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Pulmonary Embolism Pretest Probability

Aka: Pulmonary Embolism Pretest Probability, Wells Clinical Prediction Rule for PE

See Also
1. Pulmonary Embolism
Criteria
1. PE more likely than alternatives: 3.0 points
2. Deep Vein Thrombosis (DVT) suspected: 3.0 points
3. Tachycardia (pulse >100 beats per minute): 1.5 points
4. Surgery or immobilization in last 4 weeks: 1.5 points
5. Prior DVT or Pulmonary Embolism: 1.5 points
6. Hemoptysis: 1.0 points
7. Active malignancy: 1.0 points
Interpretation
1. Score 0-2 points: Low PE Probability (3.6% risk)
  1. Positive Likelihood Ratio: 0.1
  2. Negative Likelihood Ratio: 7.6
2. Score 3-6 points: Moderate PE Probability (20.5% risk)
  1. Positive Likelihood Ratio: 1.3
  2. Negative Likelihood Ratio: 0.7
3. Score >6 points: High PE Probability (66.7% risk)
  1. Positive Likelihood Ratio: 6.8
  2. Negative Likelihood Ratio: 1.8
Interpretation: Simplified
1. Score 4 or less: Unlikely
2. Score >4: Likely
3. D-Dimer negative with "unlikely" score safely excludes Pulmonary Embolism
References

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 2/1/2013 and last published on 5/14/2013.

This is one of 5887 pages in the Family Practice Notebook