Appraisal of the Karnofsky Performance Status and proposal of a simple algorithmic system for its evaluation

TLDR

The Karnofsky Performance Status has been a widely used tool for over six decades to assess patient functional status, with recent revisions addressing reliability, validity, quality‑of‑life measurement, and its role as a prognostic factor for survival. This study proposes a concise algorithm that employs only two to three questions to efficiently evaluate the Karnofsky Performance Status. The algorithm builds on the original KPS framework, incorporates recent adaptations, and updates the scoring process to maintain accuracy and speed.

Abstract

For over 60 years, the Karnofsky Performance Status (KPS) has proven itself a valuable tool with which to perform measurement of and comparison between the functional statuses of individual patients. In recent decades conditions for patients have changed, and so too has the KPS undergone several adjustments since its initial development. The most important works regarding the KPS tend to focus upon a variety of issues, including but not limited to reliability, validity and health-related quality of life. Also discussed is the question of what quantity the KPS may in fact be said to measure. The KPS is increasingly used as a prognostic factor in patient assessment. Thus, questions regarding if and how it affects survival are relevant. In this paper, we propose an algorithm which uses a minimum of two and a maximum of three questions to facilitate an adequate and efficient evaluation of the KPS. This review honors the original intention of the discoverer and gives an overview of adaptations made in recent years. The proposed algorithm suggests specific updates with the goal of ensuring continued adequacy and expediency in the determination of the KPS.