Methodological appraisal of digital psychiatry readiness among Pakistani psychiatrists: gaps and recommendations

This letter offers a critical appraisal of Riaz et al.’s study (Explor Digit Health Technol. 2026;4:101179. DOI: 10.37349/edht.2026.101179) on psychiatrists’ knowledge, perceptions, and willingness toward digital psychiatry in Pakistan. The mixed-methods design identifies critical gaps in competencies (e.g., 68.5% telepsychiatry familiarity vs. 32.5% VR) and barriers like infrastructure deficits (44.5%). However, methodological issues per STROBE guidelines such as absent response rates, convenience sampling bias, and incomplete bias mitigation limit representativeness. An adapted Newcastle-Ottawa Scale scores it 7/10, indicating moderate bias of risk from selection and non-response. Additional concerns include under-explored cultural factors. Recommendations propose a tailored LMIC digital health adoption framework emphasizing infrastructure, training, and policy to address Pakistan’s > 75% mental health treatment gap.