Core Outcome Measures Index (Neck) Flow

Core Outcome Measures Index (Neck) flow


The COMI is a validated multidimensional questionnaire for assessing the key outcomes of importance to patients with back (or neck) problems. Being brief, it is associated with minimal respondent burden and high completion rates [1-2]. The comi back questions have been adapted for the cervical spine, by enquiring about neck rather than back problems, and it too showed good validity and reliability [3]. Additionally further studies showed that the COMI neck is a valid and responsive instrument for use in assessing the outcome of patients undergoing cervical spine surgery [4].

The Core Outcome Measures Index (Neck) flow contains the Core Outcome Measures Index (Neck) questionnaire and associated calculation. After form submission, the Core Outcome Measures Index (Neck) calculation is executed automatically. It's easy to extend this flow with conditional logic based on the interpretation of the Core Outcome Measures Index (Neck) calculation.

Core Outcome Measures Index (Neck) questionnaire



  1. Neck pain
  2. Arm / shoulder pain
  3. Function
  4. Symptom specific well being
  5. General QOL
  6. Social disability
  7. Work disability

Click here to open the English version of the COMI-back


The COMI neck is scored similar to the comi back.
Link to calculation manual.

  • The higher of the two pain scores (item 1a and 1b) is taken as the "pain" score.
  • The average of the two disability items (items 5 and 6) forms the disability score.

The five domain scores for pain (higher of items 1a and 1b), neck-related function (item 2), symptom-specific well-being (item 3), general quality of life (item 4) and disability (average of items 5 and 6) are then averaged to give you a COMI score from 0-10.


[1] Deyo RA, Battie M, Beurskens AJ, Bombardier C, Croft P, Koes B, Malmivaara A, Roland M, Von Korff M, Waddell G. Outcome measures for low back pain research. A proposal for standardized use. Spine (Phila Pa 1976). 1998 Sep 15;23(18):2003-13. doi: 10.1097/00007632-199809150-00018. Erratum in: Spine 1999 Feb 15;24(4):418. PMID: 9779535.\
[2] Mannion AF, Porchet F, Kleinstück FS, Lattig F, Jeszenszky D, Bartanusz V, Dvorak J, Grob D. The quality of spine surgery from the patient's perspective. Part 1: the Core Outcome Measures Index in clinical practice. Eur Spine J. 2009 Aug;18 Suppl 3(Suppl 3):367-73. doi: 10.1007/s00586-009-0942-8. Epub 2009 Mar 25. PMID: 19319578; PMCID: PMC2899316.\
[3] White P, Lewith G, Prescott P. The core outcomes for neck pain: validation of a new outcome measure. Spine (Phila Pa 1976). 2004 Sep 1;29(17):1923-30. doi: 10.1097/01.brs.0000137066.50291.da. PMID: 15534418.\
[4] Fankhauser CD, Mutter U, Aghayev E, Mannion AF. Validity and responsiveness of the Core Outcome Measures Index (COMI) for the neck. Eur Spine J. 2012 Jan;21(1):101-14. doi: 10.1007/s00586-011-1921-4. Epub 2011 Aug 20. Erratum in: Eur Spine J. 2012 Mar;21(3):561. PMID: 21858567; PMCID: PMC3252436.

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