusters represented memory, neurological, behavioral, somatic, and autonomic problems. CPPs with moderate and severe pain had 3 and 4 symptom clusters, respectively, and differed in cluster symptom constitution. Limitations: Patients selected themselves for study inclusion and were paid for their participation. This could have affected random selection. Lastly, we used the current time definitions of acute pain versus chronic pain (90 days) to separate our patients into these groups. Currently, no consensus exists regarding the optimal time duration to divide acute from chronic. Conclusions: APPs and CPPs are characterized by symptom comorbidities that form clusters. In CPPs, cluster number and cluster symptom makeup are affected by pain level. This has implications for clinical practice and future research. Key words: Comorbidity, somatic symptoms, comorbid symptoms, chronic pain patients, acute pain patients, community patients without pain, clusters, symptom clusters