Question 108: What scale was used to determine the recipient’s functional status prior to the cellular therapy?
The CIBMTR uses the Karnofsky/Lansky scale to determine the functional status of the recipient immediately prior to the start of the cellular therapy. The Karnofsky Scale is designed for recipients aged 16 years and older, and is not appropriate for children under the age of 16. The Lansky Scale is designed for recipients one year old to less than 16 years old. For recipients less than one year old, questions 108-110 should be left blank.
Select the appropriate performance scale, Karnofsky or Lansky, based on the recipient’s age.
Question 109-110: Performance score prior to the cellular therapy:
Recipient performance status is a critical data field that has been determined to be essential for all outcome-based studies. The CIBMTR uses the Karnofsky/Lansky scale to determine the functional status of the recipient immediately prior to the start of the lympho-depleting or preparative regimen. For the purposes of this manual, the term “immediately prior” represents the pre-infusion work-up phase, or approximately one month prior to the start of the lympho-depleting or preparative regimen.
Select the appropriate performance scale, Karnofsky or Lansky, based on the recipient’s age. Using this scale, select the score (10-100) that best represents the recipient’s activity status immediately prior to the start of the preparative regimen. For an example of the Karnofsky/Lansky scale, see Appendix L.
If a Karnofsky/Lansky score is not documented in the source documentation (e.g., inpatient progress note, physician’s clinic note), data management professionals should not assign a performance score based on analysis of available documents. Rather, a physician or mid-level health care provider (NPs and PAs) should provide documentation of the performance score. Documentation from an RN who has been trained and authorized to determine performance scores may also be used.
The CIBMTR recognizes that some transplant centers prefer to collect and use the ECOG performance score as opposed to the Karnofsky/Lansky score. Although the ECOG and Karnofsky/Lansky performance score systems are based on similar principles, the scales are not the same. For example, the Karnofsky/Lansky scale is described in 11 categories, whereas the ECOG performance status is reported in six categories. Due to the overlap between the two systems, an ECOG score of “one” can represent either “80” or “90” on the Karnofsky/Lansky scale. For centers that collect only an ECOG performance score, CIBMTR will make the following accommodations when auditing the source data:
- Centers collecting ECOG scores should do so using standard practices to ensure accuracy.
- For the purposes of CIBMTR reporting, conversion of ECOG to Karnofsky/Lansky should follow a standard and consistent practice. This practice should be clear and reproducible.
For more information regarding converting an EGOG score to a Karnofsky/Lansky score, see Appendix L.
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