Emergencies
Pulmonology
Cardiology
Vascular medicine
The Wells score for pulmonary embolism organizes several clinical features to estimate the pre-test probability of PE. It is used in diagnostic strategies combined, as appropriate, with PERC, D-dimer, and imaging. A high score does not confirm PE; a low score does not exempt from applying the corresponding diagnostic algorithm.
Number of questions
7 criteria
Approximate duration
2 minutes
Population
Adults with suspected pulmonary embolism
Modality
clinical score
QuestionnaireWells EP
CLINICIAN SCORE
The clinician assesses seven criteria (clinical signs of DVT, PE more likely than an alternative diagnosis, heart rate > 100 bpm, recent immobilisation or surgery, previous DVT or PE, haemoptysis, active cancer), each scored from 1 to 3 points and added together, for a total score ranging from 0 to 12.5.
Are you patient?
Several criteria require a clinical examination and medical judgment. This score is not designed to determine on your own, at home, whether you have a pulmonary embolism. In the event of acute chest pain, severe shortness of breath, or faintness, seek urgent medical attention.
Terms of contract
The score is completed by a clinician, following a medical history and physical examination, in a patient with suspected pulmonary embolism; it is not designed for self-assessment. The criterion 'PE more likely than an alternative diagnosis' requires having considered alternative diagnoses, and the result is integrated into the associated diagnostic algorithm (D-dimer, imaging). Immobilisation for more than 3 days or surgery in the previous four weeks. Cancer: ongoing treatment, within the last six months, or palliative.
Score interpretationWells EP
Sum of points for criteria present (3, 1.5 or 1 point depending on the criterion). Score from 0 to 12.5.
Total score
First reading
0
to
4
Score ≤ 4: PE unlikely.
4.5
to
12.5
Score > 4: PE likely.
≤ 4: PE unlikely; > 4: PE likely.
Thresholds must be linked to a validated diagnostic algorithm and performance varies depending on the healthcare setting.
Frequently asked questions
Does the Wells score diagnose PE?
Why does a criterion rely on the doctor's judgment?
What are its limitations?
Sources and references
Wells PS et al.
Wells PS et al., Ann Intern Med, 2001
In practice
Full name
Wells Clinical Prediction Rule for Pulmonary Embolism
Method
clinical score
Language
Not applicable (clinical score)
Authors
Wells PS et al.
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