{
  "slug": "wells-pe-score",
  "title": "Wells Score for Pulmonary Embolism Calculator",
  "heading": "Wells Score for Pulmonary Embolism",
  "category": "fitness-health",
  "url": "https://www.revenuelab.fyi/toolbox/wells-pe-score",
  "summary": "Pretest probability of PE to decide between D-dimer and CT angiography.",
  "description": "The Wells score for pulmonary embolism weighs clinical signs of DVT, heart rate, immobilization or recent surgery, prior VTE, hemoptysis, malignancy, and whether PE is judged the most likely diagnosis, producing a pretest probability that determines the diagnostic pathway. Using the simplified two-tier interpretation, a score of 4 or less makes PE \"unlikely,\" where a negative D-dimer can exclude PE without CT, while a score above 4 makes PE \"likely\" and generally warrants CT pulmonary angiography directly, since D-dimer is not sensitive enough to reliably exclude PE in a high pretest probability population. The largest single weight in the score — \"PE is the most likely diagnosis\" at 3 points — is also the most subjective, which is a recognized criticism of the tool; clinical gestalt from an experienced clinician has been shown to perform comparably to the structured score in some studies. Age-adjusted D-dimer thresholds (age × 10 ng/mL for patients over 50) further refine the rule-out decision in low-probability patients. This tool is for education and workflow support only — not medical advice. Always verify results with a clinician and use clinical judgment alongside your institution's protocols.",
  "formula": "Sum weighted criteria; simplified two-tier: ≤4 = PE unlikely, >4 = PE likely.",
  "dateModified": "2026-09-30",
  "run_url": "https://www.revenuelab.fyi/api/public/calc?tool=wells-pe-score",
  "inputs": [
    {
      "id": "dvtSigns",
      "label": "Clinical signs of DVT (leg swelling, pain with palpation)",
      "kind": "select",
      "hint": null,
      "default": "no",
      "options": [
        {
          "value": "yes",
          "label": "Yes (+3)"
        },
        {
          "value": "no",
          "label": "No"
        }
      ]
    },
    {
      "id": "peLikely",
      "label": "PE is the #1 most likely diagnosis",
      "kind": "select",
      "hint": null,
      "default": "yes",
      "options": [
        {
          "value": "yes",
          "label": "Yes (+3)"
        },
        {
          "value": "no",
          "label": "No"
        }
      ]
    },
    {
      "id": "hr100",
      "label": "Heart rate >100 bpm",
      "kind": "select",
      "hint": null,
      "default": "yes",
      "options": [
        {
          "value": "yes",
          "label": "Yes (+1.5)"
        },
        {
          "value": "no",
          "label": "No"
        }
      ]
    },
    {
      "id": "immobilization",
      "label": "Immobilization ≥3 days or surgery in past 4 weeks",
      "kind": "select",
      "hint": null,
      "default": "no",
      "options": [
        {
          "value": "yes",
          "label": "Yes (+1.5)"
        },
        {
          "value": "no",
          "label": "No"
        }
      ]
    },
    {
      "id": "priorVte",
      "label": "Prior objectively diagnosed DVT/PE",
      "kind": "select",
      "hint": null,
      "default": "no",
      "options": [
        {
          "value": "yes",
          "label": "Yes (+1.5)"
        },
        {
          "value": "no",
          "label": "No"
        }
      ]
    },
    {
      "id": "hemoptysis",
      "label": "Hemoptysis",
      "kind": "select",
      "hint": null,
      "default": "no",
      "options": [
        {
          "value": "yes",
          "label": "Yes (+1)"
        },
        {
          "value": "no",
          "label": "No"
        }
      ]
    },
    {
      "id": "malignancy",
      "label": "Malignancy treated within 6 months or palliative",
      "kind": "select",
      "hint": null,
      "default": "no",
      "options": [
        {
          "value": "yes",
          "label": "Yes (+1)"
        },
        {
          "value": "no",
          "label": "No"
        }
      ]
    }
  ],
  "outputs": [
    {
      "id": "score",
      "label": "Wells PE score",
      "format": "decimal",
      "hint": null,
      "primary": true
    },
    {
      "id": "category",
      "label": "Pretest probability",
      "format": "raw",
      "hint": null,
      "primary": false
    },
    {
      "id": "next",
      "label": "Suggested next step",
      "format": "raw",
      "hint": null,
      "primary": false
    }
  ],
  "worked_example": {
    "inputs": [
      "Clinical signs of DVT (leg swelling, pain with palpation): No",
      "PE is the #1 most likely diagnosis: Yes (+3)",
      "Heart rate >100 bpm: Yes (+1.5)",
      "Immobilization ≥3 days or surgery in past 4 weeks: No",
      "Prior objectively diagnosed DVT/PE: No",
      "Hemoptysis: No",
      "Malignancy treated within 6 months or palliative: No"
    ],
    "outputs": [
      "Wells PE score: 4.5",
      "Pretest probability: PE likely",
      "Suggested next step: CT pulmonary angiography"
    ]
  },
  "how_to": {
    "title": "How to use this",
    "steps": [
      "Enter clinical signs of dvt (leg swelling, pain with palpation).",
      "Enter pe is the #1 most likely diagnosis.",
      "Enter heart rate >100 bpm.",
      "Enter immobilization ≥3 days or surgery in past 4 weeks.",
      "Enter prior objectively diagnosed dvt/pe.",
      "Enter hemoptysis.",
      "Enter malignancy treated within 6 months or palliative.",
      "Read your wells pe score on the right — it updates as you type.",
      "Hit Share to keep the scenario or send it to someone."
    ]
  },
  "scenarios": [
    {
      "name": "Conservative",
      "description": "Lower-end numbers — what if things land soft?",
      "values": {
        "dvtSigns": "no",
        "peLikely": "yes",
        "hr100": "yes",
        "immobilization": "no",
        "priorVte": "no",
        "hemoptysis": "no",
        "malignancy": "no"
      }
    },
    {
      "name": "Typical",
      "description": "Defaults — the most common real-world setup.",
      "values": {
        "dvtSigns": "no",
        "peLikely": "yes",
        "hr100": "yes",
        "immobilization": "no",
        "priorVte": "no",
        "hemoptysis": "no",
        "malignancy": "no"
      }
    },
    {
      "name": "Ambitious",
      "description": "Higher-end numbers — what if things really pop?",
      "values": {
        "dvtSigns": "no",
        "peLikely": "yes",
        "hr100": "yes",
        "immobilization": "no",
        "priorVte": "no",
        "hemoptysis": "no",
        "malignancy": "no"
      }
    }
  ],
  "limitations": [
    "Population formulas describe averages; individual bodies vary, especially at the extremes of height, age, or muscle mass.",
    "Results do not account for medical conditions, medication, or pregnancy.",
    "Use this as a directional reference, not a diagnosis — talk to a clinician before acting on it."
  ],
  "faq": [
    {
      "q": "Why is 'PE is the most likely diagnosis' worth so many points?",
      "a": "It carries 3 of the possible points because it captures the clinician's overall gestalt, which studies show correlates strongly with the actual presence of PE. It's also the most subjective and criticized part of the score, since two clinicians examining the same patient may score this criterion differently."
    },
    {
      "q": "What is age-adjusted D-dimer and why does it matter here?",
      "a": "D-dimer rises with age even without clot, causing more false positives in older patients if a fixed 500 ng/mL cutoff is used. Age-adjusted D-dimer (age × 10 ng/mL for patients over 50) raises the threshold in older patients, reducing unnecessary CT scans in the PE-unlikely group without missing clinically important PEs, and is now standard in many protocols."
    },
    {
      "q": "Can this replace the Geneva score?",
      "a": "They are alternative, comparable tools — the Geneva score removes the subjective 'most likely diagnosis' criterion in favor of only objective variables, which some clinicians prefer for reproducibility. Neither is universally superior; use whichever your institution has validated in its diagnostic pathway."
    },
    {
      "q": "What happens with a 'PE likely' score and a negative CT?",
      "a": "A negative CT pulmonary angiogram in a patient with a high pretest probability is still generally considered sufficient to exclude PE, given CTPA's high sensitivity, but persistent strong clinical suspicion despite a negative CT should prompt reconsideration of technical quality, alternative imaging (V/Q scan), or specialist consultation."
    }
  ],
  "related": [
    "https://www.revenuelab.fyi/toolbox/wells-dvt-score",
    "https://www.revenuelab.fyi/toolbox/shock-index",
    "https://www.revenuelab.fyi/toolbox/abg-interpretation"
  ],
  "license": "CC-BY-4.0",
  "citation": "RevenueLab — Wells Score for Pulmonary Embolism Calculator (https://www.revenuelab.fyi/toolbox/wells-pe-score)"
}