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Edmonton Symptom Assessment System (ESAS-r)

Edmonton Symptom Assessment System — Revised (9 symptoms · 0–10 each · Max: 90)

Pain0

None (0)Worst (10)

Tiredness0

None (0)Worst (10)

Nausea0

None (0)Worst (10)

Depression0

None (0)Worst (10)

Anxiety0

None (0)Worst (10)

Drowsiness0

None (0)Worst (10)

Lack of Appetite0

None (0)Worst (10)

Wellbeing0

None (0)Worst (10)

Shortness of Breath0

None (0)Worst (10)

Symptom Profile

Rate each of the 9 core symptoms right now using the sliders.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Overview

The Edmonton Symptom Assessment System — Revised (ESAS-r) is the most widely used symptom monitoring tool in palliative care and oncology globally. It assesses nine core symptoms on 11-point numeric rating scales (0–10), giving a rapid but comprehensive snapshot of a patient's symptom burden. The "revised" ESAS-r incorporates improved question wording and anchor descriptors validated to reduce ambiguity.

Target Settings

All palliative care settings: inpatient, outpatient, home care, and hospice

Oncology outpatient clinics for routine visit-to-visit symptom monitoring

Cancer centers implementing electronic patient-reported outcome (ePRO) programs

Renal and heart failure palliative programs (validated in both populations)

Quality measurement and benchmarking across palliative care services

Why 9 Symptoms?

The 9 ESAS-r symptoms were selected through Delphi consensus as the minimum necessary core set covering the major domains of palliative symptom burden: physical (pain, tiredness, nausea, drowsiness, appetite, shortness of breath), psychological (depression, anxiety), and wellbeing (overall feeling of wellbeing). They take under 5 minutes to complete.

Related Scores in Practice

In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Ipos Integrated Palliative Care Outcome Scale, Msas Memorial Symptom Assessment, Distress Thermometer or the PAINAD to formulate a comprehensive care plan.

Last Comprehensive Review: 2026