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Karnofsky performance status scale

Definition Performance status % Criteria
• 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 amount of assistance is needed.		 70
  • Care of self.
  • Unable to carry on normal activity or to do active work.
60
  • Requires occasional assistance, but is able to care for most of their 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.
  • Hospitalisation is indicated although death not imminent.
20
  • Hospitalisation necessary, very sick active supportive treatment necessary.
10
  • Moribund.
  • Fatal processes progressing rapidly.
0
  • Dead.
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Bibliography

Karnofsky, David A., Walter H. Abelmann, Lloyd F. Craver, et al. 1948. "The use of the nitrogen mustards in the palliative treatment of carcinoma. With particular reference to bronchogenic carcinoma." Cancer 1(4):634-656.
Schag, C. C., R. L. Heinrich and P. A. Ganz. 1984. "Karnofsky performance status revisited: reliability, validity, and guidelines." J Clin Oncol 2(3):187-193.

Little research has been conducted documenting the reliability and validity of the Karnofsky Performance Status (KPS) scale, and guidelines based on empirical data do not exist to govern its use. Two hundred ninety-three cancer patients completed a questionnaire that assesses their physical and psychosocial difficulties. Physicians rated patients on the KPS and a subsample of 75 patients was used to evaluate interrater reliability. Analyses were conducted to evaluate the interrater reliability and construct validity of the KPS. The KPS was shown to have good reliability and validity. Detailed examination of the reliability data suggested areas in which physicians err in their judgments. Multiple regression techniques were used to empirically identify seven behaviorally based questions that would be helpful in predicting KPS scores. The seven variables included weight loss, weight gain, reduced energy, difficulty walking, driving, grooming, and working part time. An interview approach with behaviorally based guidelines is presented using these variables to obtain relevant data and make more accurate KPS ratings. With the approach suggested and the guidelines presented, oncologists may train themselves to use the KPS in a standard way, which should increase reliability and validity of the KPS and has implications for patients and research studies that use KPS as a stratifying variable.

Version 4

Date Summary of changes
06/05/2020

Internal review. Minor updates and formatting changes.

Review in 2 years.

Version 3

Date Summary of changes
31/05/2017

Transferred to new eviQ website. Version number change to V.2.

Previous website ID: 307
20/2/2019 Reviewed. V3 no other changes.

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https://www.eviq.org.au/p/3062

27 Feb 2021