A single question with six answers, and one of the most common oncology eligibility criteria. Showing the full grade definitions on the form keeps ratings consistent across sites and visits.
Free sandbox · No credit card · 21 CFR Part 11 aligned
ECOG performance status
Protocol requires ECOG 0 or 1
At a glance
The scale
| Grade | Definition |
|---|---|
| 0 | Fully active, able to carry on all pre-disease performance without restriction. |
| 1 | Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature. |
| 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 | Capable of only limited self-care; confined to bed or chair more than 50% of waking hours. |
| 4 | Completely disabled; cannot carry on any self-care; totally confined to bed or chair. |
| 5 | Dead. |
Source: ECOG-ACRIN Cancer Research Group performance status scale.
In practice
Studies comparing raters have found that ECOG scores assigned by different clinicians, or by clinicians and patients, often disagree by a grade, especially between 1 and 2. Because the difference between 1 and 2 can decide eligibility, that matters. Showing the full definition next to each option, rather than just the number, is the simplest way to reduce disagreement, and it costs nothing.
For eligibility, add a custom-value edit check that raises a query when the grade is outside the protocol range, and link the result to the eligibility screening form. During treatment, record ECOG at each cycle or assessment visit; a decline is clinically meaningful and may accompany adverse events.
| ECOG | Karnofsky (approx.) | |
|---|---|---|
| Fully active | 0 | 90 to 100 |
| Light work only | 1 | 70 to 80 |
| Self-care, no work | 2 | 50 to 60 |
| Limited self-care | 3 | 30 to 40 |
| Disabled | 4 | 10 to 20 |
Copy the template and set your protocol range in the free sandbox.
In trial design
Performance status is one of the strongest prognostic factors in oncology, so it appears in several places in a protocol: as an inclusion criterion, often as a stratification factor for randomisation, and as a baseline characteristic in every results table. A trial that stratifies by ECOG 0 versus 1 needs the value recorded before randomisation and made available to the allocation.
During treatment, a decline in performance status can signal toxicity or progression and may prompt dose modifications. Recording ECOG at each assessment visit on the same form, by an investigator, gives a consistent series. Some studies also collect patient-reported function, for example the physical functioning scale of the EORTC QLQ-C30, which complements the clinician's grade.
Conversions
| ECOG grade | Approximate Karnofsky score | In short |
|---|---|---|
| 0 | 90 to 100 | Fully active |
| 1 | 70 to 80 | Restricted in strenuous activity, ambulatory |
| 2 | 50 to 60 | Ambulatory, capable of self-care, unable to work |
| 3 | 30 to 40 | Limited self-care, in bed or chair more than half of waking hours |
| 4 | 10 to 20 | Completely disabled |
| 5 | 0 | Dead |
The scales were developed separately and do not map exactly. Record the scale your protocol specifies rather than converting at entry; if both are needed, collect both.
Before go-live
Full grade definitions next to each option.
Custom-value check for grades outside the protocol range.
Recorded before randomisation if used as a factor.
Investigator or delegated medically qualified staff.
Screening, each cycle or assessment visit, end of treatment.
ECOG 1 means restricted in strenuous activity but ambulatory and able to do light work. ECOG 2 means ambulatory and capable of self-care but unable to work, and up and about more than half of waking hours. The distinction often decides eligibility.
ECOG is designed as a clinician rating. Some studies also collect patient-reported performance status, but record it separately and do not substitute it for the investigator's grade.
A clinician-rated scale from 0 (fully active) to 5 (dead) describing how a disease affects a patient's daily functioning.
Many oncology trials require ECOG 0 or 1, some allow 2. The protocol defines the range.
Karnofsky uses a 0 to 100 scale in steps of 10. Approximate conversions exist, but the scales are not identical.
Yes, it is widely published by ECOG-ACRIN and free to use.
Yes. A custom-value edit check raises a query when the grade is outside the protocol range.
Keep exploring
Definitions on screen, eligibility checked. Free sandbox.