Introduction:
The Men and HER-DOO-2 rule is a clinical prediction rule for estimating the risk of recurrent VTE in women ≥18 years old with unprovoked VTE. In the original publication, no predictors for a low risk of recurrence were found in men, but in women, a low-risk group was identified - see below. Women with an unprovoked VTE and a HER-DOO-2 score of 0 - 1 could discontinue anticoagulation whilst women with a score of at least 2 and all men [assuming they tolerate anticoagulation and their risk of bleeding is small] , should continue.
The original study excluded patients with a high-risk thrombophilia profile:
- Protein C deficiency
- Protein S deficiency
- Antithrombin deficiency
- Persistently positive Anticardiolipin antibodies [> 30 U/mL]
- Persistently positive Lupus anticoagulant
- Two or more thrombophilic defects [e.g., homozygosity for the Factor V Leiden or Prothrombin gene mutation, or compound heterozygosity for the Factor V Leiden and Prothrombin gene mutation.