Physician-reported ECOG-PS versus patient-reported (self) ECOG-PS: Which one is a better predictor of survival in cancer?

The aim of this study is to determine the discrepancy and agreement between Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores evaluated by doctors and patients and examine the factors that influence the performance evaluation of doctors and patients. This study is a prospective and descriptive case-control study. General, demographic, and oncologic data of the patients were collected. e-control study. General, demographic, and oncologic data of the patients were collected. Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and depression surveys were conducted to determine patients' levels of anxiety and depression, and at the same time, both the doctors and the patients were asked to determine their performance status. As a result, the discrepancy in performance evaluation between the patient and the doctor, the factors affecting this discrepancy, and its effect on progression and survival were examined. 277 patients were included. 146 (52.7%) were male, and 131 (47.3%) were female. The most common cancers were breast cancer (17.7%, n=49) and lung cancer (17.3%, n=48). It was found that the doctors' assessment of patient performance increased the progression risk by 3.1 times (HR: 3.080, 95% CI: 1,671-5,675) in ECOG-PS 2 compared to ECOG-PS 0 and by 5 times (HR: 4.980, 95% CI 1.405-17.646) in ECOG-PS 3 compared to ECOG-PS 0. Our study determined a weak agreement between the doctor and patient in terms of performance assessment. The most significant reason for this discrepancy was found to be due to the levels of depression or anxiety in patients. In conclusion, it was demonstrated that the performance evaluations determined by doctors are more accurate and meaningful in terms of progression and survival results compared to those determined by patients.