Interestingly, disagreement between the ECOG-PS scores provided by nurses and those provided by oncologists was itself significantly predictive of worse patient clinical outcome when oncologists’ scores were lower. For example, in this situation, the OR for the correlation of the magnitude of difference in nurse- and oncologist-provided scores and 6-month mortality/hospice referral was 2.99 (95% CI, 1.75-5.15; P <.0001).

One of the study limitations noted was that only those patients receiving intravenous chemotherapy were included, thereby potentially excluding those patients with very low and very high ECOG-PS scores. 

The study authors commented that “rating performance statuses of patients with cancer by nurses instead or in addition to oncologists can result in additional clinical benefits, such as improved prognostication, as well as better informed clinical decision making regarding whether or not to administer chemotherapy, the need for additional supportive care, and goals of care discussions.”


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Reference

Neeman EGresham G2Ovasapians N, et al. Comparing physician and nurse Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ratings as predictors of clinical outcomes in patients with cancer [published online June 21, 2019]. Oncologist.

doi: 10.1634/theoncologist.2018-0882