Wells Score (DVT)

DVT Pretest Probability: Combines physical signs and history. A score of ≤ 0 with a negative D-dimer effectively rules out DVT (likelihood < 1%).

Baseline & Physical Signs

Wells DVT Probability

0

Class

Low Risk

~3% Prevalence in Class

Next Clinical Step

Rule out with D-dimer

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Assessing the pretest probability of DVT in symptomatic patients.

Combined with D-dimer testing to rule out DVT without imaging (in low/moderate risk groups).

Selecting patients who require urgent venous duplex ultrasonography.

The 'Safe Rule-out'

Patients with a Wells Score ≤ 0 AND a negative high-sensitivity D-dimer have < 1% likelihood of DVT and do not require imaging.

How it Works

Risk Factors (1 pt each)

Active cancer (treatment ongoing, or within previous 6 months or palliative).

Paralysis, paresis, or recent plaster immobilization of the lower extremities.

Recently bedridden > 3 days or major surgery within 12 weeks requiring GA or spinal anesthesia.

Localized tenderness along the distribution of the deep venous system.

Entire leg swollen.

Calf swelling > 3 cm larger than asymptomatic side (measured 10 cm below tibial tuberosity).

Pitting edema confined to the symptomatic leg.

Collateral superficial veins (non-varicose).

Previously documented DVT.

Protective Factor (-2 pts)

Alternative diagnosis is at least as likely as DVT (e.g., Baker's cyst, cellulitis, muscle strain).

Thresholds

Score	Probability Level	Prevalence of DVT
≤ 0	Low Probability	3%
1 - 2	Moderate Probability	17%
≥ 3	High Probability	75%

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

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Clinical Context

We think this has broad domain relevance to Wells Score for Deep Vein Thrombosis (DVT).

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Clinical Context

We think this might be relevant to the clinical guidance for Wells Score for Deep Vein Thrombosis (DVT).

WHO NewsJul 2, 2026

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Clinical Context

We think this has broad domain relevance to Wells Score for Deep Vein Thrombosis (DVT).

Wells Score (DVT)

0

When to Use

When to Use

The 'Safe Rule-out'

How it Works

Risk Factors (1 pt each)

Protective Factor (-2 pts)

Thresholds

Clinical Pearls

The Differential Penalty

Anticoagulation Timing

The Evidence

Primary Strategy

Value of assessment of pretest probability of deep-vein thrombosis in clinical management.

Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis.

Origins & History

History

Recent Journal Updates

Wells Score (DVT)

0

When to Use

When to Use

The 'Safe Rule-out'

How it Works

Risk Factors (1 pt each)

Protective Factor (-2 pts)

Thresholds

Clinical Pearls

The Differential Penalty

Anticoagulation Timing

The Evidence

Primary Strategy

Value of assessment of pretest probability of deep-vein thrombosis in clinical management.

Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis.

Origins & History

History

Recent Journal Updates