What is the VOLO™ Health Report?

Standard laboratory reports hand a clinician a list of numbers and a column of reference ranges. They typically indicate where the value is related to the central 95% distribution of healthy individuals; however, the statistically derived range may be adjusted based on perceived healthy limits— and little else. Often, there is no population-relative context calibrated to the patient’s age and sex, nor a quantified connection between markers, and lacking an indication of what the full biomarker picture means for the patient’s long-term disease trajectory.

The VOLO™ Health Report (VHR™) is built on a different premise. It takes the patient’s lab results and applies VOLO Health’s proprietary modeling platform to generate VOLO™ Scores and analytics— the same analytical infrastructure underlying the VOLO™ Biomarker Reference Guide — to produce a structured, personalized report that quantifies long-term disease risk across multiple health domains simultaneously, expresses results relative to an age- and sex-matched population average, and tracks trajectory across successive measurements.

The VHR is not a diagnostic tool. It is a proactive clinical intelligence instrument for long-term health assessments — designed to help educate clinicians about population-relative risk patterns, track patient health trends, and understand what the biomarker panel is signaling across multiple domains of long-term health simultaneously.

The VHR does not just report a patient’s labs. It correlates them — against a patient-specific VOLO™ Modeled Range, across multiple health domains, and through a suite of scores designed to give the clinician a clear, actionable picture of that patient’s long-term health trajectory.

Ordering and report delivery: The VHR is generated from a preferred blood panel and common biometrics clinicians measure with routine office visits. Clinicians can order the preferred biomarkers through two pathways:

Report completeness scales with panel breadth. The more VHR biomarkers available, the richer the domain scores and VOLO Modeled Range (VMR™) comparisons. A full list of preferred biomarkers is available in the VOLO™ Biomarker Reference Guide. Partial panels produce valid reports — scores are computed from available inputs by imputation of missing values into the VOLO Scores and the VHR.

What’s inside the report?

The VHR is organized around four sequential views. Each view builds on the prior, moving from the multi-domain summary through per-domain detail, into individual biomarker analysis, and finally into the multi-domain longitudinal relationships across successive measurements. Each view is described below with notes on interpretation for the clinician.

1. VOLO™ Score - Domain Summary

The report opens with a radar graph view of the patient’s VOLO Score across all modeled health domains. The radar graph presents the full domain panel in a single radial display, making the relative balance of risk across domains immediately visible before entering the domain-by-domain detail.

Each domain receives a VOLO Score — a population-relative index centered at 200, where 200 represents the age- and sex-matched population average predicted long-term disease probability for that domain. Scores above 200 indicate below-average predicted risk; scores below 200 indicate above-average predicted risk. Every 20-point change corresponds to an approximate doubling or halving of predicted 15-year disease probability relative to the population average. Domain scores are derived from gradient boosting models trained on large longitudinal cohorts (UK Biobank and US clinical populations) with outcomes defined by validated ICD-10 code sets.

The preset domains shown in the report include the following, however there are additional health domains selectable:

2. VOLO™ Score – Domain Detail

The domain detail view expands each domain individually, displaying the current VOLO Score, VOLO™ Age and delta, and a trend chart plotting the patient’s score trajectory across all available measurement periods. Each domain also displays a maximum VOLO Score, representing the model’s discriminative ceiling for that domain given the patient’s age and sex, which contextualizes the available room for improvement.

The VOLO Score is calculated independently for each domain — it is not a single composite across domains. Each domain score reflects the patient’s predicted long-term disease probability (derived from the calculated Risk Ratio) for that domain’s specific ICD-10-defined outcomes relative to an age- and sex-matched population average. The score is most valuable as a longitudinal tracking metric. A single cross-sectional score provides population-relative context; a series of scores over time reveals whether the patient’s health trajectory is improving or deteriorating, and by how much. Because the scoring scale has a defined probabilistic interpretation — 20 points = doubling or halving of predicted risk — changes are directly communicable to patients without requiring additional explanation.

3. VOLO™ Age

The VOLO Age is a domain-specific biological age estimate derived by inverting the patient’s VOLO Score against the age-matched reference curve for the same-sex population in the training cohort. It identifies the age at which the average reference population member would have an equivalent VOLO Score. It is expressed as a delta from chronological age (e.g., −6.0 years) and the biological age (actual age +/- delta).

VOLO Age should be interpreted as a population-comparative measure, not a prognostic endpoint. A Cardiovascular VOLO Age of −6.0 years means the patient’s cardiovascular biomarker profile is associated with the predicted disease probability of someone 6 years younger in the reference population — it does not predict lifespan or imply a causal biological age. The delta is domain-specific: a patient may have a favorable Cardiovascular VOLO Age and an average or unfavorable Metabolic VOLO Age, reflecting divergent risk trajectories across domains that are addressable in different ways.

For patient communication, VOLO Age is one of the most patient-friendly outputs in the VHR. It translates a multi-biomarker probabilistic picture into a frame of reference that patients immediately grasp and respond to motivationally.

4. Biomarker Analysis — VMR™, Biomarker Strength, and Impact

Within each domain, the detail view also identifies which biomarkers are driving that domain’s score and by how much when viewing Score Impact. Each biomarker in the panel is displayed alongside two reference ranges: the standard laboratory reference range provided by the testing laboratory, and the VOLO Modeled Range (VMR).

Results outside either range are flagged directionally (above or below). Each biomarker contributing to the domain is displayed alongside four analytical layers:

VOLO Modeled Range (VMR) is the data-derived reference range representing the biomarker values associated with the lowest composite long-term disease risk across all modeled domains for the patient’s age and sex. Results outside the VMR are flagged directionally — above or below — since the implication differs by direction, and a value that is clinically normal by standard lab reference may still fall outside the VMR. The VMR frequently will differ from the standard lab reference range. This is expected and meaningful: the VMR is not a population normal range; it is the range the model identifies as associated with optimal long-term outcomes across multiple disease (domain) endpoints. A patient whose value falls within the standard lab range but outside the VMR has a value that is clinically “normal” but not at the modeled optimum for their demographic profile — a distinction that may have clinical relevance for long-term risk management.

Biomarker Strength (1–10) reflects the biomarker’s marginal predictive contribution to that domain’s VOLO Score, allowing the clinician to prioritize which out-of-range values are most consequential for that patient’s specific risk profile in this domain. The Biomarker Strength is population-based at the domain level and is not sex- or age-adjusted.

Score Impact quantifies each biomarker’s directional contribution to the domain VOLO Score, identifying which biomarkers are the primary drivers of elevated or reduced long-term risk for a given domain for this patient.

Together, the VMR, Biomarker Strength, and Score Impact give the clinician a prioritized, attribution-level view of which values matter most for the patient’s long-term health, in which domains, and whether they represent a modifiable risk target or a demographic baseline effect.

Methodology overview

Clinicians and scientific reviewers frequently ask about the analytical foundation behind the VHR. This section provides a summary sufficient for clinical evaluation.

Model architecture

Each health domain is modeled independently using a multi-stage architecture. After data harmonization and missing value imputations, tensor product splines are fitted to the training cohort’s empirical disease prevalence as a function of age and years of observation to produce a baseline risk surface for each sex. Each patient’s binary disease outcome is divided by their baseline risk multiplier from this surface, yielding an age- and sex-adjusted relative risk ratio removing the dominant confounding effect of demographics from the training signal.

In the final stage, a gradient-boosting machine (GBM) is trained to predict this adjusted risk ratio from the patient’s biomarker panel. GBMs were selected for their ability to capture nonlinear biomarker-outcome relationships and automatically model interaction effects between biomarkers — for example, the synergistic cardiovascular risk associated with the combination of elevated CRP and elevated BMI exceeds the sum of their independent contributions.

Training data and outcome definitions

Models are trained on two primary cohorts: the UK Biobank (approximately 500,000 participants with linked hospital episode statistics and primary care records) and over 2 million US clinical records used for external validation and calibration. Outcome endpoints for each domain are defined by validated ICD-10 code sets applied to linked records — for example, major adverse cardiovascular events are defined by ICD-10 codes I20–I25 (ischemic heart disease) and I60–I69 (cerebrovascular disease); Type 2 diabetes by E11; dementia by F00–F03 and G30–G31; renal failure by N17–N19. The observation window is 15 years from the baseline biomarker measurement.

Multi-domain design and the VMR

All domain models are trained on the same patient cohort using the same biomarker input space. This simultaneous multi-domain design means no single disease endpoint is privileged, and the VOLO Modeled Range (VMR) for each biomarker reflects the value range associated with favorable outcomes across all modeled domains simultaneously — not the value that minimizes risk for one condition while potentially elevating it for another. This is the technical basis for the outcome-agnostic positioning of the VHR.

Validation

The VHR cardiovascular domain model has been externally validated against the AHA PREVENT calculator on an independent US population cohort, demonstrating superior discrimination across ASCVD, heart failure, and total cardiovascular disease outcomes as measured by AUC, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Additional validation work across remaining domains is ongoing. Full validation methodology and results will be available in the VOLOHealth Validation Technical Brief after publication. VOLO Health validation papers will be made available after submission and publishing in peer reviewed journals.

The VHR is not FDA-cleared and is not intended as a clinical decision support tool as defined under applicable regulatory frameworks. It is a health and wellness education instrument. Clinicians should apply standard clinical judgment when integrating VHR outputs with other patient data.

What makes the VHR different?

Several direct-to-consumer and clinical biomarker interpretation tools exist. What distinguishes the VHR is the depth and rigor of its analytical foundation and the clinical utility of its outputs.

Clinical FAQ

How should I interpret a VOLO Score in a clinical context?

The VOLO Score is a population-relative index, not a diagnostic threshold. A score of 200 means the patient’s predicted 15-year disease probability in that domain equals the age- and sex-matched population average. Scores above 200 indicate below-average predicted risk; below 200 indicates above-average predicted risk. Every 20-point change corresponds to an approximate doubling or halving of predicted disease probability. Clinically, the score is most useful as a longitudinal long-term health tracking metric — direction and magnitude of change over successive measurements carry more actionable signal than any single cross-sectional value.

How does the VMR differ from a standard lab reference range?

Standard reference ranges reflect population norms and are designed to flag clinical outliers. The VMR is a data-derived optimal range — the biomarker values associated with the lowest composite long-term health risk across all modeled disease domains for the patient’s age and sex. The VMR typically is narrower and may differ meaningfully from the lab range. A patient within the lab range but outside the VMR has a clinically normal value that is not at the modeled optimum — a distinction relevant for proactive long-term risk management.

What does the maximum Score represent and how should I use it?

The max score is the model’s discriminative ceiling for a given domain — the highest score producible given the training data distribution for the patient’s age and sex. It is not a personal biological target. Its clinical utility is contextualizing the patient’s current score: a score of 212 against a max of 225 indicates the patient is near the model’s ceiling for their profile; a score of 212 against a max of 245 indicates meaningful modeled upside and potential for measurable improvement through intervention.

How should I communicate VOLO Age to patients?

VOLO Age is most useful as a patient communication and motivational tool. Frame it as a comparison: their biomarker profile in that domain looks like the average profile of someone many years younger (or older). Be precise … it is not a lifespan prediction or a literal biological age — it is a population-relative comparison translating their VOLO Score into an age-referenced frame that most patients immediately find intuitive and motivating.

How often should I order a VHR for a patient?

Annual reporting aligned with routine labs is appropriate for most patients. For patients actively undergoing clinician-recommended interventions, you may consider a 3–6 month cadence providing earlier visibility into whether the intervention is producing measurable improvement in domain scores. Score changes of 10 points or more generally are generally clinically meaningful; smaller changes between adjacent measurements often reflect biomarker variability.

Is the VHR validated against standard clinical risk tools?

The cardiovascular domain model has been validated externally against the AHA PREVENT calculator on an independent US cohort, demonstrating superior discrimination across ASCVD, heart failure, and total cardiovascular disease outcomes. This publication is under external review prior to publication submission. Validation work across additional domains is ongoing. The VHR is not FDA-cleared and is not intended as a clinical decision support instrument under applicable regulatory definitions. It is a health and wellness education tool intended to complement, not replace, the clinician’s assessment.

What panel should I order to get the most complete VHR?

The VHR provides valid scores from any available biomarkers, but completeness improves with a broader panel. The core panel includes a comprehensive metabolic panel (CMP), complete blood count (CBC), lipid panel with ApoB and ApoA1, HbA1C, C-reactive protein (high-sensitivity), Cystatin C, GGT, and physical measures including BMI and blood pressure. Advanced markers such as Lipoprotein(a), IGF-1, SHBG, and grip strength further enrich domain scores where available. A full list of supported biomarkers is in the VOLO Health Biomarker Reference Guide.

The bottom line

The VHR gives clinicians a population-relative, multi-domain interpretation of the patient’s biomarker panel and important biometrics — grounded in ICD-10-anchored outcome data from large-scale longitudinal cohorts, expressed through a scoring framework with a defined probabilistic interpretation, and built for longitudinal monitoring of long-term disease risk trajectory. It does not replace clinical judgment or guideline-based screening. It provides the context, precision, and tracking capability standard laboratory reporting cannot: a quantified, personalized picture of where each patient’s health stands today and whether it is moving in a positive long-term trajectory.

The VOLO™ Health Report is provided solely for informational and educational purposes. It is not intended to diagnose, cure, mitigate, treat, or prevent any disease or medical condition, does not constitute clinical decision support, and does not provide individualized medical advice or risk predictions. Statistical associations described herein are population-level findings and are not evidence of causation at the individual level. The VHR has not been reviewed or cleared by the Food and Drug Administration. Healthcare professionals should apply independent clinical judgment when interpreting and communicating VHR outputs to patients.