DVT and PE work-up

Which diagnostic pathway should come next?

Wells / PERCThree pathways

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PE Wells criteria

Clinical signs and symptoms of DVT+3PE is more likely than an alternative diagnosis+3Heart rate >100/min+1.5Immobilised ≥3 days or surgery in previous 4 weeks+1.5Previous DVT or PE+1.5Haemoptysis+1Active malignancy or treatment in past 6 months / palliative+1

DVT Wells criteria

Active cancer+1Paralysis, paresis or recent lower-limb plaster+1Bedridden ≥3 days or major surgery within 12 weeks+1Tenderness along deep venous system+1Entire leg swollen+1Calf ≥3 cm larger than asymptomatic side+1Pitting oedema confined to symptomatic leg+1Collateral superficial veins+1Previously documented DVT+1Alternative diagnosis at least as likely as DVT−2

PERC prerequisite

PERC is not a general PE score. Confirm low clinical suspicion first.

Clinical PE probability is low (<15%) and an alternative diagnosis is feasibleRequired

PERC positive features

Age ≥50+1Pulse ≥100/min+1SpO₂ <95%+1Unilateral leg swelling+1Haemoptysis+1Surgery or trauma within 4 weeks+1Previous DVT or PE+1Exogenous oestrogen+1

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Wells / PERC

Which diagnostic pathway should come next?

Result

What contributed

What this means

Decision support only. Use the full clinical picture, local protocol and current guideline.

Clinical content reviewed 29 July 2026

NICE NG158 · VTE diagnosis↗

The Kopitiam GP is written by Dr Nathan, a Singapore-based GP working across family medicine, clinic operations, digital health and healthcare innovation.

Educational content only. It does not replace personal medical advice from your own doctor.