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Performance scoring - how well you are - used for access to treatments or trials


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Jim Marshall (not a doctor) said ... .

Many drugs and other treatments are unlikely to be of benefit to very sick people, perhaps because they take too long to work, or because of their harshness.

So, sometimes you may see that a drug, a treatment, or a trial requires a performance status.

Performance status is a way doctors have of describing how sick someone is.

If you see that a drug trial requires a "performance status of 0-1", it will be available for patients with:

  • Performance level 0 - able to carry out all activities that they always have;
  • Performance level 1 - able to stay up all day (ambulatory), and able to carry light housework, office work.

but not to patients who are sicker than this.

.. end Jim

The following is part of the Wikipedia article on Performance Status.

Wikipedia article on Performance Status

ECOG/WHO/Zubrod score

The ECOG score (published by Oken et al. in 1982), also called the WHO or Zubrod score (after C. Gordon Zubrod), runs from 0 to 5, with 0 denoting perfect health and 5 death:[2] Its advantage over the Karnofsky scale lies in its simplicity.

0 – Asymptomatic (Fully active, able to carry on all predisease activities without restriction)

1 – Symptomatic but completely ambulatory (Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature. For example, light housework, office work)

2 – Symptomatic, <50% in bed during the day (Ambulatory and capable of all self care but unable to carry out any work activities. Up and about more than 50% of waking hours)

3 – Symptomatic, >50% in bed, but not bedbound (Capable of only limited self-care, confined to bed or chair 50% or more of waking hours)

4 – Bedbound (Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair)

5 – Death

Karnofsky scoring

The Karnofsky score runs from 100 to 0, where 100 is "perfect" health and 0 is death. Although practitioners occasionally assign performance scores in between standard intervals of 10, there is no substantiated rationale for this and prognostication is not improved. This scoring system is named after Dr David A. Karnofsky, who described the scale with Dr Joseph H. Burchenal in 1949.[1]

100% – normal, no complaints, no signs of disease

90% – capable of normal activity, few symptoms or signs of disease

80% – normal activity with some difficulty, some symptoms or signs

70% – caring for self, not capable of normal activity or work

60% – requiring some help, can take care of most personal requirements

50% – requires help often, requires frequent medical care

40% – disabled, requires special care and help

30% – severely disabled, hospital admission indicated but no risk of death

20% – very ill, urgently requiring admission, requires supportive measures or treatment

10% – moribund, rapidly progressive fatal disease processes

0% – death.

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