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|Title: ||The Australia-modified Karnofsky Performance
Status (AKPS) scale: a revised scale for contemporary palliative care clinical practice
|Authors: ||Woods, David A|
Abernethy, Amy Pickar
Shelby-James, Tania Maree
Fazekas, Belinda Susan
Currow, David Christopher
|Issue Date: ||2005|
|Citation: ||Abernethy, A.P., Shelby-James, T.M.,
Fazekas, B.S., Woods, D., & Currow, D.C., 2005. The Australia-modified Karnofsky
Performance Status (AKPS) scale: a revised scale for contemporary palliative care
clinical practice [ISRCTN81117481]. BMC Palliative Care, 4(7), 1-12.|
|Abstract: ||Background :
The Karnofsky Performance Status (KPS) is a gold standard scale. The Thorne-modified KPS (TKPS) focuses on community-based care and has been shown to be more relevant to palliative care settings than the original KPS. The Australia-modified KPS (AKPS) blends KPS and TKPS to accommodate any setting of care.
Performance status was measured using all three scales for palliative care patients enrolled in a randomized controlled trial in South Australia. Care occurred in a range of settings. Survival was defined from enrollment to death.
Ratings were collected at 1600 timepoints for 306 participants. The median score on all scales was 60. KPS and AKPS agreed in 87% of ratings; 79% of disagreements occurred within 1 level on the 11-level scales. KPS and TKPS agreed in 76% of ratings; 85% of disagreements occurred within one level. AKPS and TKPS agreed in 85% of ratings; 87% of disagreements were within one level. Strongest agreement occurred at the highest levels (70–90), with greatest disagreement at lower levels (≤40). Kappa coefficients for agreement were KPS-TKPS 0.71, KPS-AKPS 0.84, and AKPS-TKPS 0.82 (all p < 0.001). Spearman correlations with survival were KPS 0.26, TKPS 0.27 and AKPS 0.26 (all p < 0.001). AKPS was most predictive of survival at the lower range of the scale. All had longitudinal test-retest validity. Face validity was greatest for the AKPS.
The AKPS is a useful modification of the KPS that is more appropriate for clinical settings that include multiple venues of care such as palliative care.|
|Description: ||© 2005 Abernethy et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.|
|Appears in Collections:||1117 - Public Health and Health Services|
1117 - Public Health and Health Services
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