HERDOO2 decision rule for recurrent venous thromboembolism

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Clinical decision rule to identify patients at low risk of recurrent venous thromboembolism after 5-7 months of oral anticoagulant therapy.
HERDOO2 stands for: hyperpigmentation, edema, redness, D-dimer, obesity, older age, 2 scores.

Research authors: Marc A Rodger, Susan R Kahn, Philip S Wells, David A Anderson, Isabelle Chagnon, Grégoire Le Gal, Susan Solymoss, Mark Crowther, Arnaud Perrier, Richard White, Linda Vickars, Tim Ramsay, Marisol T. Betancourt, Michael J. Kovacs

Details Formula Study characteristics Files & References

★★★

Model author

Evidencio

Model ID

915

Version

1.4

Revision date

2017-10-16

Specialty

Cardiology, Clinical pharmacology, Vascular medicine

MeSH terms

Thromboembolism, Venous

Anticoagulant Drugs

Clinical Prediction Rule

Model type

Linear model ^{(Calculation)}

Status

public

Rating

★ ★ ★

Formula
No Formula defined yet

Condition	Formula

Additional information

In 2008, Rodger et al. proposed the HERDOO2 model, deriving data from a Canadian multicenter prospective cohort study that included 646 patients with a first unprovoked VTE event followed up for 18 months after discontinuing oralanticoagulation therapy.

Study Population

Total population size: 646

Males: {{ model.numberOfMales }}

Females: {{ model.numberOfFemales }}

Continuous characteristics

Name	Mean	SD	Unit
Age	52.5	17.5	years
Weight	87.5	23.6	kg
Height	171.6	10.8	cm
BMI	29.1	7.2	kg/m2
d-Dimer	307	403	ug/L
Homocysteine	10.1	8.0	umol/L
Hemoglobin	142.2	15.0	g/L
Factor VIII	1.7	0.55	U/mL

Categorical characteristics

Name	Subset / Group	Nr. of patients
Abnormal baseline compression ultrasound	Recurrent VTE	45
	No VTE	186
Abnormal baseline imaging	Recurrent VTE	64
	No VTE	327
Factor V Leiden	Recurrent VTE	19
	no VTE	81
VTE	Recurrent	91
	No VTE	555
V/Q scan or PVO result <95%	Recurrent VTE	38
	No VTE	272
Post-thrombotic signs	HER	215
	Edema	149
	Redness	71
	Hyperpigmentation	93
History of COPD or emphysema	Recurrent VTE	1
	No VTE	39
Family history of VTE	recurrent VTE	18
	no VTE	135

	HERDOO2 decision rule for recurrent venous thromboembolism
	V-1.4-915.17.10.16
	Refer to Intended Use for instructions before use
	Evidencio B.V., Irenesingel 19, 7481 GJ, Haaksbergen, the Netherlands

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Supporting Publications

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HERDOO2 risk score:
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Result

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HERDOO2 risk score: points

Outcome stratification

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Conditional information

Result interpretation

Interpretation of results:

In a study by Rodger et al (2008) including 646 patients with a first unprovoked venous thromboembolism (VTE) event, an annual risk of VTE recurrence of 9.3% [95% confidence interval (CI) 7.7–11.3%) was recorded in the whole cohort, and of 13.7% in men.

On the basis of these results, the authors recommend a long-term anticoagulant treatment as always indicated for all men.

Women with a total risk score of 0 to 1 had an annual risk of recurrence of 1.6% (95% CI 0.3-4.6%), whereas those who had a score of 2 or more had an annual risk of 14.1% (95% CI 10.9–17.3%) and deserved, according to the authors, an indefinite anticoagulation.

Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

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Disclaimer: Calculations alone should never dictate patient care, and are no substitute for professional judgement.