Supportive Care in Cancer

, Volume 27, Issue 10, pp 3793–3798 | Cite as

Objective assessment of WHO/ECOG performance status

  • Miha SokEmail author
  • Miha Zavrl
  • Boris Greif
  • Matevž Srpčič
Original Article



Performance status is an important factor in determining quality of life, the choice of treatment, and prognostic tool in patients. All scoring systems currently in use measure the patient’s performance subjectively. A new method of objective assessment of performance ECOG/WHO grades 2 and 3 was constructed and tested.


A performance meter—an adapted USB data logger with a mercury tilt switch—was constructed. The device was tested in a feasibility study on 33 residents of a retirement home. Parallel to the objective assessment, each resident gave their own estimate of their performance, and each resident was in turn assessed by the nursing staff.


With the performance meter, 4 residents (12%) were assessed as PS ≥ 3 in comparison with 8 (24%) and 7 (21%) residents with an ECOG score ≥ 3 estimated by patients themselves and nursing staff respectively.


Subjective scoring—estimated by patients themselves and by nursing staff—showed underestimation of patients’ performance. In 12% of patients, a better performance score was observed with objective measurement in comparison with subjective assessment. Performance meter could be a useful tool for health care professionals for type of care decisions.


Performance status ECOG score Objective score Performance meter 



Residents and staff of DUC Tabor-Ljubljana, Ulica Janeza Pavla II/4, Ljubljana Retirement Home, its Manager Mrs. Silva Kučan, Head Nurse Mrs. Radmila Radanović, and Mr. Iztok Zupančič, Engineer.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Thoracic SurgeryUniversity Medical Centre LjubljanaLjubljanaSlovenia
  2. 2.Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia

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