The Wells’ Criteria risk stratifies patients for pulmonary embolism (PE), and has been validated in both inpatient and emergency department settings. Its score is often used in conjunction with d-dimer testing to evaluate for PE.
- There must first be a clinical suspicion for PE in the patient (this should not be applied to all patients with chest pain or shortness of breath, for example).
- Wells' can be used with either 3 tiers (low, moderate, high) or 2 tiers (unlikely, likely). We recommend the two tier model as this is supported by ACEP’s 2011 clinical policy on PE. (See Next Steps)
- Wells’ is often criticized for having a “subjective” criterion in it (“PE #1 diagnosis or equally likely”)
- Wells’ is not meant to diagnose PE but to guide workup by predicting pre-test probability of PE and appropriate testing to rule out the diagnosis.
