Venous thromboembolism (VTE) affects about 1,200,000 individuals each year in Europe and is associated with a total annual cost ranging from €1.5 to 13.2 billion for the EU-28. About 50% of VTE are unprovoked and 30% will recur after stop of anticoagulant treatment. Guidelines recommend life-long treatment for most of these patients. Thus, most patients receive prolonged anticoagulation whereas their risk of recurrence is low. Available clinical rules have a high sensitivity, but a poor specificity for identifying recurrent VTE and do not allow reducing the proportion of patients receiving prolonged anticoagulant treatment. The scientific network STRATOSPHERE-VTE 2016 will help to personalize treatment duration after a first episode of unprovoked VTE and to reduce the proportion of patients receiving long-term treatment. This will include three steps. • In step 1, we will assess the predictive value of single nucleotide variants, plasma microRNA, proteomic biomarkers, humoral biomarkers and clinical data for the risk of recurrent VTE. A score for predicting recurrent VTE will be derived from available or financially secured data. • In step 2, the score will be externally validated and refined in new prospective cohorts. • In step 3, the effectiveness and medico-economic impact of the score will be evaluated against current practice in a multicenter randomized trial in 1660 patients with unprovoked VTE. By identifying patients at low risk of recurrent VTE, the STRATOSPHERE score will avoid unnecessary life-long anticoagulant treatment with its associated bleeding risk and costs in a substantial proportion of patients with VTE.

Reducing repeat hospitalisations is an unmet need and of great importance to patients with heart failure (HF) and, given its economic impact, to society as a whole, since HF is one of the most debilitating, deadliest and costliest of diseases. Such reduced hospitalisations may be achieved by therapy optimisation aimed at maximising efficiency and safety of evidence-based but still under-prescribed and under-dosed life-saving drugs. Aims: To meet the challenge of improving clinical decisions in the management of post-acute HF patients, CARE-MOST HF network aims at assessing the effectiveness within the framework of a randomised clinical trial of an innovative integrative theranostic method combining: i) a non-implantable, minimally invasive (a single daily fingertip drop of blood) home monitoring point-of-care tool measuring relevant cardiorenal parameters, ii) remote-monitoring facilities embedded into a patient-centred disease management programme (i.e. a telemedicine loop including a local call-centre), iii) an algorithmic expert system providing decision-making support for a more dynamic management of the complex pharmacological treatment of HF.