PUBLIC LIBRARY / SCORE

Wells score for DVT

Estimates the pretest probability of lower-limb deep vein thrombosis in outpatients and guides D-dimer and ultrasound use.

Calculate with transparency

Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

Preparing the form…

Check the method
Enter the data
Check the result

Method · Limits of application

Wells DVT 2003, Table 1: 9 factors + alternative diagnosis −2; 2 levels ≥2 / <2; the 3-level model is shown separately and its edition has not yet been checked

The Wells 2003 strategy was studied in outpatients with suspected lower-limb DVT. The protocol decision to omit ultrasound required both unlikely clinical probability and a negative D-dimer. The score alone neither confirms nor excludes DVT, and the D-dimer assay and eligibility criteria must match the protocol used. In Wells 2003 Table 1, calf circumference differs by at least 3 cm, measured 10 cm below the tibial tuberosity; major surgery within the past 12 weeks requires general or regional anesthesia. The table defines only the 2-level model (≥2 likely; <2 unlikely); the edition of the 3-level model displayed here remains unchecked.

Required fields: 0/10 completed

Complete all required fields. Optional fields are marked.

Active cancer (treatment in the last 6 months or palliative treatment) required

Paralysis, paresis or recent cast immobilization of the lower limb required

Bedridden for ≥ 3 days or major surgery within the past 12 weeks requiring general or regional anesthesia required

Localized tenderness along the deep venous system required

Swelling of the entire lower limb required

Calf circumference ≥ 3 cm greater than the opposite side (10 cm below the tibial tuberosity) required

Pitting edema confined to the symptomatic leg required

Collateral superficial veins (nonvaricose) required

Documented previous DVT required

Alternative diagnosis as likely as or more likely than DVT required

This form does not save data in your browser.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Active cancer (treatment in the last 6 months or palliative treatment)
Paralysis, paresis or recent cast immobilization of the lower limb
Bedridden for ≥ 3 days or major surgery within the past 12 weeks requiring general or regional anesthesia
Localized tenderness along the deep venous system
Swelling of the entire lower limb
Calf circumference ≥ 3 cm greater than the opposite side (10 cm below the tibial tuberosity)
Pitting edema confined to the symptomatic leg
Collateral superficial veins (nonvaricose)
Documented previous DVT
Alternative diagnosis as likely as or more likely than DVT

5/5 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

One point for each item (cancer, paralysis/cast, bed rest or surgery, tenderness along the venous system, entire leg swelling, calf swelling ≥ 3 cm, unilateral pitting edema, collateral veins, previous DVT) and −2 if an alternative diagnosis is at least as likely.

2 levels (Wells 2003): ≥ 2 = DVT likely; ≤ 1 = unlikely. 3 levels: ≤ 0 low; 1–2 moderate; ≥ 3 high.

References

Identifier: wells-tvp

Original clinical content: Brazilian Portuguese.

Method version

Wells DVT 2003, Table 1: 9 factors + alternative diagnosis −2; 2 levels ≥2 / <2; the 3-level model is shown separately and its edition has not yet been checked

wells-tvp@native-2026-10-04+53c4ddbb0d9f

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (5)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Active cancer (treatment in the last 6 months or palliative treatment): No
Paralysis, paresis or recent cast immobilization of the lower limb: No
Bedridden for ≥ 3 days or major surgery within the past 12 weeks requiring general or regional anesthesia: No
Localized tenderness along the deep venous system: No
Swelling of the entire lower limb: No
Calf circumference ≥ 3 cm greater than the opposite side (10 cm below the tibial tuberosity): No
Pitting edema confined to the symptomatic leg: No
Collateral superficial veins (nonvaricose): No
Documented previous DVT: No
Alternative diagnosis as likely as or more likely than DVT: No

{
  "cancer": false,
  "paralisia": false,
  "acamado": false,
  "dor_trajeto": false,
  "edema_total": false,
  "panturrilha": false,
  "cacifo": false,
  "colaterais": false,
  "tvp_prev": false,
  "alternativo": false
}

Expected result

{
  "score": 0,
  "level": "low"
}

Actual result

{
  "score": 0
}

Case 2

reference-002

Inputs

Active cancer (treatment in the last 6 months or palliative treatment): Yes
Alternative diagnosis as likely as or more likely than DVT: Yes
Paralysis, paresis or recent cast immobilization of the lower limb: No
Bedridden for ≥ 3 days or major surgery within the past 12 weeks requiring general or regional anesthesia: No
Localized tenderness along the deep venous system: No
Swelling of the entire lower limb: No
Calf circumference ≥ 3 cm greater than the opposite side (10 cm below the tibial tuberosity): No
Pitting edema confined to the symptomatic leg: No
Collateral superficial veins (nonvaricose): No
Documented previous DVT: No

{
  "cancer": true,
  "alternativo": true,
  "paralisia": false,
  "acamado": false,
  "dor_trajeto": false,
  "edema_total": false,
  "panturrilha": false,
  "cacifo": false,
  "colaterais": false,
  "tvp_prev": false
}

Expected result

{
  "score": -1,
  "level": "low"
}

Actual result

{
  "score": -1
}

Case 3

reference-003

Inputs

Pitting edema confined to the symptomatic leg: Yes
Active cancer (treatment in the last 6 months or palliative treatment): No
Paralysis, paresis or recent cast immobilization of the lower limb: No
Bedridden for ≥ 3 days or major surgery within the past 12 weeks requiring general or regional anesthesia: No
Localized tenderness along the deep venous system: No
Swelling of the entire lower limb: No
Calf circumference ≥ 3 cm greater than the opposite side (10 cm below the tibial tuberosity): No
Collateral superficial veins (nonvaricose): No
Documented previous DVT: No
Alternative diagnosis as likely as or more likely than DVT: No

{
  "cacifo": true,
  "cancer": false,
  "paralisia": false,
  "acamado": false,
  "dor_trajeto": false,
  "edema_total": false,
  "panturrilha": false,
  "colaterais": false,
  "tvp_prev": false,
  "alternativo": false
}

Expected result

{
  "score": 1,
  "level": "mid",
  "verdict": "improvável"
}

Actual result

{
  "score": 1
}

Case 4

reference-004

Inputs

Swelling of the entire lower limb: Yes
Calf circumference ≥ 3 cm greater than the opposite side (10 cm below the tibial tuberosity): Yes
Active cancer (treatment in the last 6 months or palliative treatment): No
Paralysis, paresis or recent cast immobilization of the lower limb: No
Bedridden for ≥ 3 days or major surgery within the past 12 weeks requiring general or regional anesthesia: No
Localized tenderness along the deep venous system: No
Pitting edema confined to the symptomatic leg: No
Collateral superficial veins (nonvaricose): No
Documented previous DVT: No
Alternative diagnosis as likely as or more likely than DVT: No

{
  "edema_total": true,
  "panturrilha": true,
  "cancer": false,
  "paralisia": false,
  "acamado": false,
  "dor_trajeto": false,
  "cacifo": false,
  "colaterais": false,
  "tvp_prev": false,
  "alternativo": false
}

Expected result

{
  "score": 2,
  "level": "mid",
  "verdict": "provável"
}

Actual result

{
  "score": 2
}

Case 5

reference-005

Inputs

Active cancer (treatment in the last 6 months or palliative treatment): Yes
Bedridden for ≥ 3 days or major surgery within the past 12 weeks requiring general or regional anesthesia: Yes
Pitting edema confined to the symptomatic leg: Yes
Localized tenderness along the deep venous system: Yes
Paralysis, paresis or recent cast immobilization of the lower limb: No
Swelling of the entire lower limb: No
Calf circumference ≥ 3 cm greater than the opposite side (10 cm below the tibial tuberosity): No
Collateral superficial veins (nonvaricose): No
Documented previous DVT: No
Alternative diagnosis as likely as or more likely than DVT: No

{
  "cancer": true,
  "acamado": true,
  "cacifo": true,
  "dor_trajeto": true,
  "paralisia": false,
  "edema_total": false,
  "panturrilha": false,
  "colaterais": false,
  "tvp_prev": false,
  "alternativo": false
}

Expected result

{
  "score": 4,
  "level": "high"
}

Actual result

{
  "score": 4
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.