Table 3.

RAM in Solid Organ Malignancy; Populations, Statistics, Advantages, and Disadvantages

RAM (Year)	Population	Type of Malignancy	Parameters	C Statistics/ HR	Validation Cohort	Advantages/Disadvantages
Khorana risk score (2008)16	Derivation cohort, n = 2701 Validation cohort, n = 1365	Breast, Lung, Ovarian, Sarcoma, Colon, and Lymphomas	Site of cancer platelet count ≥350 x 109/L haemoglobin ≤100 g/L (10 g/dL) and/or use of erythropoiesis-stimulating agents, leukocyte count ≥11 x 109/L, body mass index (BMI) of 35 kg/m2 or more	0.7 for both cohorts	More than 55 validation cohorts and several systematic reviews.	Advantages: Good in classifying high-risk. -more predictive when considering a score of ≥2 as a cut-off point for high risk Disadvantages: Suboptimal performance in predicting VTE in low-risk groups
Vienna Cancer and Thrombosis Study (CATS) Score(2018)17	n = 819	Breast, Lung, Stomach, Colorectal, Pancreas, Kidney, Prostate, Brain, Lymphoma, Multiple myeloma	Adds soluble P-selectin and D-dimer to KRS	1.9 per 1 point increase	Comparison study with no statistical significance2*	Disadvantages: Applicability in p soluble monitoring in a real-life setting might not be feasible
New Vienna (CATSCORE)18	CATS cohort, n = 1423 MICA cohort, n = 832	Breast, Prostate, Lung, Colorectal, Esophagus, Kidney, Lymphoma, Bladder or urothelial, Uterine, Cervical, Ovarian, Pancreas, Stomach	Site of cancer and D-dimer	0.66 in CATS 0.68 in MICA	Comparison study with no statistical significance2*	Advantages: only two factors score Disadvantage: Suboptimal performance in the comparison trial
PROTECHT Score (2012)	Placebo arm, n = 381 Nadroparin arm, n = 769	Gastrointestinal, Lung, Breast, Ovary, Pancreas, Head and Neck	Add gemcitabine, cisplatin, or carboplatin therapy to KRS	NA	1 study with positive19 2 studies show poor performance2,20	Advantages: easy to use, considers treatment-related risk factors Disadvantages: Suboptimal performance in the comparison trial
CONKO004(2015)21	n= 312	NA	Replace BMI in KRS with performance status	NA	Two comparison study with negative outcome*19,20	Advantage: easy applicability Disadvantages: poor stratification performance
ONKOTEV Score(2017)22	n = 843		Khorana score >2, personal history of VTE, metastatic disease, vascular/lymphatic macroscopic compression	C-statistic:0.719 at 3 months 0.754 at 6 months HR: Score = 1: 3.29 Score = 2: 6.54 Score > 2: 13.74	Multiple validation and comparison trials with negative outcome.*2,20	Advantages: easy to apply, consider tumour-related factors Disadvantages: Suboptimal performance
The COMPASS-CAT score(2016)23	n = 1023	Breast, Colorectal, Lung, or Ovarian cancer	Anthracycline or anti-hormonal therapy, time since cancer diagnosis, central venous catheter, stage of cancer, presence of cardiovascular risk factors, recent hospitalization for acute medical illness, personal history of VTE, and platelet count	C statistic: 0.850	Multiple validation.24–27	Advantages: Good performance in lung carcinoma,24 moves from traditional KRS Disadvantages: poor calibration.
Tic-ONCO score(2018)28	n = 391		Adds genetic risk score to KS	C-statistic 0.73 HR = 1.69	NA	Disadvantages: Application of genetics in a real-life setting is questionable
The MDACC CAT model29	n= 548	Breast, Gastrointestinal non-pancreas, Pancreas, Genitourinary non-kidney Kidney, Gynaecological Lung and head/neck Lymphoma	Presence of metastasis, use of platinum-based chemotherapy, the use of ESAs and malignancies of origin in the gastrointestinal, gynecologic, and head-neck/lung organs	C-index: 0.74	NA	Advantages: readily available information Disadvantages: lack of external validation

Notes: *Comparison studies was done between Khorana, PROTECHT, CONKO, CATScore and ONKOTEV.

Abbreviations: MICA, Multinational Cohort Study; CATS, Vienna Cancer and thrombosis study; HR, hazards ratio; C-statistic /C-index, concordance statistic; NA, not available.