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Acquired Cold Urticaria Severity Index (ACUSI)

Acquired Cold Urticaria Severity Index (ACUSI)

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The ACUSI is a short questionnaire to assess the severity of disease in patients with acquired cold urticaria. The ACUSI is easy to use and evaluate, meaningful and suitable for all patients with acquired cold urticaria, regardless of the underlying causes. The ACUSI is used in the routine care of patients with cold urticaria, in research projects and in clinical studies.

The ACUSI was developed at the Charité by a team headed by Dr. Frank Siebenhaar and Dr. Marcus Maurer. It consists of four questions with three or four possible answers each. The scores of the four questions are added together. Based on the total score achieved, the severity of the patient's illness is assessed. The more points achieved, the higher the severity of cold urticaria.

In contrast to the disease activity of cold urticaria, the evaluation of disease severity is based on the overall experience of patients with their cold urticaria since its onset. While the disease activity of cold urticaria is variable, for example, when contact with cold is more frequent or less frequent or when therapy is initiated, the severity of cold urticaria changes little over time and increases but does not decrease when this happens. The ACUSI is therefore not suitable for continuous monitoring of disease activity or for evaluating the effectiveness of treatment. Rather, the ACUSI is used at the initial medical contact of patients or before participation in a clinical trial, with the aim of differentiating between patients with severe, moderate and mild cold urticaria.

The ACUSI has not yet been validated. For the assessment of disease severity using a tool developed and validated according to guidelines, we recommend the use of the Severity Index Cold Urticaria, SICU.

Quick Facts ACUSI:
Number of questions: 4
Suited for: Adults (≥18 years old) with cold urticaria
Period queried: Duration of illness since onset
Evaluation: Total score (minimum: 4, maximum: 15)
Time required: <1 minute
Evaluation time: <1 minute
Copyright: Moxie GmbH (
Terms of Use: The use of the ACUSI in routine clinical care as well as in the context of non-commercial research is free of charge. For use in clinical studies or commercial research, a small user fee is charged.

Siebenhaar, F., Degener, F., Zuberbier, T., Martus, P., and Maurer, M.: High-dose desloratadine decreases wheal volume and improves cold provocation thresholds compared with standard-dose treatment in patients with acquired cold urticaria: a randomized, placebo-controlled, crossover study. J. Allergy Clin. Immunol. 2009: 123; 672-679.

Commercial or non-commercial

If you are interested or on request, we will be happy to send you our PROMs (Patient Reported Outcomes Measures) on the various topics by e-mail. 

Please understand that we have to charge a fee of 15 Euro per PRO when using our PROMs for commercial purposes. Commercial use include, for example, use in industry-sponsored studies, market research and similar purposes.

By non-commercial use we mean e.g. use for consultation hours in hospitals and private practices, use within scientific studies without sponsoring. The prerequisite is that no commercial interest is pursued.

Frequently Asked Questions

Why are there PRO (Patient Reported Outcomes) products that cost nothing and others that cost 15 Euros?

If you plan to use PRO (Patient Reported Outcomes) products (e.g. AAS, AE-QoL, UCT) commercially, there is a small fee per patient (15 €). This applies, for example, to industry-sponsored trials and clinical studies or market research.
You can order free versions, if you plan to use them for non commercial purposes, e.g. for patient management or for academia-driven non commercial
research projects. When you order PRO (Patient Reported Outcomes) products, these instruments are sent per e-mail.

I would like to use PRO (Patient Reported Outcomes) products commercially. Do I have to buy one version each for every time I plan to use it, even in the same patient?

No. Each PRO (Patient Reported Outcomes) products you purchase can be used multiple time by the same patient.

What do I do if PRO (Patient Reported Outcomes) products are not available for my country or in the language I need?

The version you are looking for is probably already under development. Feel free to get in touch with us by e-mail to check when it will be available.