AKPS - Assesses performance status
The AKPS is a measure of the patient’s overall performance status or ability to perform their activities of daily living. It is a single score between 10 and 100 assigned by a clinician based on observations of a patient’s ability to perform common tasks relating to activity, work and self-care. A score of 100 signifies normal physical abilities with no evidence of disease. Decreasing numbers indicate a reduced performance status.
| AKPS ASSESSMENT CRITERIA |
SCORE |
| Normal; no complaints; no evidence of disease |
100 |
| Able to carry on normal activity; minor sign of symptoms of disease |
90 |
| Normal activity with effort; some signs or symptoms of disease |
80 |
| Cares for self; unable to carry on normal activity or to do active work |
70 |
| Able to care for most needs; but requires occasional assistance |
60 |
| Considerable assistance and frequent medical care required |
50 |
| In bed more than 50% of the time |
40 |
| Almost completely bedfast |
30 |
| Totally bedfast and requiring extensive nursing care by professionals and/or family |
20 |
| Comatose or barely rousable |
10 |
| Dead |
0 |
Serial AKPS scores are a valuable way to monitor disease activity and treatment.
From: Palliative Care Outcomes Collaborative (PCOC) (Go to Assessment tools and AKPS)
Ref: Abernethy AP, Shelby-James T, Fazekas BS, Woods D, Currow DC. The Australia-modified Karnofsky Performance Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice. BMC Palliat Care. 2005 Nov 12;4:7.
ECOG - Assesses performance status
ECOG PERFORMANCE STATUS*
| Grade |
ECOG |
| 0 |
Fully active, able to carry on all pre-disease performance without restriction |
| 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 |
| 2 |
Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours |
| 3 |
Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours |
| 4 |
Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair |
| 5 |
Dead |
The ECOG Performance Status is in the public domain therefore available for public use. To duplicate the scale, please cite the reference above and credit the Eastern Cooperative Oncology Group, Robert Comis M.D., Group Chair.
From: Eastern Cooperative Oncology Group (ECOG)
* As published in Am. J. Clin. Oncol.
Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982 Dec;5(6):649-55.
SPICT - Prognostic guidance for cancer, organ failure and dementia
Supportive and Palliative Care Indicators Tool (SPICT)
- General prognostic indicators are provided for all patients approaching end-of-life
- Specific prognostic indicators are provided for a range of common medical conditions: cancer, chronic obstructive pulmonary disease, heart disease, renal disease, general neurological disease, motor neurone disease, Parkinson’s disease, multiple sclerosis, stroke, dementia and frailty.
Ref: Highet G, Crawford D, Murray SA, Boyd K. Development and evaluation of the Supportive and Palliative Care Indicators Tool (SPICT): a mixed-methods study. BMJ Support Palliat Care. 2014 Sep;4(3):285-90. Epub 2013 Jul 25.
Palliative Care Network of Wisconsin Fast Facts - Additional resources related to prognostication
# 013 Determining Prognosis in Advanced Cancer, 2nd ed
How long do I have, Doc?
# 030 Prognostication, 2nd ed
Physicians tend to be overly optimistic when dealing with prognosis.
# 099 Chemotherapy: Response and Survival Data, 2nd ed
The table synthesises data for several common cancers.
# 124 The Palliative Prognostic Score
This Fast Fact reviews the Palliative Prognostic Score (PaP).
# 125 The Palliative Performance Scale (PPS)
This Fast Fact reviews the Palliative Performance Scale.
# 141 Prognosis in End-Stage COPD
This Fast Fact reviews prognostication in patients with advanced COPD.
# 143 Prognostication in Heart Failure
This Fast Fact reviews prognostication in Heart Failure (HF).
# 150 Prognostication in Dementia
This Fast Fact reviews prognostication in dementia.
# 179 CPR Survival in the Hospital Setting
This Fast Fact reviews data on CPR outcomes in hospitalised patients.
# 189 Prognosis in Decompensated Chronic Liver Failure
This Fast Fact reviews prognosis in chronic liver failure, focusing on two validated prognostic indices.
# 191 Prognostication in Patients Receiving Dialysis
This Fast Fact reviews the current data regarding prognostication in patients receiving chronic hemo- and peritoneal dialysis.
# 213 Prognosis in HIV and AIDS
This Fast Fact reviews prognostication in patients who are suffering life-threatening complications related to HIV infection using data where combination antiretroviral therapy (cART) was available.
# 214 Prognosis in HIV Associated Malignancies
This Fast Fact presents survival data for malignancies commonly arising in the setting of HIV / AIDS.
# 234 Prognosis of Anoxic-Ischemic Encephalopathy
This Fast Fact reviews the progosis of patients who intially survive cardiopulmonary resuscitation but remain comatose, demonstrating obvious impairments in neurologic function.
From: Palliative Care Network of Wisconsin, US