Loading calculators...
Fetching calculator categories and tools for this section.
Preparing tools and content for you. This usually takes a second.
Fetching calculator categories and tools for this section.
Direct answer — Wells score DVT
The Wells score for DVT sums nine clinical items (range −2 to +9): eight findings are +1 each; an alternative diagnosis at least as likely as DVT is −2. Teaching cutoffs: ≤0 low, 1–2 moderate, ≥3 high pretest probability. Suspected lower-extremity DVT only — not Wells PE. Source: Wells PS et al. Lancet. 1997;350:1795-1798. Not a diagnosis.
Criteria and score bands first (below), then the interactive checklist. Prose guide: Wells score DVT explained. Last updated: August 9, 2026.
Nine criteria and teaching probability bands from Wells et al. (1997) — sum applicable items for the total score (−2 to +9).
| # | Criterion | Points |
|---|---|---|
| 1 | Active cancer (treatment ongoing, within 6 months, or palliative) | +1 |
| 2 | Paralysis, paresis, or recent plaster immobilization of the lower extremity | +1 |
| 3 | Recently bedridden >3 days or major surgery within 4 weeks requiring general or regional anesthesia | +1 |
| 4 | Localized tenderness along the deep venous system | +1 |
| 5 | Swollen entire leg | +1 |
| 6 | Calf swelling >3 cm compared to the asymptomatic leg (measured 10 cm below tibial tuberosity) | +1 |
| 7 | Pitting edema confined to the symptomatic leg | +1 |
| 8 | Collateral superficial veins (non-varicose) | +1 |
| 9 | Alternative diagnosis at least as likely as DVT | -2 |
| Score | Band | ~DVT rate |
|---|---|---|
| ≤ 0 | Low | ~5% DVT in derivation cohorts |
| 1 – 2 | Moderate | ~17–28% DVT in validation studies |
| ≥ 3 | High | ~53–75% DVT in validation studies |
Pathway notes: low → D-dimer often; moderate → D-dimer ± US; high (≥3) → ultrasound in most algorithms.
Check each criterion that applies. The total maps to the bands above. Related: warfarin dose adjustment.
Wells stratifies likelihood before imaging. Confirm DVT with compression ultrasound or a guideline-concordant pathway—not checkbox arithmetic alone.
Check each criterion that applies. The last item subtracts 2 points when an alternative diagnosis is at least as likely as DVT.
+1 point
+1 point
+1 point
+1 point
+1 point
+1 point
+1 point
+1 point
-2 points
Total score
0
Category
Low clinical probability
Pretest probability ~5% in typical derivation populations. Many validated pathways use negative high-sensitivity D-dimer to rule out DVT without initial imaging in selected outpatients.
Educational tool only
This score does not replace clinical judgment, physical examination, D-dimer interpretation, ultrasound, or institutional pathways. Pretest probability and management differ by guideline version and setting.
Wells published separate clinical prediction rules for DVT and pulmonary embolism. Do not apply DVT points to a PE workup (or vice versa).
| Aspect | Wells DVT | Wells PE |
|---|---|---|
| Clinical question | Suspected lower-extremity deep vein thrombosis | Suspected pulmonary embolism |
| Key positive items | Leg swelling, calf asymmetry >3 cm, deep-vein tenderness, edema, collateral veins | Clinical signs of DVT, PE more likely than alternatives, hemoptysis, immobilization/surgery |
| Negative / modifier item | Alternative diagnosis at least as likely (−2 points) | PE-specific Wells items — not the DVT −2 rule |
| Typical score range | −2 to +9 (nine DVT criteria) | Separate Wells PE score (different points) — do not interchange |
| Common teaching cutoffs | ≤0 low · 1–2 moderate · ≥3 high | Three-tier or two-tier (unlikely/likely) PE models — different thresholds |
| Primary next test | Compression ultrasound ± D-dimer | CT pulmonary angiography ± D-dimer |
Low — no criteria
0
Low clinical probability
Moderate — tenderness + calf swelling
2
Moderate clinical probability
High — tenderness + swelling + edema
3
High clinical probability
High — cancer + bedrest + leg swelling
3
High clinical probability
Alternative diagnosis only
-2
Low clinical probability — clinical judgment essential
Teaching pathway after you have the Wells score DVT total — follow ACCP, NICE, or hospital VTE algorithms.
| Wells | D-dimer | Action |
|---|---|---|
| Low (≤0) | Negative (high-sensitivity) | DVT often ruled out without imaging in validated pathways |
| Low (≤0) | Positive | Proceed to compression ultrasound |
| Moderate (1–2) | Negative | Guideline-dependent — some rule out, some image |
| Moderate (1–2) | Positive | Ultrasound recommended |
| High (≥3) | Any | Ultrasound typically performed regardless |
| Modality | Use | Note |
|---|---|---|
| Compression ultrasound (CUS) | First-line for suspected proximal DVT | Operator-dependent; whole-leg protocols vary |
| D-dimer (high sensitivity) | Rule-out in low/moderate Wells when negative | Less useful if high probability or recent VTE |
| CT venography | Selected cases (e.g., iliac/IVC suspicion) | Not first-line for routine calf DVT |
| MRI venography | Pregnancy, contrast allergy, selected pelvic DVT | Availability and protocol dependent |
| Finding | Action | Note |
|---|---|---|
| Confirmed proximal DVT | Anticoagulation per guideline (DOAC or warfarin/LMWH) | Duration depends on provoked vs unprovoked |
| Isolated distal (calf) DVT | Anticoagulation vs surveillance — guideline and repeat US | Institution-specific |
| High Wells, negative initial US | Repeat ultrasound in 5–7 days if still suspected | Serial testing for evolving thrombus |
Pretest probability ~17–28% in many studies. D-dimer and/or imaging decisions depend on assay sensitivity and local algorithm (including age-adjusted D-dimer).
Educational disclaimer: This calculator sums Wells DVT criteria for learning and visit-prep. It does not diagnose DVT, order imaging, interpret D-dimer, or initiate anticoagulation. Definitive care requires licensed clinicians and institutional VTE pathways. Seek emergency care for sudden dyspnea, chest pain, or massive limb swelling.
Share with trainees and teams using DVT pathways.
Suggested hashtags: #Medicine #DVT #WellsScore #VTE #Calculator