Roila F, Lupattelli M, Sassi M, Basurto C, Bracarda S, Picciafuoco M, Boschetti E, Milella G, Ballatori E, Tonato M
Medical Oncology Division, Policlinico Hospital, Perugia, Italy.
Ann Oncol. 1991 Jun;2(6):437-9. doi: 10.1093/oxfordjournals.annonc.a057981.
The Karnofsky (K) and ECOG (E) performance status (PS) scales are widely used to evaluate the functional status of cancer patients to determine their eligibility for clinical trials and their prognosis, but knowledge of inter and intraobserver variability of these scales is scarse. We therefore planned a prospective study on 209 consecutive cancer patients to evaluate this critical point. Two independent observers evaluated the KPS and EPS of each patient by interviewing them on the same day. After their interviews the patients were asked to fill in, again on the same day, a self-evaluation scale concerning their ability to perform the routine activities of daily life. The 209 patient self-evaluation scales were presented twice, randomly and blinded, to the two observers who had participated in the evaluation of PS as well as to one other observer who had not. The interobserver correlation for both scales was very high (K = 0.921 for KPS and K = 0.914 for EPS) as was the intraobserver correlation (for KPS: K = 0.993, K = 0.960, and K = 0.959 and, respectively, for EPS: K = 0.982, K = 0.970, and K = 0.920). On the basis of these results, it appears that evaluation of PS made by a clinical oncologist using K or E scales can be very reliable and is a guarantee of optimal selection of cancer patients for inclusion in clinical trials.
卡诺夫斯基（K）和东部肿瘤协作组（ECOG）的体能状态（PS）量表被广泛用于评估癌症患者的功能状态，以确定他们是否适合参加临床试验及其预后，但关于这些量表在观察者间和观察者内的变异性的了解却很少。因此，我们计划对209例连续的癌症患者进行一项前瞻性研究，以评估这一关键点。两名独立的观察者在同一天通过访谈对每位患者的KPS和EPS进行评估。访谈后，要求患者在同一天再次填写一份关于他们进行日常生活常规活动能力的自我评估量表。将209份患者自我评估量表随机且盲法地呈现给参与PS评估的两名观察者以及另一名未参与的观察者两次。两个量表的观察者间相关性都非常高（KPS的K = 0.921，EPS的K = 0.914），观察者内相关性也是如此（对于KPS：K = 0.993、K = 0.960和K = 0.959，对于EPS分别为：K = 0.982、K = 0.970和K = 0.920）。基于这些结果，看来临床肿瘤学家使用K或E量表对PS进行的评估可能非常可靠，并且是为临床试验选择最佳癌症患者的保证。
