Moving beyond Karnofsky and ECOG Performance Status Assessments with New Technologies

@article{Kelly2016MovingBK,
  title={Moving beyond Karnofsky and ECOG Performance Status Assessments with New Technologies},
  author={Ciara M. Kelly and Armin Shahrokni},
  journal={Journal of Oncology},
  year={2016},
  volume={2016}
}
Progress in cancer research is coupled with increased treatment complexity reliant upon accurate patient selection. Oncologists rely upon measurement instruments of functional performance such as the Karnofsky or Eastern Cooperative Oncology Group Performance Status scales that were developed over fifty years ago to determine a patient's suitability for systemic treatment. These standard assessment tools have been shown to correlate with response to chemotherapy, chemotherapy tolerability… 

Tables from this paper

Beyond Performance Status

The Correlative Strength of Objective Physical Assessment Against the ECOG Performance Status Assessment in Individuals Diagnosed With Cancer.

Utilization of the BNAT may reflect overall physical performance and provide comprehensive and meaningful detail to influence therapeutic decisions and there was a moderate negative linear relationship of BNAT to ECOG Performance Status scores across all participants.

Performance status and survival in cancer patients undergoing palliative care: retrospective study

PS as assessed by the most widely known tools is strongly associated with overall survival of patients with cancer attending PCS, and no large differences were observed among the scales, though results slightly favour the use of KPS.

Modernizing Clinical Trial Eligibility Criteria: Recommendations of the ASCO-Friends of Cancer Research Performance Status Work Group

Broadening PS eligibility criteria may increase the number of potentially eligible patients for a given clinical trial, thus shortening accrual time, and result in greater participant diversity, potentially reduce trial participant and patient disparities, and enable clinicians to more readily translate trial results to patients with low-functioning PS.

Prognostic value of a patient-reported functional score versus physician-reported Karnofsky Performance Status Score in brain metastases

Use of patient-reported functional outcomes like PRPS can provide the same prognostic information as KPS in patients of NSCLC with brain metastases and PRPS is an independent and significant predictor of survival inbrain metastases.

Performance Status Assessment by Using ECOG (Eastern Cooperative Oncology Group) Score for Cancer Patients by Oncology Healthcare Professionals

No significant variations in PS assessment by oncology HCPs was noted in the study sample, and Eastern Cooperative Oncology Group and Karnofsky performance status (KPS) scores used for this purpose were commonly used.

Comparing Physician and Nurse Eastern Cooperative Oncology Group Performance Status (ECOG-PS) Ratings as Predictors of Clinical Outcomes in Patients with Cancer.

Nurse-rated Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores, compared with those rated by oncologists, better predicted hospitalizations and severe chemotherapy toxicity within 1 month from ECOG- PS assessment, as well as mortality or hospice referrals within 6 months.
...

References

SHOWING 1-10 OF 79 REFERENCES

Performance status score: do patients and their oncologists agree?

There was no sex difference in patient assessment of PS scores, but oncologists scored female patients more pessimistically than males, and it may benefit their clinical practice to involve their patients in these assessments.

Patients with advanced non-small-cell lung cancer and marginal performance status: walking the tight rope towards improved survival.

  • H. West
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2013
Sub subset analyses of trials for patients with advanced NSCLC with eligibility ranging from PS 0 to 2 have historically shown that PS2 patients experience a much shorter survival, highlighting the potential value of studying this population as a distinct clinical entity for which different treatment recommendations may be appropriate.

Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study.

  • A. HurriaK. Togawa W. Tew
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2011
A risk stratification schema can establish the risk of chemotherapy toxicity in older adults and Geriatric assessment variables independently predicted therisk of toxicity.

Performance status assessment in cancer patients. An inter-observer variability study.

An inter-observer variability study of PS assessment has been carried out to evaluate the non- chance agreement among three oncologists rating 100 consecutive cancer patients, and Kappa statistics reveal the ability of the observers compared to change alone and were used to evaluate non-chance agreement.

Assessment of physical functioning in recurrent glioma: preliminary comparison of performance status to functional capacity testing

6MW distance is a clinically feasible tool that provides an objective measure of physical functioning in select patients with recurrent glioma and further research is required to investigate the prognostic value of these tests in patients with advanced malignancy.

Intra and interobserver variability in cancer patients' performance status assessed according to Karnofsky and ECOG scales.

It appears that evaluation of PS made by a clinical oncologist using K or E scales can be very reliable and is a guarantee of optimal selection of cancer patients for inclusion in clinical trials.

Functional decline in older patients with cancer receiving first-line chemotherapy.

The authors' results outline associations between baseline depression, instrumental dependencies, and early functional decline during chemotherapy for older patients and suggest ADL should be sequentially evaluated early during treatment.

Exploring physical activity level in patients with thoracic cancer: implications for use as an outcome measure

The wide variation in physical activity within each ECOG PS category suggests that this scale may lack sufficient sensitivity to evaluate new cachexia treatments, and data from three studies involving the use of one such monitor are collated to inform future work in this area.

Physical activity level as an outcome measure for use in cancer cachexia trials: a feasibility study

The ActivPAL™ is acceptable to patients with outcomes obtained over 6  days recommended for use in future studies, and the optimal period of monitoring was explored by comparing mean values of daily step count and energy expenditure for 2 or 4 and 6 days of monitoring.
...