HERDOO2 Rule for Discontinuing Anticoagulation in Unprovoked VTE
Identifies low-risk women with unprovoked VTE who can safely discontinue anticoagulation. Not validated in men.
Score interpretation
HERDOO2 = 0 in women: Low recurrence risk (~3% per year). Stopping anticoagulation is reasonable.
→ Discuss stopping anticoagulation with patient. Annual follow-up recommended.
HERDOO2 ≥ 1 in women, OR male patient: High recurrence risk. Continue long-term anticoagulation.
→ Continue indefinite anticoagulation unless contraindicated. Haematology review.
Male patient or multiple HERDOO2 criteria: High risk. Long-term anticoagulation indicated.
→ Continue indefinite anticoagulation. Haematology or vascular medicine referral.
Interpretation bands for the HERDOO2. Apply clinical judgement and local guidance.
References
- Rodger MA et al. Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy. CMAJ. 2008;179(5):417-426.
Related
Curated clinical cross-links plus same-class fallbacks.
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.