Real-Time Symptom Ratings Using Ecological Momentary Assessment Versus Traditional Questionnaires in Patients With Chronic Obstructive Pulmonary Disease: Observational Study.

BACKGROUND

Questionnaires assessing symptoms in chronic obstructive pulmonary disease (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 was to compare EMA symptom ratings with traditional questionnaires in patients with COPD.

METHODS

A subsample from the FAntasTIGUE study rated symptoms using questionnaires (visual analog scale, modified Medical Research Council Dyspnea Scale, Physical Activity Rating Scale-Dyspnea Questionnaire, Checklist Individual Strength-subscale Subjective Fatigue, Hospital Anxiety and Depression Scale, and COPD Assessment Test) and EMA. Participants rated breathlessness, fatigue, anxiety, and energy level on a 7-point Likert scale during 8 random EMA prompts daily for 5 days.

RESULTS

Among 54 participants (mean age 67, SD 7 y; forced expiratory volume in 1 s 53%, SD 20% predicted; n=35, 65% men), the EMA response rate was 76.1%. EMA scores were moderately 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 intraday and interday symptom variability.

CONCLUSIONS

EMA is a valid tool for COPD symptom assessment, capturing real-time fluctuations to improve symptom management.