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Performance Status Scoring : a standards portal resource

By Ann Christine Catlin, Sumudinie fernando, Denise Warzel1, Angela Kummerow2

1. National Cancer Institute 2. CIBMTR

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The scoring scale used may depend on patient population, disease, study goals and other criteria. Many definitions of the scale scoring do not match the standard.

What is Performance Status?

Performance status attempts to quantify the general well-being of cancer and other patients. The score measures their ability to perform ability to perform activities of daily life and is used to determine whether patients can receive certain treatments and whether dose adjustment is necessary.

Ongoing Discussion on "Performance Status Scoring" ... Join us

Ongoing community discussions for finding the right standards representation for your research study at the Performance Status Scoring discussion forum.

Evolving standards and resources for standards ... Help us

To evolve performance status standards or improve community resources, go to the Standards Portal Standards and Discovery Wish List and make a request.

Search, Explore and Discover Performance Status Standards

Use portal DataViews

to browse, search, sort, explore, drill-down and download standards that have been uploaded from caDSR to the Hub portal. DataViews provide direct links back to caDSR and the Term Browser, so find the CDEs, CRFs and Terminology of interest with DataViews, then click the links to go directly to the NCI standards content.

DataViews can also be used to "surface" important information for investigating characteristics of CDE and CRF standards, such as which CDEs share the same Data Element Concept (DEC).

Current Standards for Performance Status Scoring

ECOG Score
Zubrod Score
These scales and criteria are used by doctors and researchers to assess how a patient's disease is progressing, assess how the disease affects the daily living abilities of the patient, and determine appropriate treatment and prognosis. The Eastern Cooperative Oncology Group (ECOG) is one of the largest clinical cancer research organizations in the United States, and conducts clinical trials in all types of adult cancers. Eastern Cooperative Oncology Group

ECOG / Zubrod Performance Status

Karnofsy Score A standard way of measuring the ability of cancer patients to perform ordinary tasks. The Karnofsky Performance scores range from 0 to 100. A higher score means the patient is better able to carry out daily activities. KPS may be used to determine a patient's prognosis, to measure changes in a patient's ability to function, or to decide if a patient could be included in a clinical trial. Karnofsky Performance Status
National Cancer Institute at the National Institutes of Health
Karnofsky performance status revisited: reliability, validity, and guidelines.

Appraisal of the Karnofsky Performance Status and proposal of a simple algorithmic system for its evaluation

Lansky Score The performance status of the child with cancer is an important outcome consideration in pediatric oncology research and practice. However, no single measure for children has been available. This is a report of the development and standardization of such a scale. The play—performance scale for children is a parent-rated instrument which records usual play activity as the index of performance. The measurement of performance in childhood cancer patients
Shirley B. Lansky MD, Marcy A. List PhD, Lester L. Lansky MD, Chris Ritter-Sterr MS,RN, Denis R. Miller MD

Relationships Among Standards: Practical Tools for Comparison

  • TOOL 1: From the European Society for Medical Oncology (ESMO)
    Performance Scales: Karnofsky & ECOG Scores

  • TOOL 2: From the CIBMTR:
    Karnofsy/Lansky Performance Status
    Some transplant centers may prefer to collect and use the ECOG performance score as opposed to the Karnofsky/Lansky score.

  • TOOL 3: Can Karnofsky performance status be transformed to the Eastern Cooperative Oncology Group scoring scale and vice versa?
    There is no consensus regarding the equivalence of performance status between the Karnofsky (KPS) and the Eastern Cooperative Oncology Group (ECOG) scales. In the present study KPS and ECOG scores were compared in 150 consecutive cancer patients. An empirical relation was established through regression analysis in a subsample of 75 patients and the results tested in the second subsample. Transformation tables including 95 and 66% confidence intervals were calculated. Both performance scales are highly correlated, but inferences about individual patients were subject to a high level of error. These results stress the difficulty of translating one score to another, especially in the range of lower performance status where a wide spread is observed.

    The Karnofsky Performance Scale Index allows patients to be classified as to their functional impairment. This can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients. The lower the Karnofsky score, the worse the survival for most serious illnesses.

  • TOOL 5: From
    A Hematology/Oncology Reference Performance Status Comparisons

Adoption Experiences

ITMIG International Database: legacy data and mapping to the standard

From the International Thymic Malignancy Interest Group.

To the right is the part of the "Initial Presentation" Case Report Form (CRF) used by the ITMIG Prospective Database. that includes performance status data elements. The data elements do not conform completely to the NCI Zubrod/ECOG performance status standard, but can easily be made compliant to the standards.with some small changes .

The required changes can be identified by searching the data views at this standards portal. The relevant information is shown to the right of the screenshot.

image Use the portal DataViews to compare and investigate

References to Peer-reviewed Journals

British Journal of Cancer: Performance status assessment in cancer patients. An inter-observer variability study

European Journal of Cancer: Karnofsky and ECOG performance status scoring in lung cancer: A prospective, longitudinal study of 536 patients from a single institution

Journal of the National Cancer Institute: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology

Journal of Clinical Oncology: The Functional Assessment of Cancer Therapy scale: development and validation of the general measure.

Cite this work

Researchers should cite this work as follows:

  • Ann Christine Catlin; Sumudinie fernando; Denise Warzel; Angela Kummerow (2014), "Performance Status Scoring : a standards portal resource,"

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