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COA Instruments Distributed by Mapi Research Trust

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CDSD© / Celiac Disease Symptom Diary Celiac Disease Symptom Diary

Alvine therapeutics et al.

To capture celiac symptom data

Therapeutic indications : Celiac Disease

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CDSS / Calgary Depression Scale for Schizophrenia Calgary Depression Scale for Schizophrenia

Addington D, Addington J, Schissel B et al.

To assess the level of depression in schizophrenia (assess depressive symptoms separate from positive, negative and extrapyramidal symptoms)

Therapeutic indications : Schizophrenia

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CECA / Cuestionario Específico en Condilomas Acuminados Cuestionario Específico en Condilomas Acuminados

Badia X et al.

To measure health-related quality of life in patients with anogenital warts

Therapeutic indications : Warts

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CES-D / Center for Epidemiologic Studies Depression Scale Center for Epidemiologic Studies Depression Scale

Center for Epidemiologic Studies from the National Institute of Mental Health et al.

To assess the frequency and severity with which symptoms of depression are experienced in the general population

Therapeutic indications : Depression

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CGI / Clinical Global Impressions scale Clinical Global Impressions scale

National Institute of Mental Health (NIMH) et al.

To provide a brief, stand-alone assessment of the clinician’s view of the patient’s global functioning prior to and after initiating a study medication

Therapeutic indications : Generic for Mental Disorders

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CGI-I / Clinical Global Impression scale-Improvement Clinical Global Impression scale-Improvement

National Institute of Mental Health (NIMH) et al.

To provide a brief, stand-alone assessment of the clinician’s view of the patient’s global functioning prior to and after initiating a study medication in mental disorders.

Therapeutic indications : Generic for Mental Disorders

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CGI-S / Clinical Global Impression scale - Severity of Illness Clinical Global Impression scale - Severity of Illness

National Institute of Mental Health (NIMH) et al.

To provide a brief, stand-alone assessment of the clinician’s view of the patient’s global functioning prior to and after initiating a study medication

Therapeutic indications : Generic for Mental Disorders

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CGI-SCA / Clinical Global Impression for Schizoaffective Disorder Scale Clinical Global Impression for Schizoaffective Disorder Scale

Allen MH, Daniel DG, Revicki DA, Canuso CM, Turkoz I, Fu DJ, Alphs L, Ishak KJ, Bartko JJ, Lindenmayer JP et al.

To assess the effectiveness of a treatment or combination of treatments

Therapeutic indications : Psychotic Disorders

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CH-RLSq13 / Cambridge - Hopkins Restless Legs Syndrome Short Form 2 DIAGNOSTIC QUESTIONNAIRE Cambridge - Hopkins Restless Legs Syndrome Short Form 2 DIAGNOSTIC QUESTIONNAIRE

Allen RP, Burchell BJ, MacDonald B, Hening WA, Earley CJ et al.

To enable diagnosis of RLS

Therapeutic indications : Restless Legs Syndrome

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CHES-Q / Current Health Satisfaction Questionnaire Current Health Satisfaction Questionnaire

Janssen Global Services, LLC (USA) et al.

To assess diabetes-related health satisfaction, and knowledge of the disease and important laboratory measures

Therapeutic indications : Diabetes Mellitus, Type 2

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CHRT-C / Concise Health Risk Tracking Clinician Rating scale Concise Health Risk Tracking Clinician Rating scale

Trivedi MH, Zisook S, Luther JF, Husain MM, Gaynes BN, Nierenberg AA, Warden D, Gollan JK, Morris DW, Wisniewski SR, Fava M, Rush AJ et al.

To rate factors related to the risk of suicide attempt or completion

Therapeutic indications : Suicide Ideation

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CHRT-SR12 / Concise Health Risk Tracking Self-Report scale - 12 item self-report Concise Health Risk Tracking Self-Report scale - 12 item self-report

Trivedi MH, Wisniewski SR, Morris DW, Fava M, Gollan JK, Warden D, Nierenberg AA, Gaynes BN, Husain MM, Luther JF, Zisook S, Rush AJ et al.

To rate factors related to the risk of suicide attempt or completion

Therapeutic indications : Suicide Ideation

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CHRT-SR14 / CHRT-SR14 - Concise Health Risk Tracking - 14-item self-report CHRT-SR14 - Concise Health Risk Tracking - 14-item self-report

Trivedi MH, Wisniewski SR, Morris DW, Fava M, Gollan JK, Warden D, Nierenberg AA, Gaynes BN, Husain MM, Luther JF, Zisook S, Rush AJ et al.

To rate factors related to the risk of suicide attempt or completion

Therapeutic indications : Suicide Ideation

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CHRT-SR7 / Concise Health Risk Tracking Self-Report scale - 7 item self-report Concise Health Risk Tracking Self-Report scale - 7 item self-report

Trivedi MH, Zisook S, Luther JF, Husain MM, Gaynes BN, Nierenberg AA, Warden D, Gollan JK, Morris DW, Wisniewski SR, Fava M, Rush AJ et al.

To rate factors related to the risk of suicide attempt or completion

Therapeutic indications : Suicide Ideation

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CIS / Columbia Impairment Scale Columbia Impairment Scale

Bird H, Gould M, Staghezza B, Chen J, Hoven C, Shaffer D, Fisher P et al.

To measure global impairment in children and adolescents

Therapeutic indications : Autism Spectrum Disorder

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CMCQ / Comorbid Medical Conditions Questionnaire Comorbid Medical Conditions Questionnaire

MacLean EW, Palsson OS, Turner MJ, Whitehead WE et al.

To measure non-gastrointestinal symptoms that co-exist with Irritable Bowel Syndrome (IBS)

Therapeutic indications : Irritable Bowel Syndrome

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COMM / Current Opioid Misuse Measure Current Opioid Misuse Measure

Butler SF, Budman SH, Fernandez KC, Houle B, Benoit C, Katz N, Jamison RN et al.

To detect concurrent opioid misuse among patients prescribed opioid therapy for chronic pain

Therapeutic indications : Pain

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Contilife® / Quality of Life Assessment Questionnaire Concerning Urinary Incontinence Quality of Life Assessment Questionnaire Concerning Urinary Incontinence

Sanofi Aventis, Mapi et al.

To assess the impact of urinary incontinence on quality of life

Therapeutic indications : Urinary Incontinence

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CQLQ / Caregiver Quality Of Life Questionnaire (Physical & Emotional) Caregiver Quality Of Life Questionnaire (Physical & Emotional)

Bates GE, Hashimi AK, Bressler T, Zajac J, Hesdorffer M, Taub RN et al.

To assess physical and emotional quality of life in caregivers

Therapeutic indications : All

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CQLQ© / Cough Quality of Life Questionnaire Cough Quality of Life Questionnaire

Irwin RS, Fletcher KE, French CT et al.

Designed to reflect the impact of cough on health-related quality of life in patients complaining of acute and chronic cough

Therapeutic indications : Cough