Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

    Eastern Cooperative Oncology Group (ECOG) / Zubrod Score

    Determines ability of patient to tolerate therapies in serious illness, specifically for chemotherapy, simpler than the Karnofsky Scale.
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    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with active cancer under treatment.

    • The ECOG Score is a simple measure of functional status.
    • It has scores ranging from 0 to 5, and these correlate with scores from the Karnofsky Scale’s 0-100 scores.
    • It is commonly used as a prognostic tool, as a selection criterion for cancer research, and to help determine treatment.

    Performance status is highly correlated with survival, need for services, and may help predict ability to tolerate therapies.

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The ECOG Score may be slightly better than Karnofsky for discriminating prognostically and, as an adaptation of Karnofsky, is likely to be at least similar in other domains. It is also simpler to use, and therefore may be preferred.

    Management

    We are unaware of validated management algorithms using the ECOG Score.

    Critical Actions

    The ECOG Score and other performance scales should be used in the holistic assessment of cancer patients, though their accuracy as prognostic tools in individual cases is not yet proved.

    Formula

    Criteria Score Description
    Asymptomatic 0 Fully active, able to carry on all predisease activities without restriction.
    Symptomatic but completely ambulatory 1 Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature. For example, light housework, office work.
    Symptomatic, <50% in bed during the day 2 Ambulatory and capable of all self care but unable to carry out any work activities. Up and about more than 50% of waking hours.
    Symptomatic, >50% in bed, but not bedbound 3 Capable of only limited self-care, confined to bed or chair 50% or more of waking hours.
    Bedbound 4 Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair.
    Death 5

    Facts & Figures

    Karnofsky vs. ECOG/Zubrod Scores

    ECOG PERFORMANCE STATUS KARNOFSKY PERFORMANCE STATUS
    0—Fully active, able to carry on all pre-disease performance without restriction 100—Normal, no complaints; no evidence of disease
    90—Able to carry on normal activity; minor signs or symptoms of disease
    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 80—Normal activity with effort, some signs or symptoms of disease
    70—Cares for self but unable to carry on normal activity or to do active 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 60—Requires occasional assistance but is able to care for most of personal needs
    50—Requires considerable assistance and frequent medical care
    3—Capable of only limited selfcare; confined to bed or chair more than 50% of waking hours 40—Disabled; requires special care and assistance
    30—Severely disabled; hospitalization is indicated although death not imminent
    4—Completely disabled; cannot carry on any selfcare; totally confined to bed or chair 20—Very ill; hospitalization and active supportive care necessary
    10—Moribund
    5—Dead 0—Dead
    Dr. Martin Oken

    About the Creator

    Martin M. Oken, MD, is a professor of medicine at the University of Minnesota and the Medical Director of Research at the Hubert H. Humphrey Cancer Center. He was formerly a chairman of the Hematology, Myeloma and Lymphoma Committees of the Eastern Cooperative Oncology Group and Member of the steering Committee for the PLCO (Prostate, Lung, Colon and Ovary Screening Project). His research focuses mainly on treatment and outcomes in patients with leukemia and lymphoma.

    To view Dr. Martin Oken's publications, visit PubMed