Table 6 Possible clinical scenarios and application

You evaluate a 50 year old man who presented VTE two weeks ago. His is currently under anticoagulant therapy with Warfarin. He presented VTE without any predisposing situation and currently smokes.

The patient´s score = 2. His probability of presenting cancer during the first year of follow up is 17% with a + LLR = 2.6. He could be included into an intensive cancer screening strategy.

You evaluate a 35 year old man after one week of discharge for a thromboembolic event related to a knee surgery. He has no medical history, is otherwise healthy and his albumin levels was 4 mg/dl at admission. His score for the combined outcome is 0.

The patient’s pretest of having the combined outcome at one year is approximately 20%. After the test his probability of having cancer or dying at one year is 6% with a negative predictive value of 93% and negative likelihood ratio of 0.22. The approach could be conservative and diagnostic testing could be withheld.

You evaluate a 73 year old woman who was discharged last week after a deep venous thrombosis of her right lower limb. It is her first event and she doesn’t have any other risk factors. Her albumin levels during hospitalization were 2.3 mg/dl. Otherwise, she is a smoker and has a Charlson score > 2. This patient´s score is 5.

The probability of dying or having cancer at one year is of 60%, PPV of 80 with + LLR of 7. This warrants tight follow up and possibly further diagnostic strategies.