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Protocol - Functional Performance Status

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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.

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.

Availability

Available

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
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

Life Stage

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
StandardNameIDSource
caDSR Common Data Elements (CDE) Karnofsky Performance Status Score 2003853 CDE Browser
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 IDVariable DescriptiondbGaP 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
moving around? show less
N/A
PX320601_Functional_Performance_Status_Difficulty_Working
PX320601060000 Has there been any difficulty working full more
or part time? show less
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
increase in fatigue? show less
N/A
PX320601_Functional_Performance_Status_Weight_Loss_Gain
PX320601010000 Has there been any weight loss or weight gain? N/A
Cancer Outcomes and Survivorship
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