Purpose: To evaluate the performance status of a patient with cancer of the head or neck.						Citations with documentation. 01.01.03	Medal Project 2000. See disclaimer.
data	enter
Are you evaluating a patient with cancer of the head or neck? (Y or N)		:-):-):-)
enter an "x" in the appropriate column for each question (only 1 answer per row)
	unrestricted eating, anytime	restricts diet but can eat anywhere	restricted to certain places with certain people	eats only at home with selected people	always eats alone
eating in public							Yes	50
	always can be understood	usually understood	can understand if face-to-face	difficult to understand	never understood
understandability of speech							Yes	50
	unrestricted	can eat peanuts	can eat all meats	can handle carrots or celery	can handle dry bread or crackers
diet							Yes	80
	limited to soft chewable food	limited to soft foods needing no chewing	limited to pureed foods	can handle warm liquids	limited to cold liquids	nonoral feeding
calculate	result
data complete?	Yes
evaluation appropriate?	Yes	:-):-):-)
performance status for eating in public	50
performance status for speech	50
performance status for diet	80