Assessing Functional Status
The ECOG Performance Status Scale and the Karnofsky Performance Status Scale are two widely used methods to assess the functional status of a patient.
The Karnofsky index, between 100 and 0, was introduced in a textbook in 1949.^ Key elements of the ECOG scale first appeared in the medical literature in 1960.^^
There are several ways to map the two scales. The table below displays one commonly used comparison.
| ECOG PERFORMANCE STATUS | KARNOFSKY PERFORMANCE STATUS |
|---|---|
| 0—Fully active, able to carry on all pre-disease performance without restriction | 100—Normal, no complaints; no evidence of disease |
| 90—Able to carry on normal activity; minor signs or symptoms of disease | |
| 1—Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work | 80—Normal activity with effort, some signs or symptoms of disease |
| 70—Cares for self but unable to carry on normal activity or to do active work | |
| 2—Ambulatory and capable of all selfcare but unable to carry out any work activities; up and about more than 50% of waking hours | 60—Requires occasional assistance but is able to care for most of personal needs |
| 50—Requires considerable assistance and frequent medical care | |
| 3—Capable of only limited selfcare; confined to bed or chair more than 50% of waking hours | 40—Disabled; requires special care and assistance |
| 30—Severely disabled; hospitalization is indicated although death not imminent | |
| 4—Completely disabled; cannot carry on any selfcare; totally confined to bed or chair | 20—Very ill; hospitalization and active supportive care necessary |
| 10—Moribund | |
| 5—Dead | 0—Dead |
^ Karnofsky DA, Burchenal JH, The clinical evaluation of chemotherapeutic agents in cancer. In: Evaluation of Chemotherapeutic Agents. Edited by: MacLeod CM. New York, NY: Columbia University Press; 1949:191–205.
^^ Zubrod C, et al. Appraisal of methods for the study of chemotherapy in man: Comparative therapeutic trial of nitrogen mustard and thiophosphoramide. Journal of Chronic Diseases; 1960:11:7-33.