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Free Wells DVT score calculator with all nine validated criteria, automatic total (−2 to +9), and low / moderate / high pretest probability bands. Educational context for D-dimer and compression ultrasound pathways—suspected leg DVT only, not PE. Pair with warfarin dose adjustment. Not a diagnosis.
Last updated: June 5, 2026
Wells score stratifies likelihood before imaging. Definitive DVT diagnosis requires compression ultrasound or 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.
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 bands from validation literature—follow local ACCP, NICE, or hospital VTE pathways.
| Score | Category | Approx. prevalence | Typical pathway |
|---|---|---|---|
| ≤ 0 | Low clinical probability | ~5% DVT in derivation cohorts | Often D-dimer if assay available; imaging if still concerned |
| 1 – 2 | Moderate clinical probability | ~17–28% DVT in validation studies | D-dimer ± compression ultrasound per local algorithm |
| ≥ 3 | High clinical probability | ~53–75% DVT in validation studies | Proceed to venous ultrasound in most pathways |
| Criterion | Points |
|---|---|
| Active cancer (treatment ongoing, within 6 months, or palliative) | +1 |
| Paralysis, paresis, or recent plaster immobilization of the lower extremity | +1 |
| Recently bedridden >3 days or major surgery within 4 weeks requiring general or regional anesthesia | +1 |
| Localized tenderness along the deep venous system | +1 |
| Swollen entire leg | +1 |
| Calf swelling >3 cm compared to the asymptomatic leg (measured 10 cm below tibial tuberosity) | +1 |
| Pitting edema confined to the symptomatic leg | +1 |
| Collateral superficial veins (non-varicose) | +1 |
| Alternative diagnosis at least as likely as DVT | -2 |
| 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 |
| Aspect | DVT rule | PE rule |
|---|---|---|
| Population | Suspected lower-extremity DVT | Suspected pulmonary embolism |
| Key positive items | Leg swelling, calf asymmetry, venous tenderness | PE more likely than DVT, hemoptysis, immobilization |
| Negative item | Alternative diagnosis as likely (−2) | Different PE-specific criteria |
| Score range | Typically −2 to +9 | Separate Wells PE score — do not interchange |
| 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.
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