Australia-modified Karnofsky Performance Scale and physical activity in COPD and lung cancer: an exploratory pooled data analysis

Barbetta, Carlo; Allgar, Victoria; Maddocks, Matthew; Ribeiro, Catarina; Wilcock, Andrew; Currow, David C; Phillips, Jane; Johnson, Miriam J.

Abstract

Objectives: Patient-relevant measures of functional status are required in chronic obstructive pulmonary disease (COPD) and lung cancer in clinical practice and research. We explored the relationship between the Australia-modified Karnofsky Performance Scale (AKPS) and measures of functional capacity and physical activity in these patient groups. Methods: Pooled clinical trial data were analysed to explore the relationship between AKPS and average daily steps (ADS), 6 min walk distance (6MWD), and body mass index, airflow obstruction, dyspnoea and exercise score (COPD group). Receiver operator characteristic curves were produced to compare sensitivity and specificity of cut-offs (no dependency >70, high dependency 70, the optimal ADS cut-points were COPD, 3342 steps (AUC 0.88, 95% CI 0.79 to 0.97, sensitivity 82%, specificity 76%), and lung cancer, 3380 steps (AUC 0.72, 95% CI 0.64 to 0.81, sensitivity 61%, specificity 74%), and for 6MWD (COPD only) 242 m (AUC 0.72, 95% CI 0.63 to 0.81, sensitivity 73%, specificity 34%). Conclusions: An AKPS score is strongly related to ADS in people with COPD and lung cancer. The AKPS may be useful in clinical practice and research to indicate levels of physical activity where ADS and 6 min walk test are not possible. Longitudinal data are needed to confirm these findings.

Citation

Barbetta, C., Allgar, V., Maddocks, M., Ribeiro, C., Wilcock, A., Currow, D. C., Phillips, J., & Johnson, M. J. (in press). Australia-modified Karnofsky Performance Scale and physical activity in COPD and lung cancer: an exploratory pooled data analysis. BMJ supportive & palliative care, https://doi.org/10.1136/bmjspcare-2019-001869

• Journal Article Type: Article
• Acceptance Date: Jun 26, 2019
• Online Publication Date: Jul 11, 2019
• Deposit Date: Jul 17, 2019
• Publicly Available Date: Jul 17, 2019
• Journal: BMJ Supportive and Palliative Care
• Print ISSN: 2045-435X
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1136/bmjspcare-2019-001869
• Keywords: Physical activity; Chronic obstructive pulmonary disease; Lung cancer; Performance status; Outcome measurement; Functional independence
• Public URL: https://hull-repository.worktribe.com/output/2201671
• Publisher URL: https://spcare.bmj.com/content/early/2019/07/11/bmjspcare-2019-001869
• Additional Information: This article has been accepted for publication in BMJ Supportive & Palliative Care, 2019 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/bmjspcare-2019-001869; © Authors. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) http://creativecommons.org https://creativecommons.org/licenses/by-nc/4.0/
• Contract Date: Jul 17, 2019