Inter-rater reliability in performance status assessment between clinicians and patients: a systematic review and meta-analysis

Chow, Ronald; Zimmermann, Camilla; Bruera, Éduardo; Temel, Jennifer S.; Im, James; Lock, Michael

doi:10.1136/bmjspcare-2019-002080

Cited by 15 publications

(15 citation statements)

References 36 publications

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“…The excellent inter-rater concordance observed in this study was higher than in an updated meta-analysis recently published [20]. The explanation of this phenomenon partially could be explained by the careful inclusion of rating staff, who attended to patients for several hours daily and had a great understanding of their mobility and functionality [11].…”

Section: Discussioncontrasting

confidence: 42%

“…through a whole shift) to assess the potential capability of evaluated functions. When comparing various performance tools, it appears that no one is statistically superior to others in terms of inter-rater reliability [20]. The ECOG PS or KPS are often used in determining eligibility for clinical trials.…”

Section: Discussionmentioning

confidence: 99%

“…Patients' age, preferences and socio-economic background may also influence the assessment. Numerous studies confirmed good correlations of KPS, ECOG PS, and PPS tools, and meta-analysis favors KPS as descriptively better [20]. Authors of the original version of the PPSv2 noticed that in contrary to the KPS, this scale does not focus on the need for hospitalization (which is of poor definability and does not help in defining performance) but instead assesses food/fluid intake and level of consciousness [2].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Palliative Performance Scale: cross cultural adaptation and psychometric validation for Polish hospice setting

Dzierżanowski

Grądalski²,

Kozlowski

2020

BMC Palliat Care

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Background: Measuring functional status in palliative care may help clinicians to assess a patient's prognosis, recommend adequate therapy, avoid futile or aggressive medical care, consider hospice referral, and evaluate provided rehabilitation outcomes. An optimized, widely used, and validated tool is preferable. The Palliative Performance Scale Version 2 (PPSv2) is currently one of the most commonly used performance scales in palliative settings. The aim of this study is the psychometric validation process of a Polish translation of this tool (PPSv2-Polish). Methods: Two hundred patients admitted to a free-standing hospice were evaluated twice, on the first and third day, for test-retest reliability. In the first evaluation, two different care providers independently evaluated the same patient to establish inter-rater reliability values. PPSv2-Polish was evaluated simultaneously with the Karnofsky Performance Score (KPS), Eastern Cooperative Oncology Group (ECOG) Performance Status (ECOG PS), and Barthel Activities of Daily Living (ADL) Index, to determine its construct validity.Results: A high level of full agreement between test and retest was seen (63%), and a good intra-class correlation coefficient of 0.85 (P < 0.0001) was achieved. Excellent agreement between raters was observed when using PPSv2-Polish (Cohen's kappa 0.91; P < 0.0001). Satisfactory correlations with the KPS and good correlations with ECOG PS and Barthel ADL were noticed. Persons who had shorter prognoses and were predominantly bedridden also had lower scores measured by the PPSv2-Polish, KPS and Barthel ADL. A strong correlation of 0.77 between PPSv2-Polish scores and survival time was noted (P < 0.0001). Moderate survival correlations were seen between KPS, ECOG PS, and Barthel ADL of 0.41; − 0.62; and 0.58, respectively (P < 0.0001). Conclusion: PPSv2-Polish is a valid and reliable tool measuring performance status in a hospice population and can be used in daily clinical practice in palliative care and research.

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Section: Discussioncontrasting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Palliative Performance Scale: cross cultural adaptation and psychometric validation for Polish hospice setting

Dzierżanowski

Grądalski²,

Kozlowski

2020

BMC Palliat Care

View full text Add to dashboard Cite

show abstract

“…The excellent inter-rater concordance observed in this study was higher than in an updated metaanalysis recently published [20]. The explanation of this phenomenon partially could be explained by the careful inclusion of rating staff, who attended to patients for several hours daily and had a great understanding of their mobility and functionality [11].…”

Section: Discussioncontrasting

confidence: 42%

Palliative Performance Scale: Cross cultural adaptation and psychometric validation for Polish hospice setting

Dzierżanowski

Grądalski

Kozlowski

2020

Preprint

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Background: Measuring functional status in palliative care may help clinicians to assess a patient’s prognosis, recommend adequate therapy, avoid futile or aggressive medical care, consider hospice referral, and evaluate provided rehabilitation outcomes. An optimized, widely used, and validated tool is preferable. The Palliative Performance Scale Version 2 (PPSv2) is currently one of the most commonly used performance scales in palliative settings. The aim of this study is the psychometric validation process of a Polish translation of this tool (PPSv2-Polish).Methods: Two hundred patients admitted to a free-standing hospice were evaluated twice, on the first and third day, for test-retest reliability. In the first evaluation, two different care providers independently evaluated the same patient to establish inter-rater reliability values. PPSv2-Polish was evaluated simultaneously with the Karnofsky Performance Score (KPS), Eastern Cooperative Oncology Group (ECOG) Performance Status (ECOG PS), and Barthel Activities of Daily Living (ADL) Index, to determine its construct validity. Results: A high level of full agreement between test and retest was seen (63%), and a good intra-class correlation coefficient of 0.85 (P<0.0001) was achieved. Excellent agreement between raters was observed when using PPSv2-Polish (Cohen’s kappa 0.91; P<0.0001). Satisfactory correlations with the KPS and good correlations with ECOG PS and Barthel ADL were noticed. Persons who had shorter prognoses and were predominantly bedridden also had lower scores measured by the PPSv2-Polish, KPS and Barthel ADL. A strong correlation of 0.77 between PPSv2-Polish scores and survival time was noted (P<0.0001). Moderate survival correlations were seen between KPS, ECOG PS, and Barthel ADL of 0.41; -0.62; and 0.58, respectively (P<0.0001).Conclusion: PPSv2-Polish is a valid and reliable tool measuring performance status in a hospice population and can be used in daily clinical practice in palliative care and research.

show abstract

“…through a whole shift) to assess the potential capability of evaluated functions. When comparing various performance tools, it appears that no one is statistically superior to others in terms of inter-rater reliability [18]. The ECOG PS or KPS are often used in determining eligibility for clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Palliative Performance Scale: Polish validation in hospice setting - a prospective observational study

Dzierżanowski¹,

Grądalski²,

Kozlowski³

2020

Preprint

View full text Add to dashboard Cite

Background: Measuring functional status in palliative care may help clinicians to assess a patient’s prognosis, recommend adequate therapy, avoid futile or aggressive medical care, consider hospice referral, and evaluate provided rehabilitation outcomes. An optimized, widely used, and validated tool is preferable. The Palliative Performance Scale Version 2 (PPSv2) is currently one of the most commonly used performance scales in palliative settings. The aim of this study is the translation and validation process of a Polish translation of this tool (PPSv2-Polish). Methods: Two hundred patients consecutively admitted to a free-standing hospice were evaluated twice during 2 consecutive days for test-retest reliability. In the first evaluation, two different care providers independently evaluated the same patient to establish inter-rater reliability values. PPS-Polish was compared with the Karnofsky Performance Score (KPS), Eastern Cooperative Oncology Group (ECOG) Performance Status (ECOG PS), and Barthel Activities of Daily Living (ADL) Index to determine its construct validity. Results: A high level of full agreement between test and retest was seen (63%), and a good intra-class correlation coefficient of 0.85 (P<0.0001) was achieved. Excellent agreement between raters was observed when using PPSv2-Polish (Cohen’s kappa 0.91; P<0.0001). Satisfactory correlations with the KPS and good correlations with ECOG PS and Barthel ADL were noticed. Persons who had shorter prognoses and were predominantly bedridden also had lower scores measured by the PPSv2-Polish, KPS and Barthel ADL. A strong correlation of 0.77 between PPSv2-Polish scores and survival time was noted (P<0.0001). Moderate survival correlations were seen between KPS, ECOG PS, and Barthel ADL of 0.41; -0.62; and 0.58, respectively (P<0.0001). Conclusion: PPSv2-Polish is a valid and reliable tool measuring performance status in a hospice population and can be used in daily clinical practice in palliative care and research.

show abstract

Inter-rater reliability in performance status assessment between clinicians and patients: a systematic review and meta-analysis

Cited by 15 publications

References 36 publications

Palliative Performance Scale: cross cultural adaptation and psychometric validation for Polish hospice setting

Palliative Performance Scale: cross cultural adaptation and psychometric validation for Polish hospice setting

Palliative Performance Scale: Cross cultural adaptation and psychometric validation for Polish hospice setting

Palliative Performance Scale: Polish validation in hospice setting - a prospective observational study

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