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Calcimator

Palliative Care Assessment Calculator

Score the Edmonton Symptom Assessment System (ESAS-r) with 9 symptom domains. Calculates total symptom distress, physical/psychological subscores, and palliative care referral criteria.

Inputs

Results

Total symptom distress score

24

Severe symptoms (score ≥7)

0

Physical subscore (0–60)15
Psychological subscore (0–30)9
Average symptom intensity2.7
Burden category (1=mild, 2=mod, 3=severe)1
Palliative referral indicated (0/1)0
How to Use This Calculator
  1. Score the patient's pain level, symptom burden, functional status, and psychological distress.
  2. Enter prognosis estimate and goals-of-care discussion status.
  3. Read the palliative care needs assessment score and recommended level of support.
  4. Review specific symptom domains requiring targeted intervention.
  5. Use results to trigger early palliative care consultation and goals-of-care conversations.

What each input means

Pain (0–10)
0 = no pain, 10 = worst possible pain.
Tiredness (0–10)
0 = no tiredness, 10 = worst possible tiredness.
Drowsiness (0–10)
0 = no drowsiness, 10 = worst possible drowsiness.
Nausea (0–10)
0 = no nausea, 10 = worst possible nausea.
Lack of appetite (0–10)
0 = best appetite, 10 = worst possible appetite.
Shortness of breath (0–10)
0 = no shortness of breath, 10 = worst possible.
Depression (0–10)
0 = not depressed, 10 = worst possible depression.
Anxiety (0–10)
0 = not anxious, 10 = worst possible anxiety.
Poor wellbeing (0–10)
0 = best feeling of wellbeing, 10 = worst possible.

What each result means

Total symptom distress score
Sum of all 9 symptoms (0–90). Mild <28, Moderate 28–54, Severe ≥55.
Physical subscore (0–60)
Sum of pain, tiredness, drowsiness, nausea, appetite, dyspnea.
Psychological subscore (0–30)
Sum of depression, anxiety, wellbeing.
Average symptom intensity
Mean score across all 9 symptom domains.
Severe symptoms (score ≥7)
Number of individual symptoms rated 7 or higher, requiring urgent attention.
Burden category (1=mild, 2=mod, 3=severe)
Overall symptom burden classification.
Palliative referral indicated (0/1)
1 if total SDS ≥28, any symptom ≥7, or ≥3 symptoms ≥4.

How this is calculated

Worked example, using the default values

  1. Identify Input Parameters
    4 parameters
    Pain (0–10) = 3, Tiredness (0–10) = 4, Drowsiness (0–10) = 2, Nausea (0–10) = 1 = 9 input(s) provided
  2. Calculate Total symptom distress score
    Total symptom distress score
    24 = 24
  3. Calculate Severe symptoms
    Severe symptoms
    0 = 0
  4. Calculate Physical subscore
    Physical subscore
    15 = 15
  5. Calculate Psychological subscore
    Psychological subscore
    9 = 9

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