Protocol - Functional Performance Status
Description
The KPS scale is a standard way of measuring the ability of cancer patients to perform ordinary tasks. The scale describes functional status on a 11-point scale, with items in 10- unit increments Scores range from 0 to 100. A higher score indicates better functioning and greater ability to carry out daily activities. The KPS scale 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. The score can be used to track disease progression.
Specific Instructions
A baseline KPS score should be recorded. Following this assessment, the KPS scale should be completed any time significant changes occur in a patient’s status and documented where the data for the study is being captured. Please be aware that the KPS scale has only been validated as a predictor of terminal decline in cancer and HIV patients.
Availability
Protocol
How to complete the KPS
1. Nurses, physicians, and patients may complete the KPS scale. Please note that patients ratings are more accurate than clinician ratings.
2. Review KPS scale form.
3. Review medical record to assess presence and extent of specific disease, signs and symptoms.
4. During assessment, observe the patient’s subtle dependencies and interactions within the existing support networks.
5. Interview patient and/or family to obtain functional assessment information using questions
The following questions can begin to serve as guidelines and aid in the standardization for increased consistency for determining the performance status of an individual patient.
Evidence of Disease
1. Has there been any weight loss or weight gain?
2. Has there been any reduction in energy or increase in fatigue?
Self-Care
1. Has there been any difficulty grooming or bathing?
Daily Activities
1. Has there been any difficulty in walking or moving around?
2. Has there been any difficulty driving?
Work Difficulty
1. Has there been any difficulty working full or part time?
The information obtained from these questions, the assessment and other medical data should be used to determine a KPS score.
Following the admission assessment, when possible, the same health care provider should administer the scale on subsequent evaluations.
| Condition | Performance status % | Comments |
| Able to carry on normal activity and to work. No special care needed. | [ ] 100 | Normal. No complaints. No evidence of disease. |
| [ ] 90 | Able to carry on normal activity. Minor signs or symptoms of disease. | |
| [ ] 80 | Normal activity with effort. Some signs or symptoms of disease. | |
| Unable to work. Able to live at home and care for most personal needs. A varying degree of assistance is needed. | [ ] 70 | Cares for self. Unable to carry on normal activity or to do active work. |
| [ ] 60 | Requires occasional assistance, but is able to care for most of personal needs. | |
| [ ] 50 | Requires considerable assistance and frequent medical care. | |
| Unable to care for self. Requires equivalent of institutional or hospital care. Disease may be progressing rapidly. | [ ] 40 | Disabled. Requires special care and assistance. |
| [ ] 30 | Severely disabled. Hospital admission is indicated although death is not imminent. | |
| [ ] 20 | Hospitalization necessary. Very sick, active supportive treatment necessary. | |
| [ ] 10 | Moribund; fatal processes progressing rapidly. | |
| [ ] 0 | Dead. |
Personnel and Training Required
None
Equipment Needs
None
Requirements
| Requirement Category | Required |
|---|---|
| Major equipment | No |
| Specialized training | No |
| Specialized requirements for biospecimen collection | No |
| Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Physical measurement and/or medical record abstraction
Lifestage
Adult, Senior
Participants
Adult cancer patients and other populations
Selection Rationale
The Karnofsky Performance Status (KPS) scale is used extensively and for many purposes, including an evaluation of responses to chemotherapy in cancer and chronic disease assessment. It quantifies a patient’s functional abilities and the impact of treatments like chemotherapy on their basic functional capacities. It can be used prognostically and to help determine treatment options. There is a formula to map the KPS score to the ECOG Performance Status score.
Language
English
Standards
| Standard | Name | ID | Source |
|---|
Derived Variables
None
Process and Review
Not Applicable
Protocol Name from Source
Karnofsky Performance Status Scale (KPS)
Source
Karnofsky, DA, Burchenal, JH. The Clinical Evaluation of Chemotherapeutic Agents in Cancer. Pg. 196. IN: MacLeod CM (Ed), Evaluation of Chemotherapeutic Agents. Columbia Univ Press, 1949.
General References
Sperduto PW, Kased N, Roberge D, Xu Z, Shanley R, Luo X, Sneed PK, Chao ST, Weil RJ, Suh J: Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol. 2012, 30 (4): 419-425. 10.1200/JCO.2011.38.0527
Carson KA, Grossman SA, Fisher JD, Shaw EG: Prognostic factors for survival in adult patients with recurrent glioma enrolled onto the new approaches to brain tumor therapy CNS consortium phase I and II clinical trials. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2007, 25 (18): 2601-2606. 10.1200/JCO.2006.08.1661
Abernethy AP, Shelby-James T, Fazekas BS, Woods D, Currow DC: The Australia-modified Karnofsky Performance Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice [ISRCTN81117481]. BMC palliative care. 2005, 4: 7-10.1186/1472-684X-4-7.
Crooks, V, Waller S, et al. The use of the Karnofsky Performance Scale in determining outcomes and risk in geriatric outpatients. J Gerontol. 1991; 46: M139-M144.
de Haan R, Aaronson A, et al. Measuring quality of life in stroke. Stroke. 1993; 24:320- 327.
Hollen PJ, Gralla RJ, et al. Measurement of quality of life in patients with lung cancer in multicenter trials of new therapies. Cancer. 1994; 73: 2087-2098.
O'Toole DM, Golden AM. Evaluating cancer patients for rehabilitation potential. West J Med. 1991; 155:384-387.
Oxford Textbook of Palliative Medicine, Oxford University Press. 1993;109.
Schag CC, Heinrich RL, Ganz PA. Karnofsky performance status revisited: Reliability, validity, and guidelines. J Clin Oncology. 1984; 2:187-193.
Protocol ID
320601
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX320601_Functional_Performance_Status_Difficulty_Driving | ||||
| PX320601050000 | Has there been any difficulty driving? | N/A | ||
| PX320601_Functional_Performance_Status_Difficulty_Grooming_Bathing | ||||
| PX320601030000 | Has there been any difficulty grooming or bathing? | N/A | ||
| PX320601_Functional_Performance_Status_Difficulty_Walking_Moving | ||||
| PX320601040000 | Has there been any difficulty in walking or more | N/A | ||
| PX320601_Functional_Performance_Status_Difficulty_Working | ||||
| PX320601060000 | Has there been any difficulty working full more | N/A | ||
| PX320601_Functional_Performance_Status_Difficulty_Working_Describe1 | ||||
| PX320601070000 | Describe the condition: | N/A | ||
| PX320601_Functional_Performance_Status_Difficulty_Working_Describe2 | ||||
| PX320601080000 | Describe the condition: | N/A | ||
| PX320601_Functional_Performance_Status_Difficulty_Working_Describe3 | ||||
| PX320601090000 | Describe the condition: | N/A | ||
| PX320601_Functional_Performance_Status_Reduction_Energy_Fatigue | ||||
| PX320601020000 | Has there been any reduction in energy or more | N/A | ||
| PX320601_Functional_Performance_Status_Weight_Loss_Gain | ||||
| PX320601010000 | Has there been any weight loss or weight gain? | N/A | ||
Measure Name
Functional Performance Status
Release Date
December 17, 2020
Definition
The Karnofsky Performance Status (KPS) scale is an assessment tool intended to assist clinicians and family caregivers in gauging a patient’s functional status and ability to carry out activities of daily living. It has been shown to be prognostic and is often used to determine how a patient will tolerate therapy or be eligible to participate in a clinical trial. Scores are assigned ranging from 0 which indicates death or non- functioning, to 100 which indicates no disease and full functioning.
Purpose
The KPS Scale classifies patients into groups associated with specific levels of functional impairment. This score can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients.
Keywords
Karnofsky Performance Status scale, cancer patients, functional status, functional impairment, functional capacity, cognitive, functional ability, performance status, survival, Cancer outcomes and survivorship, palliative care
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 320601 | Functional Performance Status |
Publications
There are no publications listed for this protocol.