Skip to main content
. Author manuscript; available in PMC: 2020 Jul 3.
Published in final edited form as: Contemp Clin Trials. 2020 Feb 19;91:105961. doi: 10.1016/j.cct.2020.105961

Table 1.

Assessment Instruments and Timeline.

Instrument name Purpose/domain Baseline Weekly End of treatment Follow up
Informed consent Obtain informed consent X
Demographics form Characterize sample X
History and physical examination Assess medical problems & eligibility X
MINI interview for DSM-5 Assess AUD and other DSM-5 psychiatric disorders X
Columbia-suicide severity rating scale: CSSRSa Assess suicidality & eligibility X Week 6 X X
Pregnancy test for female subjectsb Assess for pregnancy X Week 6
Clinical institute withdrawal assessment of alcohol-revised: CIWA Study eligibility, safety X
Urine drug screen tests: UDSa Assess drug use X Week 6 X X
Breathalyzer Assess alcohol use (biological) X X X X
Adverse events Monitor AEs and safety X X X X
Vital signs Blood pressure and heart rate X X X
Concurrent medications form Monitor medications X X X X
Medication adherence log Assess medication compliance X X
Urine riboflavin testa Biomarker of medication compliance Week 6 X
Clinician administered PTSD scale: CAPS-5a PTSD diagnosis and symptoms (clinician rated) X Week 6 X X
PTSD checklist: PCL-5 PTSD symptoms (self-report) X X X X
Timeline follow-back: TLFB Assess alcohol use (amount and frequency) X X X X
Obsessive compulsive drinking scale: OCDS Measure alcohol craving X X X X
Visual analog scale: VAS Assess alcohol craving X X X X
Alcohol use disorders identification test: AUDIT Assess alcohol use and related problems X Month 12
Ethyl Glucuronide: EtGa Biomarker of alcohol use Week 6 X X
Beck depression inventory-II: BDI-lI Measure depression X X X X
Satisfaction questionnaire Asses overall satisfaction X Month 12
Treatment services review Monitor services utilization X X X X

Note. Follow up = 3, 6, and 12 months following treatment.

a

Repeated at week 6.

b

Pregnancy test at baseline, before medication initiation, before neuroimaging sessions, and at week 6.