Clinical calculator summary
WHO Performance Status
Clinical calculator summary
WHO Performance Status
A 0-5 scale describing functional activity, self-care ability, and time confined to bed or chair in cancer patients.
Evidence-based context for fast calculator use
- Purpose:
- Document functional status for treatment eligibility, prognosis, trial screening, and supportive-care planning.
- Population:
- Patients with cancer or serious illness requiring performance status documentation.
- Factors:
- Activity restriction, Ambulation, Self-care ability, Time in bed or chair, Treatment fitness
- Reference:
- WHO Handbook for Reporting Results of Cancer Treatment, 1979.
WHO Performance Status
Clinical Context & Background
Scale from 0 (Normal) to 5 (Dead)Reference Data
| Grade | Classification | Activity Level |
|---|---|---|
| 0 | Fully Active | Able to carry on all pre-disease performance. |
| 1 | Restricted | Restricted in strenuous activity; ambulatory. |
| 2 | Ambulatory | Up and about >50% of waking hours. |
| 3 | Limited Self-care | Confined to bed/chair >50% of waking hours. |
| 4 | Completely Disabled | Totally confined to bed or chair. |
| 5 | Dead | - |
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 at baseline oncology assessment, before treatment decisions, and whenever clinical status changes.
- Useful for chemotherapy eligibility, radiation tolerance, trial screening, prognosis documentation, and supportive-care planning.
- Reassess after acute reversible problems such as infection, dehydration, pain crisis, anemia, treatment toxicity, or hospitalization.
How To Interpret
- Grades 0-1 usually indicate a patient who is fully active or ambulatory with limited restriction.
- Grade 2 means ambulatory and self-caring but unable to work; this often triggers dose, regimen, or goals-of-care discussion.
- Grades 3-4 indicate major functional impairment and should prompt careful review of treatment burden, reversibility, and supportive-care needs.
What To Do Next
- Document the reason for impaired function and whether it is cancer-related, treatment-related, or potentially reversible.
- Use ECOG or Karnofsky alongside WHO PS when a protocol, trial, or guideline requires a specific scale.
- Pair performance status with comorbidity, frailty, organ function, nutrition, cognition, symptoms, and patient goals before changing treatment.
Limitations
- Do not use a single performance-status number as the only determinant of treatment eligibility.
- Scores are observer-dependent and can vary by clinician, setting, symptom control, and timing.
- WHO PS does not directly measure geriatric vulnerability, cognition, social support, or organ reserve.
Validated Population
Patients with cancer or serious illness requiring functional-status documentation for treatment planning or prognosis.
Example use
A patient who is ambulatory and self-caring but unable to work and out of bed more than half the day is WHO PS 2; before withholding therapy, check whether symptoms such as pain, infection, or anemia are reversible.
Frequently Asked Questions
Is WHO Performance Status the same as ECOG?
WHO Performance Status is functionally aligned with ECOG grades 0-5. Many clinicians use the terms interchangeably, but local trial protocols may specify one scale.
When should performance status be reassessed?
Reassess before treatment decisions and when clinical status changes, such as new infection, toxicity, progression, pain, hospitalization, or rehabilitation.
Evidence-based oncology decision support. Verify with clinical guidelines.