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COA Instruments Distributed by Mapi Research Trust

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AHLQ / Adherence to a Healthy Lifestyle questionnaire Adherence to a Healthy Lifestyle questionnaire

Sanofi Aventis et al.

To measure adherence to a healthy lifestyle (diet and exercise; motivation, barriers, results, satisfaction, adherence to lifestyle changes)

Therapeutic indications : Obesity

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AIM / Ascites Impact Measure Ascites Impact Measure

Sanofi Aventis et al.

To record patients’ daily experiences of symptoms that trigger a request for a paracentesis in patients with ascites

Therapeutic indications : Ascites

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ALS Survey / Amyotrophic Lateral Sclerosis Survey Amyotrophic Lateral Sclerosis Survey

Barohn RJ et al.

To assess symptoms and their impact on activities of daily living (ADL) in patients with Amyotrophic Lateral Sclerosis (ALS)

Therapeutic indications : Amyotrophic Lateral Sclerosis, Muscular Atrophy, Spinal, Motor Neuron Disease

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AOM-Diary / Acute Otitis Media Symptoms Diary Acute Otitis Media Symptoms Diary

Sanofi Aventis et al.

To capture data on the child’s daily level of Acute Otitis Media (AOM) symptom severity and to systematically assess resolution of symptoms

Therapeutic indications : Otitis Media

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AQLQ / Asthma Quality of Life Questionnaire Asthma Quality of Life Questionnaire

Juniper E et al.

To measure the functional impairments that are most troublesome to adults (17-70 years) as a result of their asthma

Therapeutic indications : Asthma

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AQLQ-M / Asthma Quality of Life Questionnaire - Marks Asthma Quality of Life Questionnaire - Marks

Marks GB, Dunn M, Woolcock AJ et al.

To measure the impact of asthma on quality of life

Therapeutic indications : Asthma

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ASAT / Addiction Severity Assessment Tool Addiction Severity Assessment Tool

Butler SF, McGee MD, Davis MS, Cornelli R, Morey LC, Budman SH et al.

Behavioral health adult screener that measures problem severity in daily functioning, relationships, dysphoric states, dependence severity, recovery skill/self-efficacy, and existential factors for substance abuse clients

Therapeutic indications : Substance-Related Disorders

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ASI / Addiction Severity Index Addiction Severity Index

McLellan AT, Luborsky L, Woody GE, O'Brien CP et al.

To produce a problem severity profile of each patient through an analysis of six general areas

Therapeutic indications : Substance-Related Disorders, Alcoholism

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ASI - Lite: Clinical Trials Network Version – Part 1 / Addiction Severity Index – Lite: Clinical Trials Network Version – Part 1 Addiction Severity Index – Lite: Clinical Trials Network Version – Part 1

McLellan AT, Luborsky L, Woody GE, O'Brien CP et al.

To produce a problem severity profile of each patient through an analysis of six general areas

Therapeutic indications : Substance-Related Disorders, Alcoholism

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ASI - Lite: Clinical Trials Network Version – Part 2 / Addiction Severity Index – Lite: Clinical Trials Network Version – Part 2 Addiction Severity Index – Lite: Clinical Trials Network Version – Part 2

McLellan AT, Luborsky L, Woody GE, O'Brien CP et al.

To produce a problem severity profile of each patient through an analysis of six general areas

Therapeutic indications : Substance-Related Disorders, Alcoholism

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ASI – 5th Edition Clinical Training Version / Addiction Severity Index – 5th Edition Clinical Training Version Addiction Severity Index – 5th Edition Clinical Training Version

McLellan AT, Luborsky L, Woody GE, O'Brien CP et al.

To produce a problem severity profile of each patient through an analysis of six general areas

Therapeutic indications : Substance-Related Disorders, Alcoholism

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ASI-Lite-CF / Addiction Severity Index Lite-CF Addiction Severity Index Lite-CF

McLellan AT, Luborsky L, Woody GE, O'Brien CP et al.

To produce a problem severity profile of each patient through an analysis of six general areas

Therapeutic indications : Substance-Related Disorders, Alcoholism

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ASK-12 / Adherence Starts with Knowledge 12 Adherence Starts with Knowledge 12

GlaxoSmithKline Research and Development Limited (GSK) et al.

To measure barriers to medication adherence and adherence-related behavior.

Therapeutic indications : All

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ASK-20 / Adherence Starts with Knowledge 20 Adherence Starts with Knowledge 20

GlaxoSmithKline Research and Development Limited (GSK) et al.

To measure barriers to medication adherence and adherence-related behavior

Therapeutic indications : All

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ASRS / Augmentation Severity Rating Scale Augmentation Severity Rating Scale

The European Restless Legs Syndrome Study Group (EURLSSG) et al.

To assess severity of augmentation, the main complication during long-term dopaminergic treatment of restless legs syndrome (RLS)

Therapeutic indications : Restless Legs Syndrome

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AUQUEI / Pictured Child’s Quality of Life Self Questionnaire Pictured Child’s Quality of Life Self Questionnaire

Dazord A, Manificat S et al.

To assess the child’s subjective Quality of Life

Therapeutic indications : All

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Barthel Index / Barthel Index Barthel Index

Mahoney FI, Barthel DW et al.

To measure a person's daily functioning specifically the activities of daily living (ADL) and mobility

Therapeutic indications : All

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BAS-G / Bath Ankylosing Spondylitis Global score Bath Ankylosing Spondylitis Global score

Jones SD, Steiner A, Garrett SL, Calin A et al.

To reflect the effect of ankylosing spondylitis (AS) on the patient's well-being

Therapeutic indications : Spondylitis, Ankylosing

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BASDAI / Bath Ankylosing Spondylitis Disease Activity Index Bath Ankylosing Spondylitis Disease Activity Index

Calin A et al.

To define disease activity in patients with ankylosing spondylitis

Therapeutic indications : Spondylitis, Ankylosing

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BASFI / Bath Ankylosing Spondylitis Functional Index Bath Ankylosing Spondylitis Functional Index

Calin A et al.

To define and monitor functional ability in patients with ankylosing spondylitis

Therapeutic indications : Spondylitis, Ankylosing