Online Patient Feedback About Medical Services: A Systematic Critical Review

Background: Online patient feedback (OPF), comprising ratings, narrative reviews, patient stories and social-media posts about healthcare encounters, increasingly informs patient choice and service improvement, yet the evidence base is heterogeneous and vulnerable to bias. Objective: To critically synthesise evidence on how OPF is produced, analysed and used, whether it indicates care quality, and how healthcare organisations respond. Methods: Reporting followed PRISMA 2020 and PRISMA-S. Six databases were searched (2005–2025), supplemented by citation searching. Two reviewers independently screened records and appraised studies (MMAT; AMSTAR 2). Findings were synthesised thematically without meta-analysis. Results: Of 308,636 deduplicated records, 40 sources were included: 28 primary empirical studies, eight systematic or scoping reviews and four contextual sources. Evidence was concentrated in the United States and United Kingdom and dominated by cross-sectional platform analyses. Ratings correlated more consistently with patient-experience measures than with clinical outcomes. Self-selection, extreme-response patterns, platform disagreement and gender-related bias limited individual-clinician inference. Evidence that organisational responses improve care was sparse. Conclusions: OPF is best treated as complementary experiential and safety intelligence rather than a stand-alone measure of clinical quality or a basis for ranking individual clinicians.