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21
MELD-NaAssesses the severity of chronic liver diseaseChild-Pugh ScoreAssesses the prognosis of chronic liver disease, mainly cirrhosisFIB-4 IndexLiver fibrosis scoring indexAPRIAST to platelet ratio — liver fibrosisMaddrey's DFAlcoholic hepatitis severityGlasgow-BlatchfordUpper GI bleed risk stratificationGAHSGlasgow alcoholic hepatitis scoreMontreal IBDIBD classification — CD & UCMayo ScoreUlcerative colitis activityBISAP ScoreBedside index for severity of pancreatitisCLIF-SOFAOrgan failure scoring in cirrhosisAlcohol ContentStandard drinks & alcohol grams calculatorAARC-ACLFAcute-on-chronic liver failure gradePELD / CR ScorePediatric end-stage liver diseaseHarvey-BradshawCrohn's disease activity indexCTSICT severity index — pancreatitisRockall ScoreGI bleed rebleeding & mortality riskCAGEAlcohol use disorder screening (4 questions)MELD 3.0Updated MELD — sex-inclusive formulaAUDIT ScoreAlcohol use disorders identification testVOCAL-Penn ScorePost-operative mortality risk in cirrhosis surgery

Liver & Cirrhosis

17
ALBI GradeAlbumin-bilirubin liver function grade in HCCUKELD ScoreUK model for end-stage liver diseaseMELD-XIMELD excluding INR — for anticoagulated patientsWest Haven CriteriaHepatic encephalopathy gradingMilan CriteriaLiver transplant eligibility in hepatocellular carcinomaLI-RADS v2018 (CT/MRI)Liver observation category from size, APHE and major featuresBCLC StagingHepatocellular carcinoma stage and treatment allocationSimplified AIH CriteriaSimplified criteria for autoimmune hepatitisRevised Original AIH ScoreIAIHG 1999 comprehensive autoimmune hepatitis scoreSAAGSerum-ascites albumin gradient — cause of ascitesR FactorHepatocellular vs cholestatic pattern in liver injuryCLIF-C ACLFMortality prediction in acute-on-chronic liver failureKing's College CriteriaTransplant criteria in acute liver failureGALAD ScoreHCC detection from gender, age, AFP-L3, AFP and DCPMetroticket 2.0AFP-adjusted up-to-seven for HCC transplant eligibilityRUCAMCausality in drug- and herb-induced liver injuryBaveno VII CriteriacACLD, CSPH and sparing screening endoscopy

Fibrosis & MASLD

8
NAFLD Fibrosis ScoreAdvanced fibrosis probability in MASLD/NAFLDBARD ScoreBMI, AST/ALT ratio, diabetes — MASLD fibrosisFatty Liver IndexPredicts hepatic steatosis from routine labsFibrotic NASH Index (FNI)At-risk NASH probability from AST, HbA1c and HDLNAFLD Activity Score (NAS)Histologic activity grade — steatosis, inflammation, ballooningMEFIB IndexMRE + FIB-4 rule for significant fibrosis (≥F2) in MASLDFAST ScoreFibroScan-AST — at-risk NASH from LSM, CAP and ASTSAFE ScoreSteatosis-Associated Fibrosis Estimator for MASLD in primary care

Pancreas & Biliary

8
Ranson's CriteriaAcute pancreatitis severity at 48 hoursGlasgow-Imrie CriteriaAcute pancreatitis severity — the PANCREAS criteriaHAPSHarmless acute pancreatitis scoreTokyo Guidelines — CholangitisTG18 diagnosis and severity grade for acute cholangitisTokyo Guidelines — CholecystitisTG18 diagnosis and severity grade for acute cholecystitisBiliary Pain (Rome IV)Rome IV — defining biliary-type pain before interventionFunctional Pancreatic SODRome IV — pancreatic sphincter of Oddi disorderRevised Atlanta ClassificationAcute pancreatitis severity — mild, moderately severe, severe

IBD

9
Truelove & Witts CriteriaAcute severe ulcerative colitis — admission decisionUCEISUlcerative colitis endoscopic index of severitySCCAISimple clinical colitis activity index — symptoms onlyCDAICrohn's disease activity index — the trial standardSES-CDEndoscopic severity in Crohn's diseasePUCAIPaediatric ulcerative colitis activity indexTravis (Oxford) CriteriaDay 3 colectomy risk in acute severe ulcerative colitisHo IndexDay 3 steroid failure risk in acute severe ulcerative colitisRutgeerts ScorePostoperative Crohn's recurrence at ileocolonoscopy

GI Bleeding

7
EVendo ScorePredicts oesophageal varices needing treatmentForrest ClassificationPeptic ulcer bleeding — rebleeding risk at endoscopyAIMS65 ScoreUpper GI bleed mortality — five bedside criteriaOakland ScoreSafe-discharge risk for acute lower GI bleedingABC ScoreAge, blood tests, comorbidities — GI bleed mortalitySarin ClassificationEndoscopic classification of gastric varicesEGUS (Gastric Ulcer)Malignancy risk in a gastric ulcer, and who needs repeat endoscopy

Alcohol

2
ABIC ScoreAge, bilirubin, INR, creatinine — alcoholic hepatitisLille ModelSteroid response at day 7 in alcoholic hepatitis

Upper GI

4
Chicago Classification v4.0Oesophageal motility pattern from high-resolution manometryLA Classification (Oesophagitis)Los Angeles grade A–D for erosive oesophagitisPrague C & M CriteriaCircumferential and maximal extent of Barrett's oesophagusEREFS (Eosinophilic Oesophagitis)Endoscopic reference score — oedema, rings, exudates, furrows, stricture

Colorectal

3
Boston Bowel Prep ScaleColonoscopy preparation adequacy by segmentStool Osmotic GapOsmotic vs secretory diarrhoea from stool electrolytesATLAS Score (C. difficile)Predicted response to therapy in Clostridioides difficile infection

Functional GI

37
Bristol Stool ScaleStool form types 1–7 and colonic transitRome IV Criteria for IBSIrritable bowel syndrome diagnosis and subtypeFunctional ConstipationRome IV — two of six items, IBS excludedOpioid-Induced ConstipationRome IV — constipation tied to opioid therapyFunctional DiarrhoeaRome IV — loose stools without predominant painFunctional Bloating / DistensionRome IV — bloating without other bowel disorder criteriaUnspecified Functional Bowel DisorderRome IV — bowel symptoms fitting no other categoryCentrally Mediated Abdominal Pain (CAPS)Rome IV — continuous pain unrelated to gut eventsNarcotic Bowel SyndromeRome IV — opioid-induced hyperalgesia of the gutFaecal Incontinence (Rome IV)Rome IV — the criteria, and why nobody is askedFunctional Anorectal PainLevator ani, unspecified pain and proctalgia fugaxFunctional Defecation DisordersRome IV — dyssynergia and inadequate propulsionInfant RegurgitationRome IV — the happy spitter, and the alarm features that rule it outInfant ColicRome IV — recurrent unexplained crying in a well infant under 5 monthsInfant DyscheziaRome IV — straining before a soft stool, and why not to intervenePaediatric Functional ConstipationRome IV — two of six over one month, with overflow soiling as a criterionToddler's DiarrhoeaRome IV functional diarrhoea of childhood — painless, thriving childPaediatric Cyclic Vomiting SyndromeRome IV — both age bands, with different criteria for eachPaediatric Rumination SyndromeRome IV — infant and child/adolescent criteriaFunctional Nausea & Vomiting (Children)Rome IV — two separate disorders that can be met togetherAerophagiaRome IV — distension that increases through the dayPaediatric Functional DyspepsiaRome IV — four times a month, with PDS and EPS subtypingPaediatric Irritable Bowel SyndromeRome IV — plus the constipation clause clinicians missAbdominal MigraineRome IV — stereotypical incapacitating episodes weeks apartFunctional Abdominal Pain — NOSRome IV — the residual category, reached after the other threeNonretentive Faecal IncontinenceRome IV — soiling without retention, where laxatives make it worseFunctional DyspepsiaRome IV — with PDS and EPS subtypingRumination SyndromeRome IV — effortless regurgitation without retchingCyclic Vomiting SyndromeRome IV — stereotypical episodic vomitingCannabinoid HyperemesisRome IV — CVS pattern relieved by cannabis cessationChronic Nausea & VomitingRome IV — chronic nausea and vomiting syndromeBelching DisordersRome IV — supragastric vs gastric belchingFunctional HeartburnRome IV — heartburn with normal acid exposureReflux HypersensitivityRome IV — normal acid exposure, positive symptom associationFunctional Chest PainRome IV — non-cardiac, non-reflux chest painGlobusRome IV — painless lump-in-throat sensationFunctional DysphagiaRome IV — dysphagia with normal endoscopy and manometry
  1. Calculators
  2. /
  3. EVendo Score
GI Bleeding

EVendo Score

Predicts oesophageal varices needing treatment

When to use
Use EVendo when deciding whether a patient with cirrhosis needs a screening endoscopy for varices, in exactly the population where that question is routine — compensated or early decompensated cirrhosis under surveillance. Its strongest performance is in Child-Turcotte-Pugh class A disease, which is also where the yield of endoscopy is lowest and the case for deferral strongest. It is a screening-avoidance tool, not a diagnostic one: a low score defers endoscopy with follow-up and re-scoring, it does not exclude varices. It has no role in acute variceal bleeding, where endoscopy is therapeutic and immediate, nor in deciding whether to start non-selective beta blockers in someone already known to have varices.
Why use it
Because screening endoscopy in cirrhosis is a procedure with real cost and real risk that mostly finds nothing actionable, and the alternatives for avoiding it have gaps. The Baveno VI criteria already spare endoscopy in patients with a liver stiffness under 20 kPa and platelets above 150, but they require transient elastography, which many services cannot offer at scale or at all. EVendo uses only blood tests and a clinical examination finding, so it works wherever a full blood count and liver panel are available. Its authors framed the target precisely — not varices in general but varices *needing treatment*, since finding a small varix that requires no intervention is not a clinical gain.
Formula, evidence and interpretation

About the EVendo Score for Oesophageal Varices Needing Treatment

Most patients with cirrhosis who undergo screening endoscopy turn out to have no varices or only small ones, and the EVendo score exists to identify who can safely skip the procedure. Six routinely available items feed it — INR, AST, platelet count, blood urea nitrogen, haemoglobin and the presence of ascites — combined as a ratio rather than a points total. At the published cut-off of 3.90 or below, applying the score to the derivation population would have spared 30.5% of endoscopies while missing only 2.8% of varices needing treatment, rising to 40.0% of endoscopies spared and 1.1% of VNT missed in Child-Turcotte-Pugh class A cirrhosis. It was developed with a random forest algorithm rather than conventional regression, which is unusual among liver scores.

On this page

  • Formula
  • Interpreting the result
  • Inputs
  • What it returns
  • How it is calculated
  • Facts & figures
  • Evidence
  • How it compares
  • Pearls & pitfalls
  • Critical actions
  • Why it exists
  • About the creator
  • Limitations
  • If you are the patient
  • FAQ
  • Related calculators
  • References

Formula

A = (8.5 × INR) + (AST / 35); B = (platelets / 150) + (BUN / 20) + (haemoglobin / 15); EVendo = A / B + (1 if ascites present)
INR
International normalised ratio, multiplied by 8.5 — the largest weight in the formula.
AST
In U/L, divided by 35.
platelets
In ×10³/µL (equivalent to ×10⁹/L), divided by 150.
BUN
Blood urea nitrogen in mg/dL, divided by 20.
haemoglobin
In g/dL, divided by 15.
ascites
Adds 1 to the final ratio, not to the numerator — it is applied after the division.
  • The ascites point is added to the quotient, after A has been divided by B. Adding it inside the numerator gives a different and incorrect result.
  • This is a ratio, not a sum, so the terms interact: the same platelet count contributes differently depending on the BUN and haemoglobin alongside it.
  • BUN is not the same as urea. Where a laboratory reports urea in mmol/L, convert to BUN in mg/dL by dividing by 0.357 — this is the most likely unit error outside the United States.
  • Because ascites adds a full point, its presence alone pushes most patients above the 3.90 threshold, which is clinically appropriate but means the score adds little in patients with obvious ascites.

Interpreting the result

A score of 3.90 or below identifies a low-probability group in whom screening endoscopy may reasonably be deferred, with clinical follow-up and re-scoring at intervals rather than discharge from surveillance. Above 3.90, varices needing treatment cannot be excluded and endoscopy should proceed. The figures behind the threshold matter for how confidently it is applied: in the full derivation population it would have avoided 30.5% of endoscopies at the cost of missing 2.8% of varices needing treatment, whereas in Child-Turcotte-Pugh class A patients it would have avoided 40.0% while missing only 1.1%. That difference is the practical message — the score is safest and most useful in compensated disease, and a clinician should be more cautious about deferring endoscopy in a patient with more advanced cirrhosis. Discrimination for varices needing treatment specifically (AUROC 0.74–0.75) was consistently lower than for varices of any size (0.82–0.84).

ScoreBandWhat it meansAction
≤ 3.90Low probability of varices needing treatmentWould have spared 30.5% of endoscopies overall (40.0% in CTP class A) while missing 2.8% of VNT (1.1% in CTP class A)Screening endoscopy may reasonably be deferred, with clinical follow-up and re-scoring later — not discharge from surveillance
> 3.90Screening endoscopy indicatedVarices needing treatment cannot be excludedProceed with screening upper endoscopy

What the EVendo Score needs (6 inputs)

INR
Weighted 8.5 in the numerator, making it the dominant single term — small changes in INR move the score substantially.
AST (U/L)
Divided by 35 in the numerator, so it contributes on a scale of multiples of the upper reference range.
Platelet count (×10³/µL)
Divided by 150 in the denominator, so falling platelets raise the score — the portal-hypertension signal.
Blood urea nitrogen (mg/dL)
Divided by 20 in the denominator.
Haemoglobin (g/dL)
Divided by 15 in the denominator, so anaemia raises the score.
Ascites
Adds a flat 1 point to the final result when present.

Units. The formula expects US conventional units: BUN in mg/dL (not urea in mmol/L — divide mmol/L by 0.357), haemoglobin in g/dL (divide g/L by 10), platelets in ×10³/µL (numerically the same as ×10⁹/L), and AST in U/L. The BUN conversion is the commonest error outside the United States.

What it returns

EVendo score
A continuous ratio, reported to two decimal places.
Screening recommendation
Low probability of varices needing treatment (≤ 3.90) or screening endoscopy indicated (> 3.90).

How it is calculated

Dong and colleagues collected data on 238 patients with cirrhosis undergoing screening endoscopy at three Los Angeles hospitals between January 2016 and December 2017, recording sex, age, ethnicity, platelets, haemoglobin, sodium, AST, ALT, bilirubin, INR, albumin, urea nitrogen, creatinine, cirrhosis aetiology, and the presence of ascites and hepatic encephalopathy. Rather than fitting a logistic regression, they applied a random forest algorithm to identify which factors were associated with varices and with varices needing treatment. Six emerged, and the resulting formula was then tested prospectively in 109 further patients at the same centres during 2018. The machine-learning derivation explains the score's unusual ratio structure — the form was chosen to fit the data rather than for interpretability, which is why it does not resemble a conventional points scale.

Facts & figures

Discrimination in the derivation study (Dong 2019)
OutcomeTraining (n = 238)Validation (n = 109)CTP class A (n = 235)
Oesophageal varices (any)AUROC 0.84AUROC 0.82AUROC 0.81
Varices needing treatmentAUROC 0.74AUROC 0.75AUROC 0.75

Performance for varices needing treatment — the clinically decisive outcome — is consistently lower than for varices of any size, which is the score's main statistical limitation.

Endoscopies avoided at the 3.90 cut-off
PopulationEndoscopies sparedVNT missed
All patients30.5%2.8%
Child-Turcotte-Pugh class A40.0%1.1%

The score performs best where the pre-test probability is lowest — compensated cirrhosis — which is also where deferring endoscopy is most attractive.

Evidence

Derivation — Dong (random forest)

2019 · n = 238

238 patients with cirrhosis undergoing screening oesophagogastroduodenoscopy at three separate hospitals in Los Angeles from January 2016 through December 2017. Demographic, laboratory and clinical variables — including platelets, haemoglobin, sodium, AST, ALT, bilirubin, INR, albumin, urea nitrogen, creatinine, aetiology, ascites and hepatic encephalopathy — were analysed with a random forest algorithm to identify predictors of varices and of varices needing treatment.

The resulting EVendo score, based on INR, AST, platelets, urea nitrogen, haemoglobin and ascites, identified oesophageal varices with an AUROC of 0.84 in training and varices needing treatment with an AUROC of 0.74. A cut-off below 3.90 would have spared 30.5% of patients an endoscopy while missing only 2.8% of varices needing treatment.

Prospective validation — Dong

2019 · n = 109

109 patients undergoing screening endoscopy prospectively at the same three medical centres from January through December 2018, used to test the accuracy of the derived formula.

AUROC 0.82 for varices of any size and 0.75 for varices needing treatment, closely reproducing the training performance. In the 235 patients with Child-Turcotte-Pugh class A cirrhosis, AUROCs were 0.81 and 0.75, and the same cut-off would have spared 40.0% of endoscopies while missing 1.1% of varices needing treatment.

How it compares

EVendo Score vs Baveno VI criteria (liver stiffness < 20 kPa and platelets > 150)

Baveno VI is the guideline-endorsed route to avoiding endoscopy but requires transient elastography; EVendo reaches a similar decision from blood tests alone, which makes it usable where elastography is not.

The Baveno VI criteria spare screening endoscopy in compensated advanced chronic liver disease when liver stiffness is below 20 kPa and platelets exceed 150 × 10⁹/L, and they carry consensus backing that EVendo does not. Their limitation is access: elastography is unavailable in many services and unreliable in obesity and ascites. EVendo needs only a full blood count, a liver panel, urea and a clinical examination, so it extends the same decision to settings without elastography — at the cost of a lower evidence base and no guideline endorsement.

de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C; Baveno VII Faculty. Baveno VII – Renewing consensus in portal hypertension. J Hepatol. 2022;76(4):959-974.

EVendo Score vs Child-Pugh score

Child-Pugh grades overall cirrhosis severity and does not predict varices; EVendo predicts varices needing treatment specifically, and its own performance is stratified by Child-Pugh class.

The two are complementary rather than competing, and the relationship runs one way: knowing a patient is Child-Turcotte-Pugh class A is what tells you EVendo is at its most reliable, where it spared 40.0% of endoscopies while missing 1.1% of varices needing treatment. Child-Pugh itself was never designed to answer whether a varix needs banding, and using it that way would be a misapplication.

Open the Child-Pugh score calculator →

EVendo Score vs Glasgow-Blatchford score

Opposite clinical moments — EVendo decides whether an asymptomatic patient with cirrhosis needs elective screening endoscopy, while the Glasgow-Blatchford score triages a patient who is already bleeding.

The pairing is worth distinguishing because both scores use haemoglobin and urea and both bear on whether endoscopy is needed, which invites confusion. Glasgow-Blatchford is a pre-endoscopy risk score in acute upper gastrointestinal bleeding, identifying who can be managed as an outpatient. EVendo operates before any bleeding has occurred, in surveillance. A patient with acute variceal bleeding needs urgent therapeutic endoscopy regardless of any EVendo score.

Open the Glasgow-Blatchford score calculator →

Pearls & pitfalls

  • The ascites point is added after the division, not to the numerator. Getting this wrong changes the result substantially.
  • BUN is not urea. Outside the United States, divide urea in mmol/L by 0.357 to obtain BUN in mg/dL — otherwise the denominator is badly wrong.
  • INR carries a weight of 8.5 and dominates the numerator, so it is the value most worth double-checking, particularly in a patient on anticoagulation where the INR does not reflect liver function at all.
  • The score predicts varices needing treatment less well (AUROC ~0.75) than varices of any size (~0.83). Read the headline discrimination figures carefully, because the lower number is the clinically relevant one.
  • A low score defers endoscopy; it does not exclude varices. Re-score at follow-up rather than treating a single result as a permanent clearance.
  • It is most reliable in Child-Turcotte-Pugh class A cirrhosis. Be more cautious about deferring endoscopy in class B or C, where fewer validation data support the threshold.
  • Because ascites alone adds a full point, the score contributes little in a patient with clinically obvious ascites, who will almost always cross the threshold anyway.

Critical actions

  • Convert urea to BUN in mg/dL before calculating if your laboratory does not report BUN directly.
  • Apply the ascites point to the quotient, after dividing A by B.
  • Arrange endoscopy without delay for any score above 3.90, and do not use a borderline score to justify deferral.
  • Re-score patients at surveillance intervals rather than treating one low result as lasting reassurance — portal hypertension progresses.
  • Check whether the INR is raised by anticoagulation rather than by liver disease, since that inflates the score's dominant term and will falsely trigger endoscopy.
  • Consider the Baveno VI criteria alongside EVendo where transient elastography is available, as the two can be used together to strengthen a decision to defer.

Why this score exists

The authors' opening premise was economic and ethical rather than diagnostic: endoscopic screening for varices is, in their framing, a potentially deferrable procedure that increases patient risk and healthcare cost, and most of the patients who undergo it are found to have no varices or only small ones. That framing dictated the design target. They aimed not at detecting varices — which would have been the easier statistical problem, and indeed the score does it better — but at detecting varices *needing treatment*, because a small varix found at endoscopy changes nothing. The choice of a random forest over regression follows the same pragmatism: the goal was a formula that worked on readily available data, not one whose coefficients told a physiological story, which is why the published expression is a ratio with no obvious clinical interpretation.

About the creator

  • Tien S. Dong

    First author, 2019 derivation and validation study

    Applied a random forest algorithm to routinely available data to derive the score, then tested it prospectively.

  • James H. Tabibian

    Senior author

    Led the work aimed at safely deferring screening endoscopy in patients unlikely to have varices needing treatment.

Limitations

  • Discrimination for varices needing treatment — the outcome that actually matters — is only moderate, with AUROCs of 0.74 to 0.75, notably lower than for varices of any size.
  • The cut-off still misses varices needing treatment in 2.8% of patients overall, so deferral is a calculated risk rather than a safe exclusion.
  • It was derived and validated at three hospitals in a single city, with no independent multi-centre validation in the original publication.
  • Validation data are strongest in Child-Turcotte-Pugh class A cirrhosis; the threshold is less well supported in class B and C.
  • The random forest derivation produced a formula with no physiological interpretation, which makes it harder to reason about when a component is confounded.
  • INR is heavily weighted and is unreliable in anticoagulated patients, in whom the score will be systematically inflated.
  • It carries no guideline endorsement comparable to the Baveno criteria, so deferring endoscopy on EVendo alone is a departure from consensus recommendations.
  • BUN is affected by renal function, diet, gastrointestinal bleeding and hydration, none of which relate to portal hypertension.

If you are the patient

The EVendo score helps doctors decide whether someone with cirrhosis needs a camera test (endoscopy) to look for enlarged veins in the food pipe, called varices. Most people with cirrhosis who have this test turn out to have no varices, or only small ones that need no treatment, so avoiding an unnecessary procedure is worthwhile. The score uses five blood results — a clotting test (INR), a liver enzyme (AST), your platelet count, a kidney test (urea), and your haemoglobin — plus whether you have fluid in your abdomen. A score of 3.90 or below suggests the test can safely be put off for now, with continued monitoring and re-checking later. Above that, the camera test is recommended. It is not a perfect test: in the original study, deferring the procedure at this cut-off missed a small number of varices that did need treatment, which is why your team will keep reviewing you rather than dropping the check altogether.

Frequently asked questions

What is the EVendo score cut-off?#

3.90. A score of 3.90 or below identifies patients unlikely to have varices needing treatment, in whom screening endoscopy may reasonably be deferred with continued follow-up. Above 3.90, endoscopy should proceed.

How many endoscopies does the EVendo score avoid?#

At the 3.90 cut-off it would have spared 30.5% of endoscopies overall while missing 2.8% of varices needing treatment, and 40.0% in Child-Turcotte-Pugh class A cirrhosis while missing only 1.1%.

How accurate is the EVendo score?#

AUROC was 0.84 in training and 0.82 in prospective validation for varices of any size, but 0.74 and 0.75 for varices needing treatment — the lower figure is the clinically relevant one.

Is EVendo better than the Baveno VI criteria?#

Not better, but more widely applicable. Baveno VI carries consensus endorsement and requires transient elastography plus a platelet count; EVendo needs only blood tests and an examination, so it works where elastography is unavailable, at the cost of a smaller evidence base.

Does EVendo use urea or BUN?#

Blood urea nitrogen (BUN) in mg/dL. If your laboratory reports urea in mmol/L, divide by 0.357 to convert. Entering urea directly will give an incorrect score.

Can a low EVendo score rule out varices?#

No. It identifies a low-probability group in whom endoscopy can reasonably be deferred, not excluded — 2.8% of varices needing treatment were still missed at the cut-off, so continued surveillance and re-scoring are essential.

Related calculators

  • Child-Pugh Score — Assesses the prognosis of chronic liver disease, mainly cirrhosis
  • MELD-Na — Assesses the severity of chronic liver disease
  • Sarin Classification — Endoscopic classification of gastric varices
  • Glasgow-Blatchford — Upper GI bleed risk stratification
  • Milan Criteria — Liver transplant eligibility in hepatocellular carcinoma
  • Baveno VII Criteria — cACLD, CSPH and sparing screening endoscopy

References

Original / primary reference

  1. Dong TS, Kalani A, Aby ES, et al. Machine learning-based development and validation of a scoring system for screening high-risk esophageal varices. Clin Gastroenterol Hepatol. 2019;17(9):1894-1901.e1.

Guidelines

  1. de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C; Baveno VII Faculty. Baveno VII – Renewing consensus in portal hypertension. J Hepatol. 2022;76(4):959-974.

Clinical practice guidance

  1. Kaplan DE, Ripoll C, Thiele M, et al. AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis. Hepatology. 2024;79(5):1180-1211.

Last updated July 30, 2026. Clinical knowledge base written and curated by GastroAGI Team from primary medical literature.

Written from primary literature and not yet independently clinically reviewed.

For use by qualified healthcare professionals. This calculator supports clinical judgement and does not replace it.