Research Instruments



NMOU Risk/History of Alcoholism and Substance Abuse
  • CAGE (Cut Down, Annoyed, Guilty, and Eye-Opener) Questionnaire: A simple 4 question validated screening survey for alcoholism. Positive CAGE score ≥ (2 of 4) = high risk of NMOU
  • CAGE-AID (CAGE-Adjusted to Include Drugs Questionnaire): An adaptation of the original CAGE questionnaire that includes illicit drugs. Positive CAGE-AID score ≥ (2 of 4) = high risk of NMOU
  • SOAPP (Screener and Opioid Assessment for Patients with Pain): A 14-item survey that asks questions about the patient’s history of substance use, medication-related behaviors, and psychiatric and neurobiological need for medicine
Symptom Assessment
  • ESAS (Edmonton Symptom Assessment Scale): A validated tool that measures the average intensity of 12 symptoms in cancer patients over the past 24 hours (pain, fatigue, nausea, depression, anxiety, drowsiness, appetite, feeling of well-being, shortness of breath, sleep, spiritual distress, and financial distress). Provides information regarding the patient's overall symptom burden.
Mood: Depression/Anxiety
  • PHQ-9 (Patient Health Questionnaire-9 Items): A validated, simple (9 items) questionnaire that screens for depression in medical settings. Positive PHQ-9 (>10) indicates depression
  • GAD-7 (Generalized Anxiety Disorder-7 Items): A validated, simple (7 items) assessment for anxiety in patients. Scores of >5, >10, and >15 indicate mild, moderate, and severe levels of anxiety, respectively. 
  • HADS (Hospital Anxiety and Depression Scale): A validated 14-item self-assessment scale for detecting states of anxiety and depression. Asks patients to mark the answer that comes closest to how they have been feeling in the past week. Contact the publisher for use (
  • FACT-G (Functional Assessment of Cancer Therapy-General): A quality-of-life instrument commonly used in cancer clinical trials. Consists of 27 questions divided into 4 domains (physical, social, emotional, and functional). Includes the 13-item fatigue subscale (FACIT-F Subscale) in which the patient rates the intensity of fatigue and its related symptoms on a scale from 0-4 in the past week. The total score can range between 0-52, with higher scores denoting less fatigue.

Selected Publications

Arthur J et al. Frequency, Predictors, and Outcomes of Urine Drug Testing Among Patients With Advanced Cancer on Chronic Opioid Therapy at an Outpatient Supportive Care Clinic. Cancer. 2016;122:3732-9. X X
Yennurajalingam S et al. Sleep disturbance in patients with cancer: a feasibility study of multimodal therapy. BMJ Supportive & Palliative Care. 2020; 0:1-10. X X
Arthur J et al. Random vs Targeted Urine Drug Testing among patients undergoing long-term opioid treatment for cancer pain. JAMA Oncol. 2020; published online February 6, 2020. X X
Haider A, et al. Implications of the parenteral opioid shortage for prescription patterns and pain control among hospitalized patients with cancer referred to palliative care. JAMA Oncol. 2019;5(6):841-846. X X
Azhar A, et al. Frequency of concomitant use of opioids and psychoactive medications among cancer patients referred to outpatient palliative care. JPSM. 2019;57(6):e7-e10. X X
Yennurajalingam S, et al. Patterns of opioid prescription, use, and costs among patients with advanced cancer and inpatient palliative care between 2008 and 2014. J Oncol Pract. 2019;15(1):e74-e83. X X
Dev R, et al. Association between tobacco use, pain expression, and coping strategies among patients with advanced cancer. Cancer. 2019;125(1):153-160. X X X
Azhar A, et al. Response to oral immediate-release opioids for breakthrough pain in patients with advanced cancer with adequately controlled background pain. Oncologist. 2019;24(1):125-131. X X
Yennurajalingam S, et al. Predicting the risk for aberrant opioid use behavior in patients receiving outpatient supportive care consultation at a comprehensive cancer center. Cancer. 2018;124(19):3942-3949. X X X
Arthur J, et al. Outcomes of a specialized interdisciplinary approach for patients with cancer with aberrant opioid-related behavior. Oncologist. 2018;23(2):263-270. X X