Validation of the Wells Score for Predicting DVT

Clinical prediction instruments are intended to improve case-finding while being both efficient (specific) and reliable (sensitive). Wells and colleagues have shown that the Wells deep venous thrombosis score (in its several iterations) is both efficient and reliable when used in combination with d-dimer testing (JWEM Oct 29 2003). They contend that a low Wells DVT score plus a negative d-dimer result allows clinicians to forgo further testing. Now, two recent studies and an editorial address whether this scheme is better than physician judgment and whether it is valid when used in other settings and by other clinicians.

In a meta-analysis, researchers in the U.K. compared physician judgment and performance of one version (9-item) of the Wel…