Performance status decides trial eligibility, regimen intensity and often whether treatment is offered at all, and it is the least reliably recorded number in the oncology note. A status assigned at diagnosis follows a patient for months; one copied from a referral letter may never have been assessed by anyone who examined them.
Write the score, the date, and who assigned it. Assess it yourself before each treatment decision rather than before each cycle, and record what the patient actually does — how far they walk, how much of the day they spend in bed, whether they manage the stairs at home. A number without that description cannot be checked or challenged by the next clinician, and a status that drifts unexamined is how a patient ends up receiving a regimen they were fit for six weeks ago.
- Record the score with the date and the assessor's name
- Describe the function behind the number — distance walked, hours up, stairs managed
- Reassess before each treatment decision, not just at diagnosis
- Ask the patient and a relative separately; the answers often differ
- Never carry a performance status forward from a referral letter without checking it
Why it matters
A performance status copied forward is the commonest way a patient receives a regimen they are no longer fit for.
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