UICC World Cancer Congress 2006

Objective: While valuable, PS can be often misjudged by health care professionals. Concerns include: 1) accuracy depends on observers correctly using the scale definitions, 2) observer-completed scales are prone to rater bias, 3) observer scoring of patient reported outcomes eliminates the advantages of patient self-rating. If patients can accurately and easily determine their PS, these issues may be overcome. Methods: We prospectively evaluated the KPS and ECOG observer scales, and a Patient-Rated PS (visual analog scale [VAS]) in NSCLC. The Patient-Rated PS VAS is part of the validated LCSS. Patients completed the VAS on paper and a computerized handheld device (LCSS-QL). Eligibility: advanced NSCLC, KPS > 60, no prior chemotherapy, receiving docetaxel + platinum. Patients completed all 3 scales prior to chemotherapy. Results: 75 patients were enrolled. Characteristics: 45% women; median age 68 (range 46-81); 73% Stage IV disease; median KPS 80%; median: ECOG PS 1. There was moderately high correlation between the Patient-Rated PS VAS and both KPS (Pearson r, 0.66), and ECOG (Pearson r, 0.62). A high correlation (Pearson r, 0.93) was found between the electronic and paper formats for the VAS scale. Patient completion time for PS VAS scale was < 1 minute. Patients can rate their own performance status rapidly, easily, and accurately with the one VAS question from the LCSS-QL. Patient-rated PS eliminates observer bias and allows PS to become a true PRO. Further studies will test whether Patient-Rated PS more accurately predicts such major outcomes as treatment-related response or survival than either the ECOG or KPS scales.