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Invited Commentary
July 2015

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

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

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.