Malignancy (including treatment up to six months previously)
+1
Intravenous drug use
+3
Alternative diagnosis as more likely than DVT
-2
Pre-test Clinical probability of a DVT with score:
DVT "Likely" if Well's > 1
DVT "Unlikely" if Wells< 2
Wells criteria / scoring for PE
Present
Score
Clinical Signs and Symptoms of DVT?
+3
PE is No. 1 Dx or Equally likely Dx
+3
Heart Rate > 100
+1.5
Immobilization at least 3 days, or Surgery in the Previous 4 weeks
+1.5
Previous, objectively diagnosed PE or DVT?
+1.5
Haemoptysis?
+1
Malignancy with treatment within 6 months, or palliative?
+1
Pre-test clinical probability of a PE:
Wells Score > 4 - PE likely. Consider diagnostic imaging.
Wells Score 4 or less - PE unlikely. Consider D-dimer to rule out PE.
2003 BTS Guidelines - a practical approach to ? PE (not using the Wells criteria) are available in the PE page
References
Wells PS, Owen C, Doucette S, Fergusson D, Tran H. Does this patient have deep vein thrombosis? JAMA. 2006 Jan 11;295(2):199-207
Scarvelis D, Wells PS. Diagnosis and treatment of deep-vein thrombosis. CMAJ. 2006 Oct 24;175(9):1087-92. Review. Erratum in: CMAJ. 2007 Nov 20;177(11):1392
Wells PS, Anderson DR, Rodger M, Forgie M, Kearon C, Dreyer J, Kovacs G, Mitchell M, Lewandowski B, Kovacs MJ. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med. 2003 Sep 25;349(13):1227-35
Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost. 2000 Mar;83(3):416-20
Writing Group for the Christopher Study Investigators. Effectiveness of Managing Suspected Pulmonary Embolism Using an Algorithm Combining Clinical Probability, D-Dimer Testing, and Computed Tomography. JAMA. 2006;295:172-179