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Nurse and physician inter-rater agreement of three performance status measures in palliative care outpatients
Camilla Zimmermann1, Debika Burman, Shazeen Bandukwala
1Division of Medical Oncology and Hematology, Department of Medicine, University of Toronto, Toronto, Canada. camilla.zimmermann@uhn.on.ca
Introduction:
Performance status (PS) scales are used widely in oncology practice and research. We compared inter-rater agreement, between nurses and physicians, for three commonly used PS scales.
Materials And Methods:
Patients attending an oncology palliative care clinic were assessed by a physician and nurse who blindly completed Eastern Cooperative Oncology Group (ECOG), Karnofsky PS (KPS), and palliative PS (PPS) scales. Patients completed the Edmonton symptom assessment system (ESAS).
Results:
Inter-rater agreement (weighted kappa) for the 457 patients was 0.67 for the ECOG, 0.74 for the KPS, and 0.72 for the PPS. There was no difference between proportions of physicians' vs. nurses' ratings of KPS, >60 vs.
Conclusions:
Although inter-rater agreement was good for all three scales, physicians tended to rate patients as healthier for the PPS and ECOG. The KPS may provide greater consistency of PS ratings by different oncology professionals in clinical and research settings.
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