Scores & indices

Wells score calculator (PE)

Seven criteria that decide the D-dimer question: can a blood test rule PE out, or does this patient need imaging first?

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Two-tier: ≤ 4 unlikely · > 4 likely. Three-tier: < 2 low · 2–6 moderate · > 6 high.Reference: Wells et al. 2000.

How to read the result

Wells (PE) falls into these published bands.

< 2.0Low probability
2.0 – 6.4Moderate probability
≥ 6.5High probability
Worked example

A patient with clinical signs of DVT and a heart rate over 100 — no other criteria.

Wells 4.5 — PE likely

Above the two-tier threshold: proceed to CTPA; a D-dimer cannot exclude PE at this probability.

Who this is for

For clinicians working up suspected pulmonary embolism. The two-tier Wells strategy anchors testing: at 4 or below, PE is unlikely and a negative D-dimer safely ends the work-up; above 4, PE is likely and the pathway goes straight to CT pulmonary angiography — a D-dimer cannot rule it out at that probability. Paired in-app with PERC and a guided PE work-up.

How it works

What it calculates

Pre-test probability of pulmonary embolism from seven clinical criteria, anchoring the D-dimer strategy.

The two-tier pathway

Score ≤ 4: PE unlikely — a negative D-dimer safely rules it out without imaging (consider PERC first in genuinely low-risk patients). Score > 4: PE likely — go straight to CT pulmonary angiography; a D-dimer cannot rule out PE at this probability.

Worth remembering

"PE is the most likely diagnosis" carries 3 points and is deliberately subjective — the score formalises gestalt rather than replacing it.

Built on published evidence

  • Wells et al. 2000

Codification last reviewed 2026-08-28, and checked against published reference values in automated tests on every release — see the full evidence ledger.

Questions clinicians ask

Is 'PE is the most likely diagnosis' too subjective to score?

It is deliberately subjective — three points of formalised clinical gestalt. The score was derived and validated with that judgement inside it, so second-guessing it away changes the tool's performance.

When should PERC come before the D-dimer?

When your overall suspicion is already low (below ~15%): a fully negative PERC in that patient rules PE out with no blood test at all, avoiding the false-positive D-dimer cascade.

Two-tier or three-tier Wells?

This tool leads with the two-tier cut (≤4 unlikely, >4 likely) used by the validated D-dimer strategies; the classic three-tier bands are shown alongside for continuity with older literature.

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