In medicine (oncology and other fields), performance status is an attempt to quantify cancer patients' general wellbeing. This measure is used to determine whether they can receive chemotherapy, whether dose adjustment is necessary, and as a measure for the required intensity of palliative care. It is also used in oncological randomized controlled trials as a measure of quality of life. Medicine is a branch of health science concerned with restoring and maintaining health. ... Please refer to cancer for the biology of malignant disease, as well as a list of malignant diseases. ... When normal cells are damaged or old they undergo apoptosis; cancer cells, however, avoid apoptosis. ... Although every disease has its patients, to be a cancer patient has a very specific meaning, both to the patients and their relatives and the general public. ... Chemotherapy is the use of chemical substances to treat disease. ... Palliative care is any form of medical care or treatment that concentrates on reducing the severity of the symptoms of a disease or slows its progress rather than providing a cure. ... Please refer to cancer for the biology of malignant disease, as well as a list of malignant diseases. ... A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ... The well-being or quality of life of a population is an important concern in economics and political science. ...

Scoring systems

There are various scoring systems. The most generally used are the Karnofsky score and the Zubrod score, the latter being used in publications by the WHO. For children, the Lansky score is used. For other meanings of the acronym WHO, see WHO (disambiguation) WHO flag Headquartered in Geneva, Switzerland, the World Health Organization (WHO) is an agency of the United Nations, acting as a coordinating authority on international public health. ...

Parallel scoring systems include the Global Assessment of Functioning (GAF) score, which has been incorporated as the fifth axis of the Diagnostic and Statistical Manual (DSM) of psychiatry. The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, is the handbook used most often in diagnosing mental disorders in the United States and other countries. ... Psychiatry is a branch of medicine that studies and treats mental and emotional disorders (see mental illness). ...

Karnofsky scoring

The Karnofsky score runs from 100 to 0, where 100 is "perfect" health and 0 is death. Although the score has been described with intervals of 10, a practitioner may choose decimals if he or she feels a patient's situation holds somewhere between two marks.

• 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% - , 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.

Zubrod score

The WHO/Zubrod score (also sometimes called the "Eastern Cooperative Oncology Group" score) runs from 0 to 5, with 0 denoting perfect health and 5 death:

• 0 - Asymptomatic
• 1 - Symptomatic but completely ambulant
• 2 - Symptomatic, <50% in bed during the day
• 3 - Symptomatic, >50% in bed, but not bedbound
• 4 - Bedbound
• 5 - Death

Lansky score

Children, who might have more trouble expressing their experienced quality of life, require a somewhat more observational scoring system:

• 100 - fully active, normal
• 90 - minor restrictions in strenous physical activity
• 80 - active, but tired more quickly
• 70 - greater restriction of play and less time spent in play activity
• 60 - up and around, but active playminimal; keeps busy by being involved in quieter activities
• 50 - lying around much of the day, but gets dressed; no active playing participates in all quiet play and activities
• 40 - mainly in bed; participates in quiet activities
• 30 - bedbound; needing assistance even for quiet play
• 20 - sleeping often; play entirely limited to very passive activities
• 10 - doesn't play; does not get out of bed
• 0 - unresponsive

References

• Performance status calculator (http://www.fda.gov/cder/cancer/perstatframe.htm) (FDA)
• A table (http://www.hospicepatients.org/karnofsky.html) with the Karnofsky Performance Status.
• Karnofsky and Zubrod/WHO score (http://www.slz.nl/hora/protocol/appendices/whoperfo.htm)