Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Jun 14, 2025
Date Accepted: Feb 5, 2026
Comparing Real-Time Symptom Ratings via Ecological Momentary Assessment and Traditional Questionnaires in Patients With Chronic Obstructive Pulmonary Disease: Observational Study
ABSTRACT
Background:
Questionnaires assessing symptoms in COPD rely on retrospective reporting, introducing recall bias and missing symptom variability. Ecological Momentary Assessment (EMA) addresses these limitations by capturing real-time symptom data.
Objective:
The aim of this study is to compare EMA symptom ratings with traditional questionnaires in patients with COPD.
Methods:
A subsample from the FAntasTIGUE study rated symptoms using questionnaires (Visual Analogue Scale (VAS), modified Medical Research Council (mMRC) Dyspnea Scale, Physical Activity Rating Scale - Dyspnea Questionnaire (PARS-D), Checklist Individual Strength – subscale subjective Fatigue (CIS-Fatigue), Hospital Anxiety and Depression Scale (HADS) and COPD Assessment Test (CAT)) and EMA. Further, participants rated breathlessness, fatigue, anxiety and energy level on a 7-point Likert-scale during eight random EMA prompts daily for five days.
Results:
Among 54 participants (67±7 years, FEV1% 53±20, 63% men) EMA response rate was 76.1%. EMA scores moderate-to-strongly correlated with questionnaire scores (rs = 0.49–0.78, all P<.05) and varied across severity groups (all P<.05). EMA captured significant within- and between-day symptom variability.
Conclusions:
EMA is a valid tool for COPD symptom assessment, capturing real-time fluctuations to improve symptom management.
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