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Pulmonology / Infectious Disease

Wells Score for Pulmonary Embolism

Pre-test probability assessment for suspected acute pulmonary embolism. Drives the D-dimer vs CTPA decision per ESC 2019, ACEP, and AIIMS Emergency Medicine protocols.

Clinical signs/symptoms of DVT (leg swelling, pain on palpation)+3PE is #1 diagnosis OR equally likely as alternative+3Heart rate > 100 bpm+1.5Immobilisation ≥ 3 days OR surgery in past 4 weeks+1.5Previous PE or DVT+1.5Hemoptysis+1Active malignancy (on Rx, treated past 6 months, or palliative)+1

Wells Score

PE Unlikely • ~12% PE prevalence

Next Step

Obtain age-adjusted D-dimer. If D-dimer negative (< age × 10 ng/mL in >50y, or < 500 ng/mL otherwise) — PE excluded, no imaging needed. If positive — proceed to CTPA. Consider PERC rule first in low-pretest cohort.

Three-tier interpretation: Low (1.3%)

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DoctorScribe combines Wells + PERC + age-adjusted D-dimer logic in a single OPD workflow. Studies show 30% fewer unnecessary CTPAs when the algorithm is applied consistently — saving the patient the cost of an avoided scan.

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Clinical Disclaimer: Wells score is validated in non-pregnant adults with suspected acute PE. In pregnancy use the YEARS-pregnancy algorithm. In high-pretest patients, do NOT skip CTPA based on D-dimer. Empirical anticoagulation while awaiting imaging should be individualised. Always verify against your local prescribing reference and apply clinical judgment.

Smart PE workups, integrated with your lab and radiology

DoctorScribe flags Wells, PERC, age-adjusted D-dimer cut-offs, and Geneva score side-by-side. One click to order CTPA with the right contrast volume calculated for the patient's eGFR — and the pre-authorisation message drafts itself for insurance.

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