The Karnofsky performance status scale: An examination of its reliability and validity in a research setting

Abstract

The Karnofsky Performance Status Scale (KPS) is widely used to quantify the functional status of cancer patients. However, limited data exist documenting its reliability and validity. The KPS is used in the National Hospice Study (NHS) as both a study eligibility criterion and an outcome measure. As part of intensive training, interviewers were instructed in and tested on guidelines for determining the KPS levels of patients. After 4 months of field experience, interviewers were again tested based on narrative patient descriptions. The interrater reliability of 47 NHS interviewers was found to be 0.97. The construct validity of the KPS was analyzed, and the KPS was found to be strongly related (P < 0.001) to two other independent measures of patient functioning. Finally, the relationship of the KPS to longevity (r = 0.30) in a population of terminal cancer patients documents its predictive validity. These findings suggest the utility of the KPS as a valuable research tool when employed by trained observers.

A multidimensional examination of correlates of fatigue during radiotherapy

“…Recommended scoring methods for each questionnaire were applied to obtain raw and subscale scores for the MFI, 9 EuroQol 5 Dimensions questionnaire, 32 KPS scale, 20 FAI, 33 IPAQ, 34 HADS, 24 MST, 27 MOSS measure, 29 and HLQ. 31 Dummy variables were created for categoric data.…”

“…Patients were included in the study if they were aged >18 years, were undergoing treatment with radiotherapy or concurrent radiotherapy and chemotherapy for cure or control of cancer rather than palliation, were able to communicate in English, had adequate cognition to complete the assessments, and had a physical performance status ranging from normal to requiring occasional assistance as demonstrated by a Karnofsky performance status (KPS) of 60 to 100. 19,20 Patients with breast cancer were excluded from the study because of a separate intervention study being conducted at the research location that may have contaminated results.…”

“…Each subscale consists of 4 items, 2 indicative of fatigue and 2 contraindicative (subscale score range, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The responder indicates on a scale of 1 to 5 to what extent the statement applies to him or her.…”

“…The inter-rater reliability, construct validity, and predictive validity have all been reported to be high. 19,20 their activities over the recent past across 3 activity domains-domestic, leisure/work, and outdoors-which are also compiled into a single summary score (with a range of 15-60 points), with a higher score indicating more frequent activity participation. The FAI has good construct validity, particularly in middle-aged and elderly people, and is reliable.…”

Metastatic paraplegia: care management characteristics within a rehabilitation center

“…We are probably faced with a selection bias since the patients were included based on a vital prognosis43 months and an aptitude to undergo at least 3 h of rehabilitation training per day. A literature analysis led us to assess the evolution rate using the Karnofsky performance status scale (KPSS) 26 (Table 2), a so-called Piper fatigue scale 27,28 and the FIM. 29 The correlation between the FIM and the KPSS is linear.…”