Ecological momentary assessment methodology in chronic pain research: a systematic review
Open accessAbstract
Self-reported pain intensity assessments are central to chronic pain research. Ecological momentary assessment (EMA) methodologies are uniquely positioned to collect these data, and are indeed being used in the field. However, EMA protocols are complex, and many decisions are necessary in the design of EMA research studies. A systematic literature review identified 105 articles drawing from 62 quantitative EMA research projects examining pain intensity in adult chronic pain patients. Study characteristics were tabulated to summarize and describe the use of EMA, with an emphasis placed on various dimensions of decision-making involved in executing EMA methodologies. Most identified studies considered within-person relationships between pain and other variables, and a few examined interventions on chronic pain. There was a trend toward the use of smartphones as EMA data collection devices more recently, and completion rates were not reported in nearly one third of studies. Pain intensity items varied widely with respect to number of scale points, anchor labels, and length of reporting period; most used numeric rating scales. Recommendations are provided for reporting to improve reproducibility, comparability, and interpretation of results, and for opportunities to clarify the importance of design decisions.Perspective Studies that use EMA methodologies to assess pain intensity are heterogeneous. Aspects of protocol design, including data input modality and pain item construction, have the potential to influence the data collected. Thorough reporting on design features and completion rates therefore facilitates reproducibility, comparability, and interpretation of study results.
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Well-designed smartphone apps can be very easy to use and well accepted even in relatively old pain populations.
“There is growing evidence indicating that well-designed smartphone can be very easy to use and well accepted even in relatively old pain populations, and compliance rates with daily assessment have been as high as 75%.66”
From Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study) (2020) · cites this paper as [66]
Prospective and repeated evaluation over time substantially improves the accuracy, reliability and quality of research.
“Moreover, the prospective and repeated evaluation over time substantially improves the accuracy, reliability and quality of research.66”
From Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study) (2020) · cites this paper as [66]
Compliance rates with daily assessment have been as high as 75%.
“There is growing evidence indicating that well-designed smartphone can be very easy to use and well accepted even in relatively old pain populations, and compliance rates with daily assessment have been as high as 75%.66”
From Efficacy, cost-utility and physiological effects of Acceptance and Commitment Therapy (ACT) and Behavioural Activation Treatment for Depression (BATD) in patients with chronic low back pain and depression: study protocol of a randomised, controlled trial including mobile-technology-based ecological momentary assessment (IMPACT study) (2020) · cites this paper as [66]
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- Authors
- May, M., Junghaenel, D. U., Ono, M., Stone, A. A., & Schneider, S.
- Affiliations
- University of Southern California (US)
- Corresponding author
- May, Marcella
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 19
- Issue
- 7
- Pages
- 699-716
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC6026050
- OpenAlex
- W2791408187
- Cited by
- 247
- References
- 150
- Citations by year
- 2026: 33 · 2025: 32 · 2024: 38 · 2023: 28 · 2022: 37 · 2021: 24 · 2020: 34 · 2019: 15 · 2018: 5 · 2013: 1
- FWCI
- 3.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR066200)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- ecological momentary assessment, chronic pain, pain intensity, self-reported pain, smartphone data collection, completion rates, numerical rating scale, within-person relationships, reproducibility, reporting recommendations
- MeSH terms
- Ecological Momentary Assessment, Data Collection, Humans, Pain Measurement, Self Report, Chronic Pain
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