Performance status¶

1. Endpoint Definition¶

Description:
Performance status is a clinician-assigned score that summarises a patient’s functional capacity.

The most widely used scale is ECOG Performance Status (0–5):

ECOG	Definition
0	Fully active; no restrictions
1	Restricted in physically strenuous activity but ambulatory
2	Ambulatory >50% of waking hours; unable to work
3	Limited self-care; >50% of time in bed/chair
4	Completely disabled
5	Dead

Relevant Background & Links: - Oken, M. M., Creech, R. H., Tormey, D. C., Horton, J., Davis, T. E., McFadden, E. T., & Carbone, P. P. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. American journal of clinical oncology, 5(6), 649-656.

Cancer Domains:
- Any / All

Endpoint Type:
- EAV

Endpoint Status:

Assessment	Details
Feasibility	Generally feasible — ECOG typically expressed explicitly (e.g., “ECOG 1”, “PS: 0–1”).
Priority	High priority — required for trial / treatment eligibility, prognostic modelling, and risk adjustment across most cancers.
Maturity / Current State	Prototype regex and lightweight phrase matcher exist at some sites; notebooks and heuristics shared informally; no consolidated cross-site tool yet.
Shareability	High — ECOG terminology and phrasing are consistent across oncology documentation; minimal site-specific tuning expected.

2. Examples¶

2.1 Positive Examples¶

Example Clinical Phrasing:
- Performance status 2 - ECOG: 0–1

2.2 Negative / Exclusions¶

Some notes use descriptive phrases e.g. Patient reports minimal exertional dyspnea
- Current solutions do not infer PS from descriptions alone without valid and explicit physician-assessed score
- Open-ended nature of these assessments likely to induce high degree of hallucination in LLM applications and too heterogeneous for heuristic approach

2.3 General Guidelines for Disambiguation¶

Range will always resolve to the higher of the two scores (e.g. PS 1-2 will be extracted as score = 2)

3. Mapping to CDM¶

What exactly must the NLP pipeline output?

Specify format and constraints.

Structured Output Format:

{
    "measurement": {  
        "person_id": 1,
        "measurement_id": 2,
        "measurement_concept_id": 36305384,
        "measurement_date": "2025-11-13",
        "value_as_number": 3
    }
}

4. Existing Work¶

Current Solutions or Prototypes:

Demo binder: https://github.com/gkennos/ecog_nlp_demo

Implementations in Use:

Include performance evaluations if available

5. Proposed Approach¶

Rule-based / Heuristic Approach

List key patterns or features

Example regex/patterns

Expected performance / challenges