Vascular medicine
Emergencies
General medicine
The Wells score for DVT helps structure the clinical probability estimation of a deep vein thrombosis in a symptomatic patient. It is used upstream of a diagnostic strategy that combines D-dimer testing and imaging, depending on the probability level and the guidelines followed. It neither confirms nor excludes a DVT on its own.
Number of questions
9 positive criteria and 1 negative criterion
Approximate duration
2 to 3 minutes
Population
Adults with suspected DVT
Modality
clinical score
QuestionnaireWells DVT
CLINICIAN SCORE
The professional assesses nine clinical criteria, each worth 1 point (active cancer, immobilisation, bed rest or recent surgery, tenderness along the deep venous system, swelling, calf asymmetry, etc.) and deducts 2 points if an alternative diagnosis is at least as likely.
Are you patient?
This score requires a clinical examination and comparative measurements. It is not suitable for self-assessment.
Terms of contract
Two-level NICE version. Active cancer: treatment ongoing, within the last six months, or palliative. Bedridden for ≥ 3 days, or major surgery within the last 12 weeks requiring general or regional anaesthesia. Calf circumference difference ≥ 3 cm compared to the asymptomatic side, measured 10 cm below the tibial tuberosity. Documented history of DVT. An alternative diagnosis at least as likely scores −2 points.
Score interpretationWells DVT
Total score: +1 for each criterion present, −2 if an alternative diagnosis is at least as likely as DVT. Score ranges from −2 to 9.
Total score
First reading
-2
to
1
Total ≤ 1: DVT unlikely.
2
to
9
Total ≥ 2: DVT likely.
≤ 1: DVT unlikely; ≥ 2: DVT likely.
The result determines the rest of the diagnostic strategy, but does not replace D-dimer testing when indicated, nor does it replace ultrasound.
Frequently asked questions
What is the Wells DVT score used for?
Can a DVT be diagnosed with a score ≥2?
What are its limitations?
Sources and references
Wells PS et al.
Wells PS et al., N Engl J Med, 2003
In practice
Full name
Wells Clinical Prediction Rule for Deep Vein Thrombosis
Method
clinical score
Language
Not applicable (clinical score)
Authors
Wells PS et al.
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