We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

The Wells Deep Vein Thrombosis Score for Inpatients Not the Right Tool for the Job

Erika Leemann Price, MD, MPH1,2; Tracy Minichiello, MD1,2
[+] Author Affiliations
1Department of Medicine, University of California–San Francisco
2Anticoagulation and Thrombosis Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
JAMA Intern Med. 2015;175(7):1118-1119. doi:10.1001/jamainternmed.2015.1699.
Text Size: A A A
Published online


This Invited Commentary discusses the poor utility of the Wells score for deep vein thrombosis in inpatients and suggests alternative approaches to stratify the risk of deep vein thrombosis.

A 75-year-old man hospitalized 4 days ago with congestive heart failure now has new mild right-sided leg pain. Examination reveals bilateral pitting edema to the mid-thighs; the right leg is 3.5 cm larger than the left leg, which is measured 10 cm below the tibial tuberosity. There is no significant tenderness to palpation. The patient has no known malignant neoplasms. His mobility has been limited for the past month owing to his heart failure, and he has not ambulated since admission other than to use the bathroom. Vital signs are unchanged and the patient reports that his dyspnea has improved with diuresis. Lower-extremity ultrasound will not be available overnight.

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

1 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Clinical Scenario

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Clinical Scenario