Wells 2003

Wells Score (DVT)

Pre-test probability

Clinician mode· direct action wording

Active cancer (treatment within 6 mo)Paralysis, paresis, or recent plaster immobilisationRecently bedridden ≥3 days or major surgery within 12 wksLocalised tenderness along deep venous systemEntire leg swollenCalf swelling ≥3 cm vs asymptomatic legPitting oedema confined to symptomatic legCollateral (non-varicose) superficial veinsPreviously documented DVTAlternative diagnosis at least as likely as DVT (−2)

Low risk

0

DVT unlikely

Likely → proximal leg vein US within 4 h (or interim DOAC + US within 24 h).
Unlikely → D-dimer; if positive → US.
Pregnancy: Wells not validated — always US both legs if suspected.

Reference range

≥2 = DVT likely · ≤1 = DVT unlikely (two-level Wells, NICE NG158)

References

Wells PS — NEJM 2003 (DVT model) (opens in a new tab)

Common pitfalls

Not validated in pregnancy — image if any suspicion.
D-dimer unreliable in pregnancy.

For educational use only

Not medical advice. Verify dosing against the BNF and your local trust guidelines before prescribing.

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