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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.
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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.

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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.
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