The Palliative Performance Scale (PPS)

  • L Scott Wilner MD
  • Robert M Arnold MD

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Background     Accurate prognostic information is important for patients, families and physicians.   This Fast Fact reviews the Palliative Performance Scale (PPS); see Fast Fact #124 The Palliative Prognostic Score for another prognostic tool used in palliative care patients.   

The PPS uses five observer-rated domains correlated to the Karnofsky Performance Scale (100-0). The PPS is a reliable and valid tool and correlates well with actual survival and median survival time for cancer patients in outpatient and ambulatory settings. It has been found useful for purposes of identifying and tracking potential care needs of palliative care patients, particularly as these needs change with disease progression. Large validation studies are still needed, as is analysis of how the PPS does, or does not, correlate with other available prognostic tools and commonly used symptom scales.


  1. Anderson F, Downing GM, Hill J. Palliative Performance Scale (PPS):  a new tool. J Palliat Care. 1996; 12(1): 5-11.
  2. Morita T, Tsunoda J, Inoue S, et al. Validity of the Palliative Performance Scale from a survival perspective. J Pain Symp Manage. 1999; 18(1):2-3.
  3. Virik K, Glare P. Validation of the Palliative Performance Scale for inpatients admitted to a palliative care unit in Sydney, Australia. J Pain Symp Manage. 2002; 23(6):455-7.
  4. Myers J, Kim A, Flanagan J. Palliative performance scale and survival among outpatients with advanced cancer. Supportive Care in Cancer 2015; 23.4: 913-918.

Version History:  This Fast Fact was originally edited by David E Weissman MD and published in November 2004. Version re-copy-edited in April 2009; revised again July 2015 – reference 4 added and incorporated into text.