Validation of a Risk Score for Cancer-Associated Thrombosis Using Nationwide EHR Data

Can routinely collected electronic health record (EHR) data from diverse health systems be used to model cancer-associated thrombosis (CAT) risk?In this prognostic study using a retrospective cohort of 732 594 patients with cancer receiving systemic therapy between 2018 and 2023 from 184 health systems, the EHR-CAT score significantly outperformed the benchmark Khorana score and had 20% improved accuracy. The model had consistent calibration by demographic subgroups, health system sites, and cohorts stratified by bleeding risk.These results suggest that standardized structured EHR data from different health systems can support scalable validation and implementation of CAT risk assessment.

Corresponding Author: Ang Li, MD, MS, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, 011DF, Houston, TX 77030 (ang.li2@bcm.edu).

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