Wells Score Calculator for Pulmonary Embolism (PE)
Calculate the seven-criterion Wells score for pulmonary embolism with modified two-level and standard three-level classifications.
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Wells score for pulmonary embolism
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A pretest-probability reference only; it does not diagnose or exclude pulmonary embolism.
About
This Wells score calculator applies the seven weighted Wells criteria for pulmonary embolism (PE) in adults with suspected acute PE. It reports one score with the modified two-level and standard three-level pretest-probability classifications. [1, 2, 3, 4]
This is the Wells score for PE, not the separate Wells DVT score. It cannot diagnose or exclude PE by itself, verify the submitted findings, choose a D-dimer or imaging pathway, grade confirmed PE, or recommend treatment. [3, 4, 5]
Interpretation
| Model | Score range | Published label | What it means and does not mean |
|---|---|---|---|
| Modified two-level | ≤4.0 / >4.0 | PE unlikely / PE likely | A pretest-probability grouping used in some adult pathways; 4.0 is unlikely and 4.5 is likely. It is not exclusion, confirmation, or a treatment instruction. |
| Standard three-level | <2 / 2–6 / >6 | Low / Moderate / High pretest probability | A three-group model. Scores 2.0 and 6.0 are moderate; the label is model terminology, not an individual probability or diagnosis. |
- Model
- Modified two-level
- Score range
- ≤4.0 / >4.0
- Published label
- PE unlikely / PE likely
- What it means and does not mean
- A pretest-probability grouping used in some adult pathways; 4.0 is unlikely and 4.5 is likely. It is not exclusion, confirmation, or a treatment instruction.
- Model
- Standard three-level
- Score range
- <2 / 2–6 / >6
- Published label
- Low / Moderate / High pretest probability
- What it means and does not mean
- A three-group model. Scores 2.0 and 6.0 are moderate; the label is model terminology, not an individual probability or diagnosis.
The modified two-level result is shown first because current adult suspected-PE pathways commonly use the ≤4 / >4 split. The standard three-level classification remains a valid, separate presentation of the same score. Neither label is a diagnosis, exclusion, individual probability, or treatment instruction. [3, 4, 5]
Wells Score and criteria for pulmonary embolism
What the Wells PE score calculates
The score sums seven explicitly assessed findings from an adult suspected-PE evaluation. “PE more likely than an alternative diagnosis” is intentionally a clinician judgment rather than a laboratory or imaging finding. This page validates that every item has been assessed, then reports the frozen weighted total and both published classification systems; it does not inspect a record or infer any criterion. [1, 3, 4]
Seven Wells criteria and points
The table below preserves the original seven-item wording and points. It describes what a submitted Yes means; it does not perform an examination or retrieve a history.
| Criterion | Points | Required interpretation | Important boundary |
|---|---|---|---|
| Clinical signs and symptoms of DVT | 3 | Leg swelling and pain with palpation of the deep veins. | Leg swelling and pain with palpation of the deep veins are the original clinical signs; this page does not verify an examination. |
| PE more likely than an alternative diagnosis | 3 | A subjective clinical judgment; it is not a laboratory or imaging finding. | This is a clinician judgment about the leading alternative, not a laboratory or imaging finding and not an automatic diagnosis. |
| Heart rate over 100 beats/min | 1.5 | A heart rate of exactly 100 does not score this item. | The threshold is strictly over 100 beats/min; exactly 100 receives zero points. |
| Immobilization or recent surgery | 1.5 | Immobilization for at least 3 days or surgery in the previous 4 weeks. | The original weighted model says immobilization for at least 3 days or surgery in the previous 4 weeks. NICE NG158 uses adapted wording of more than 3 days. |
| Previous DVT or PE | 1.5 | A documented prior venous thromboembolism history. | Use a documented previous venous thromboembolism history; the calculator does not retrieve a medical record. |
| Hemoptysis | 1 | Coughing blood. | The item is hemoptysis (coughing blood), not a general respiratory symptom. |
| Malignancy | 1 | Active, treated within the previous 6 months, or palliative. | The original definition includes active cancer, treatment within the previous 6 months, or palliative disease. |
- Criterion
- Clinical signs and symptoms of DVT
- Points
- 3
- Required interpretation
- Leg swelling and pain with palpation of the deep veins.
- Important boundary
- Leg swelling and pain with palpation of the deep veins are the original clinical signs; this page does not verify an examination.
- Criterion
- PE more likely than an alternative diagnosis
- Points
- 3
- Required interpretation
- A subjective clinical judgment; it is not a laboratory or imaging finding.
- Important boundary
- This is a clinician judgment about the leading alternative, not a laboratory or imaging finding and not an automatic diagnosis.
- Criterion
- Heart rate over 100 beats/min
- Points
- 1.5
- Required interpretation
- A heart rate of exactly 100 does not score this item.
- Important boundary
- The threshold is strictly over 100 beats/min; exactly 100 receives zero points.
- Criterion
- Immobilization or recent surgery
- Points
- 1.5
- Required interpretation
- Immobilization for at least 3 days or surgery in the previous 4 weeks.
- Important boundary
- The original weighted model says immobilization for at least 3 days or surgery in the previous 4 weeks. NICE NG158 uses adapted wording of more than 3 days.
- Criterion
- Previous DVT or PE
- Points
- 1.5
- Required interpretation
- A documented prior venous thromboembolism history.
- Important boundary
- Use a documented previous venous thromboembolism history; the calculator does not retrieve a medical record.
- Criterion
- Hemoptysis
- Points
- 1
- Required interpretation
- Coughing blood.
- Important boundary
- The item is hemoptysis (coughing blood), not a general respiratory symptom.
- Criterion
- Malignancy
- Points
- 1
- Required interpretation
- Active, treated within the previous 6 months, or palliative.
- Important boundary
- The original definition includes active cancer, treatment within the previous 6 months, or palliative disease.
The original derivation uses immobilization for at least 3 days. NICE NG158 uses adapted wording of more than 3 days; those phrases should not be silently mixed. [1, 5]
Modified two-level vs standard three-level interpretation
The modified model uses ≤4 PE unlikely and >4 PE likely; the standard model uses <2 low, 2–6 moderate, and >6 high pretest probability. Thus 4.0 is PE unlikely, 4.5 is PE likely, 6.0 remains moderate, and a score above 6 is high. Current NICE guidance specifically uses the two-level model, while the 2026 AHA/ACC guideline lists both. [3, 4, 5]
PE Wells and DVT Wells are separate models
Wells scores exist for both pulmonary embolism and deep-vein thrombosis, but their criteria, weights, and intended tasks are different. This page calculates only the seven-item weighted Wells score for pulmonary embolism. “Clinical signs and symptoms of DVT” is one PE criterion; it does not turn this result into a DVT Wells score. [1, 3, 4]
Where D-dimer, PERC, and YEARS fit
Wells is a pretest-probability step. D-dimer is a separate laboratory step whose meaning depends on the pathway and assay; age-adjusted D-dimer is also separate. PERC is an eight-item rule for selected very-low-suspicion adults, while YEARS uses three clinical items with its own D-dimer thresholds. None can be inferred from this seven-item score, and this page does not calculate them or choose imaging. [3, 4, 5, 6, 7, 8]
Important populations and limitations
NICE two-level Wells guidance applies to adults and excludes pregnancy and people under 18. Pregnancy-specific assessment, recurrent PE, anticoagulation, hospitalization, cancer, confirmed PE, and unstable or resuscitation settings can require different evidence or pathways. A confirmed-PE severity score such as PESI/sPESI is a different task. Do not let this calculator delay urgent evaluation, and do not use it as an imaging order, disposition rule, or treatment recommendation. [3, 4, 5, 9]
References
- Wells PS, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism. Thromb Haemost. 2000;83(3):416-420. PMID 10744147.
- Wells PS, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging. Ann Intern Med. 2001;135(2):98-107. PMID 11453709.
- 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults. Circulation. PMID 41712677. DOI 10.1161/CIR.0000000000001415.
- Creager MA, Barnes GD, Giri J, et al. Correction to: 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults. Circulation. 2026;154(2):e24. PMID 42441758. DOI 10.1161/CIR.0000000000001462.
- NICE NG158. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing.
- Kline JA, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost. 2008;6:772-780. PMID 18318689.
- Righini M, et al. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: ADJUST-PE. JAMA. 2014;311:1117-1124. PMID 24686878. DOI 10.1001/jama.2014.2135.
- van der Hulle T, et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study). Lancet. 2017;390:289-297. PMID 28549662. DOI 10.1016/S0140-6736(17)30885-1.
- van der Pol LM, et al. Pregnancy-Adapted YEARS Algorithm for Pulmonary Embolism. N Engl J Med. 2019;380:1139-1149. PMID 30893534. DOI 10.1056/NEJMoa1813865.
FAQ
Clinical DVT signs and PE more likely than an alternative diagnosis each add 3 points. Heart rate over 100, immobilization for at least 3 days or surgery in the prior 4 weeks, and previous DVT/PE each add 1.5. Hemoptysis and qualifying malignancy each add 1. The maximum is 12.5. NICE uses adapted immobilization wording of more than 3 days; this page retains the original weighted criterion rather than blending the two versions.
No. Pulmonary embolism Wells and deep-vein thrombosis Wells are separate clinical prediction rules with different criteria and weights. This calculator implements only the seven-item weighted Wells score for pulmonary embolism; a Yes response for clinical DVT signs is one PE criterion, not a DVT Wells calculation.
No. It estimates pretest probability in a specific suspected-PE assessment. PE unlikely does not mean excluded, and PE likely does not mean confirmed. The result must be interpreted with the presentation, examination, appropriate testing pathway, laboratory assay, and imaging availability.
Current pathways use pretest probability before choosing an appropriate D-dimer or imaging step. A negative D-dimer is meaningful only in the applicable probability, assay, and pathway context; an elevated D-dimer does not diagnose PE. Some suitable adults older than 50 use an age-adjusted FEU threshold, but this page does not enter, convert, or interpret D-dimer.
This page is for an adult suspected-acute-PE assessment. NICE two-level Wells guidance excludes pregnancy and people under 18. Pregnancy-specific assessment, confirmed PE, unstable presentations, anticoagulation, hospitalization, recurrent PE, and other special contexts can require different evidence or pathways.
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Disclaimer
Educational and informational reference only. Not intended to replace professional medical advice, diagnosis, treatment, or independent verification.