Performance status agreement assessed by the patient and clinician in a rapid access lung cancer service: Can either predict completion of treatment?

Introduction: Clinician‐rated performance status (C‐PS) is used routinely to predict whether patients are fit enough to undergo treatment for lung cancer. However, a good proportion of those with seemingly good C‐PS do not go on to receive, let alone complete treatment. The value of C‐PS in accurately predicting this is unclear, as is the merit of evaluating patient‐rated PS (P‐PS). Objectives: Our aim was to prospectively assess Eastern Cooperative Oncology Group (ECOG) and Karnofsky C‐PS and P‐PS in patients attending a rapid access lung cancer service (RALCS), the agreement between these scores, and whether any score could predict receipt and completion of multidisciplinary team (MDT)‐planned treatment. Results: ECOG and Karnofsky scores were highly correlated (Spearman's rho −0.79 for C‐PS and −0.828 for P‐PS, both p < 0.001). There was poor agreement between C‐PS and P‐PS scores (kappa statistics 0.275 for ECOG and 0.172 for Karnofsky); however, clinicians did not tend to consistently under‐ or overestimate patients' scores. ECOG P‐PS showed an association with completion of MDT‐planned treatment (p = 0.007), but C‐PS did not. Conclusion: Clinician‐rated PS was not associated with completion of MDT‐planned treatment, but there may be a role for patient‐rated PS. C‐PS and P‐PS were poorly correlated in a RALCS. [ABSTRACT FROM AUTHOR]