HeyHippocratesVTE, thrombocytopenia, the smear — a colleague who cites every call.
Clinical decision support that reasons like a hematologist while you decide: anticoagulate the clot, work up the low platelets, catch the emergency, read the anemia — with the decision rule and exactly what would change it. Built for verified hematologists.
Watch it think — in hematology.
Two worked examples, reasoned the way it answers: the relevant clinical checks run, the answer is cited, the decision rule is explicit, and what is missing is flagged.
Unprovoked proximal deep-vein thrombosis, no cancer, low bleeding risk — anticoagulation choice and duration?
A direct oral anticoagulant (apixaban or rivaroxaban) is first-line over warfarin or LMWH for most VTE. Because this clot is unprovoked and the bleeding risk is low, treat beyond the initial three months with extended (indefinite) anticoagulation, reassessing the bleeding risk periodically — a reduced maintenance dose is an option. A cancer-associated clot would favor a DOAC or LMWH; a massive PE with instability needs thrombolysis.
Decision ruleVTE → DOAC first-line; provoked by a transient factor → 3 months; unprovoked / persistent risk + acceptable bleeding risk → extended anticoagulation.
Not established from this alone — the provoking factor, bleeding risk, cancer and renal function change the choice and duration.
Platelets 15, new anemia with schistocytes, acute kidney injury, fever and confusion — the diagnosis and first move?
Microangiopathic hemolytic anemia (schistocytes) with severe thrombocytopenia and end-organ signs is thrombotic thrombocytopenic purpura until proven otherwise — a hematologic emergency. Start urgent therapeutic plasma exchange without waiting for the ADAMTS13 result, add corticosteroids, and avoid platelet transfusion unless there is life-threatening bleeding. Send the ADAMTS13 before treatment.
Decision ruleMAHA + thrombocytopenia + organ injury → treat as TTP: urgent plasma exchange + steroids, do not wait for ADAMTS13; avoid platelet transfusion.
Not established from this alone — the smear, ADAMTS13, hemolysis markers and the clinical picture change the diagnosis.
Illustrative simulations. The physician always decides.
The answers hematologists actually look up.
The exact questions your field searches for — answered in the format the knowledge base speaks: the answer, the decision rule, what's missing, and the source.
Acute VTE — anticoagulation choice and duration?
A direct oral anticoagulant is first-line for most venous thromboembolism, over warfarin or low-molecular-weight heparin. Duration follows the provoking context: a clot provoked by a major transient factor is treated for about three months, while an unprovoked clot or a persistent risk factor favors extended anticoagulation when the bleeding risk is acceptable. Cancer-associated VTE uses a DOAC or LMWH; a massive PE with hemodynamic instability needs thrombolysis.ASH/CHEST · VTE
Decision ruleDOAC first-line; transient provoked → 3 months; unprovoked / persistent risk → extended (weigh bleeding); cancer → DOAC/LMWH; unstable PE → thrombolysis.
Missing data: the provoking factor, bleeding risk, cancer, renal function and patient preference change the plan.
Thrombocytopenia — the approach and the emergencies?
Work thrombocytopenia by mechanism and always look at the smear. Two emergencies cannot be missed: thrombotic thrombocytopenic purpura (microangiopathic hemolysis with schistocytes) needs urgent plasma exchange, and heparin-induced thrombocytopenia (a platelet fall on heparin with thrombosis, scored by the 4Ts) means stop all heparin and start a non-heparin anticoagulant. Isolated thrombocytopenia after excluding others is immune thrombocytopenia, treated when bleeding or very low.ASH · guideline
Decision ruleSmear first; MAHA + low platelets → TTP (plasma exchange); heparin + falling platelets/thrombosis (4Ts) → stop heparin, non-heparin anticoagulant; isolated → ITP.
Missing data: the smear, the timing and drug exposure, hemolysis markers and the 4T score change the diagnosis.
Febrile neutropenia — the emergency management?
A single fever with an absolute neutrophil count under 500 is an oncologic emergency. Draw cultures and give a broad-spectrum antipseudomonal beta-lactam within the first hour — do not wait for the workup. Risk-stratify with the MASCC score: low-risk, stable patients may be managed with oral antibiotics or as outpatients, while high-risk patients are admitted for IV therapy. Escalate for instability or a resistant organism.IDSA · guideline
Decision ruleANC <500 + fever → cultures then empirical antipseudomonal beta-lactam within 1 h; MASCC-stratify (low → oral/outpatient, high → admit IV).
Missing data: the neutrophil count and trajectory, hemodynamics, the source and prior prophylaxis change the plan.
New anemia — the diagnostic approach by MCV?
Start with the mean corpuscular volume and the reticulocyte count. Microcytic anemia is iron deficiency, thalassemia or anemia of chronic disease; normocytic is acute blood loss, hemolysis or chronic disease; macrocytic is B12 or folate deficiency, myelodysplasia, alcohol, hypothyroidism or a drug. A high reticulocyte count points to blood loss or hemolysis, a low one to underproduction. Let the pattern direct focused testing.guideline synthesis
Decision ruleMCV + reticulocytes frame it: micro → iron/thalassemia/chronic; normo → loss/hemolysis/chronic; macro → B12-folate/MDS/drugs; reticulocytes split loss vs underproduction.
Missing data: the MCV, reticulocytes, the smear and iron studies drive the workup.
What it knows in hematology
Your whole practice, one specialist brain — grounded in specialist-written, cited knowledge.
A generalist hematology colleague across thrombosis, cytopenias, anemia, malignancy and bleeding — cited, non-directive, always with the decision rule.
Deep specialist agents for malignant hematology, thrombosis & hemostasis, benign hematology and transfusion medicine — each its own specialist voice and knowledge base — plus your own uploaded materials.
Why not just use OpenEvidence or ChatGPT?
A large language model answers any clinical question with total confidence and no idea whether it is right. A search engine finds papers. HeyHippocrates reasons inside your specialty from a knowledge base a specialist in your field wrote and signed, and tells you the decision rule and what is missing.
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Questions hematologists ask
It reasons in the tools you use — provoked-versus-unprovoked VTE, the 4Ts, the MASCC score and the smear — and always shows the reasoning, the decision rule and what would change it. The decision always stays your call.
Both. Residents use it to pressure-test a plan and learn the decision rule; attendings use it as a fast, cited second opinion in clinic and on consults. Access is gated to verified physicians.
Malignant hematology, thrombosis & hemostasis, benign hematology and transfusion medicine each have their own deep specialist agent on the Pro plan, on top of the full hematology scope on Basic.
No. It is physician-facing clinical decision support — a cited thinking partner. It does not diagnose, does not treat, and gives no patient-facing advice. The decision always stays with you.
Every answer is grounded only in specialist-written, cited hematology knowledge — traceable to a named source — and always states the decision rule plus what data is missing, instead of a confident guess.