OBJECTIVES: To conduct a systematic review and meta-analysis of the equivalence between electronic and paper administration of patient reported outcome measures. METHODS: A systematic literature review was undertaken in which 1,997 records were identified from which 73 studies met our inclusion criteria. The data were subject to a random effects meta-analysis. Pooled estimates of correlation and mean difference were estimated. The modifying effect of particular study characteristics was explored by calculation of pooled values for studies grouped by: mode of administration, year of publication, study design, and time interval between administrations. RESULTS: =91.56). After excluding 20 studies with outlying values the I2 was 56.63, with an overall random effects pooled correlation coefficient of 0.870 (95% CI 0.856 to 0.882). In terms of factors that might explain the heterogeneity, there was a statistically significant difference in pooled correlation estimates between years, with a tendency for agreement to be greater in more recent studies (fixed p<0.001, random p<0.001). Paper vs hand-held agreement was significantly higher than paper vs web agreement (0.894 vs 0.855), with non-overlapping 95% CI. CONCLUSIONS: The present study supports the conclusion of previous a previous manuscript (Gwaltney et al 2008) showing that written assessments administered on paper are the same as written assessments on an electronic device. This study has confirmed this conclusion and has also broadened the comparison out to include IVRS assessments and breaking the comparison down by hand-held vs internet administration. The results suggest that scores obtained by different modalities are directly comparable.