Accounting for power imbalances in online public deliberations. A systematic review of asymmetry measures

Objective: Considering the increasing popularity of public engagement in health policy, this study aims to identify how asymmetries in online public deliberations are measured and to appraise the methodological properties of these measures.Methods: Electronic searches in three databases were combined with reference tracking of included articles. Peer reviewed articles (in French, English, Portuguese, and Spanish) reporting quantitative and mixed method measures to assess power imbalances in online public deliberations, which we call "asymmetries", were included. Information about study characteristics, operational definitions and measurement properties was extracted. The quality of the studies was assessed through the MMAT tool and the quality of the measures through the COSMIN checklist.Results: 12 studies were included, from which we extracted 52 asymmetry measures for different deliberative process stages. Most studies were well conducted according to the MMAT tool (5 of 7 quantitative descriptive studies, 2 of 3 mixed methods studies and 1 of 1 quasi-randomized study). We found 1 measure for the recruitment stage, 2 measures for information provision, 19 measures for discussion stage and 12 measures for outcomes assessment. Their measurement properties quality ranged from "poor" to "good." We also identified 4 measures for cognitive resources and 14 stratifying variables including cultural, relational and lived experience resources.Conclusions: As far as the authors know, this is the first exhaustive review of the measures available for reporting power asymmetries underlying inequalities in online public deliberations. To choose the most appropriate measures, researchers and practitioners should consider both measurement properties and conceptual relevance. This study offers guidance to this end.