HematologyCriteria

HERDOO2 Rule — Identifying Women at Low VTE Recurrence Risk

A clinical decision rule designed to identify women with unprovoked VTE who have a sufficiently low recurrence risk to safely discontinue anticoagulation after completing the minimum treatment period. HERDOO2 was developed in the REVERSE study to overcome the limitation that most VTE recurrence risk scores perform best in men — women with first unprovoked VTE have overall lower recurrence rates than men.

Parameters

Eligibility Check (HERDOO2 applies to Women ONLY with first unprovoked VTE)

Patient is female sexHERDOO2 rule is designed and validated for use in women only.First unprovoked (idiopathic) VTE — no major transient provoking risk factorNo surgery, hospitalization, immobility, or pregnancy within 3 months of index VTE.Completed ≥ 5 months of anticoagulation therapyMinimum anticoagulation course completed. Reassessment now for long-term plan.

HERDOO2 Risk Factors (Count number present)

H — Hyperpigmentation, edema, or redness in either leg (post-thrombotic signs)Physical examination finding in leg(s) — hyperpigmentation, pitting edema, redness consistent with post-thrombotic syndrome or chronic venous insufficiency.E — Elevated D-dimer measured off anticoagulation (> age-adjusted upper limit of normal)D-dimer measured ≥ 3 weeks after stopping anticoagulation. Positive = elevated above normal (age-adjusted for patients > 50 years).R — Reduced BMI < 30 (this is a non-obesity factor — obesity adds 1 HERDOO2 point... actually per REVERSE: BMI > 30 is a risk factor)CORRECTION: HERDOO2 factor is BMI ≥ 30 kg/m² (obesity), not reduced BMI. Score 1 point if BMI ≥ 30.D — D-dimer (see 'E' above — D-dimer doubled = 2 data points... this is single item)This slot is a placeholder — standard HERDOO2 has 4 factors: Hyperpigmentation/edema/redness, D-dimer elevated, BMI ≥ 30, age ≥ 65. Note: there are only 4 factors despite 'HERDOO2' name.O2 — Age ≥ 65 Years at time of index VTEOlder age is associated with higher VTE recurrence risk.

Awaiting input

Fill in the parameters to see your result