HeLP score
A paper-based aid to discussing hemangiosarcoma likelihood with owners of dogs presenting with spontaneous hemoabdomen.
Clinical education only. This resource does not affect surgical estimates. Entries stay in this page; they are not saved or sent.
What does the result mean?
HeLP predicts HSA diagnosis, not survival, all malignancy, or the complexity of surgery. The paper labels scores 0–40 low, 41–55 medium, and above 55 high. “Low” does not mean cancer is excluded.
The original study included 406 dogs: 219 for model construction and 187 for validation. A 2024 external study found acceptable, imperfect discrimination. Interpret this tool alongside the full clinical assessment.
Why do the points look counterintuitive?
The four variables were modelled together. Normal radiographs receive 17 points; an abnormal, nonmetastatic lung pattern receives zero. Protein and platelet categories are also not monotonic. These are the published model weights, not independent clinical rules.
The original validation dataset lacked thoracic radiograph findings and assigned the normal category. Selecting “unavailable” here explicitly reproduces the paper’s 17-point option without describing the chest as normal.
Evidence and limitations
The original cohort excluded primary coagulopathy and required histology obtained at surgery or necropsy. Its frequencies should not be transferred indiscriminately to incidental nonbleeding splenic masses. Individual uncertainty remains substantial.
Schick et al., 2019: Original HeLP study. Point assignments verified against Figure 2; category frequencies from the reported study results.
Hillier et al., 2024: External validation. Among 141 dogs with HeLP data, cumulative-score AUC was 0.79 and categorical-score AUC 0.73. These values describe discrimination, not a patient's probability.