| Variables | Points | |
| Risk factors | Age >65 years | 1 |
| Previous deep venous thrombosis or pulmonary embolism | 3 | |
| Surgery under general anesthesia or fracture of the lower limbs within one month | 2 | |
| Active malignancy (solid or hematologic; currently active or cured within the last year) | 2 | |
| Symptoms | Unilateral lower-limb pain | 3 |
| Hemoptysis | 2 | |
| Signs | Heart rate 75 to 94 beats per minute | 3 |
| ≥95 beats per minute | 5 | |
| Pain on lower limb deep venous palpation and unilateral edema | 4 | |
| Total points | ||
| Pre-test probability assessment | Low | 0 to 3 |
| Intermediate | 4 to 10 | |
| High | ≥11 | |
