Clinical calculator summary
WHO Performance Status
Clinical calculator summary
WHO Performance Status
A five-grade 0-4 scale documenting adult activity and disability.
Evidence-based context for fast calculator use
- Purpose:
- Record functional status at a specific assessment time without embedding treatment recommendations.
- Population:
- Adults over 16 years of age for whom WHO performance status is being documented.
- Factors:
- Normal activity, Strenuous activity restriction, Ambulation, Self-care, Time in bed or chair
- Reference:
- World Health Organization. Handbook for reporting results of cancer treatment. WHO Offset Publication No. 48. Geneva; 1979.
WHO Performance Status
Clinical Context & Background
Direct selection of one required WHO adult performance-status grade from 0 through 4.Reference Data
| WHO grade | Adult performance-status description |
|---|---|
| 0 | Able to carry out all normal activity without restriction |
| 1 | Restricted in strenuous activity but ambulatory and able to carry out light work |
| 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 |
| 3 | Symptomatic and in a chair or in bed for greater than 50% of the day but not bedridden |
| 4 | Completely disabled; cannot carry out any self-care; totally confined to bed or chair |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use when an adult WHO performance-status grade is required for clinical documentation or a named protocol.
- Record the assessment date because functional status can change over time.
How To Interpret
- Grade 0 indicates unrestricted normal activity; grades 1-4 describe progressively greater activity and self-care limitation.
- Choose the single description that best matches the observed state rather than averaging features across grades.
- WHO grade 4 is the highest grade in this adult WHO code set; death is not a WHO grade 5 entry here.
What To Do Next
- Document contributors to impaired function and whether the limitation may be temporary or reversible.
- Use the exact scale named by the relevant protocol; do not substitute ECOG 0-5 or a Karnofsky conversion automatically.
- Interpret the recorded grade together with disease context, organ function, comorbidity, frailty, symptoms, and patient goals.
Limitations
- A performance-status grade is observer-dependent and can vary by assessor, setting, symptom control, and timing.
- WHO Performance Status does not independently determine treatment, dose, prognosis, or trial eligibility.
- This calculator does not validate or convert ECOG, Karnofsky, or performance-panel results.
Validated Population
Adult persons over 16 years of age for whom the WHO adult performance-status classification is recorded.
Example documentation
An adult who is ambulatory and capable of all self-care but unable to work, while up for more than half of waking hours, is recorded as WHO grade 2.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Five source-backed WHO adult performance-status cases were exercised on the public production route through visible browser controls; 5/5 expected grades and source-defined descriptions matched across grades 0 through 4.
- No unexpected N/A, literal undefined value, stale control, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/who-performance-status-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/who-performance-status.json.
: Calculation verification
- Corrected the adult WHO scale to grades 0-4, removed grade 5, and replaced the grade 0 default with one required direct selection.
- Passed 19/19 valid-grade, exact-description, missing, extra, malformed, fractional, nonnumeric, nonfinite, and out-of-range checks.
- Separated WHO from the official ECOG 0-5 scale and removed automatic treatment implications.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Frequently Asked Questions
Is WHO Performance Status the same as ECOG?
No. This WHO adult code set has grades 0-4. The official ECOG scale is a separate six-grade scale from 0-5, with grade 5 representing death.
Does a WHO grade determine treatment?
No. It documents functional status. Any treatment, dose, prognosis, or trial implication must come from the applicable disease, regimen, protocol, and clinical assessment.
When should performance status be reassessed?
Record the assessment date and reassess when function changes or when a protocol requires a current value.
Evidence-based oncology decision support. Verify with clinical guidelines.