Wells PE vs sPESI on shift — transparent bedside scores

On a busy shift, “score” can mean two very different jobs. Wells for PE is a pretest probability tool: it helps structure the question, “How likely is pulmonary embolism before testing?” It is not a diagnosis, and it should sit alongside the history, exam, ECG, imaging pathway, and local protocols. The value is transparency—making the clinical assumptions behind “PE likely” or “PE unlikely” visible to the team.

sPESI answers a different question. Once acute PE is being considered or confirmed, the simplified Pulmonary Embolism Severity Index is a short-term prognostic screen. It estimates baseline risk using clinical features; it does not rule PE in or out, and it is not a substitute for haemodynamic assessment, right-heart strain data, or a conversation about the whole patient. A low score is not a permission slip to ignore red flags.

For a quick, auditable bedside pass, I keep the tools separate:

• PE decision hub
• Wells PE calculator
• sPESI calculator

These are intended for licensed clinicians. The calculations run locally in the browser, with no patient data uploaded. They are not an EMR, do not replace clinical judgment or institutional guidance, and are not haoyisheng.com. I’m sharing them as transparent aids for teaching, handover, and a second look—not as an automated disposition engine.

My practical check: say out loud which question you are answering before opening a calculator—pretest probability with Wells, or prognosis with sPESI. That small pause can prevent a prognostic score from being misused as a diagnostic one.

FOAMed clinicians: where do these tools help on your shift, and where do they create false confidence? I’d genuinely welcome critique of the wording, assumptions, and workflow.