How it's calculated
Eight fully objective clinical criteria (no subjective 'PE most likely diagnosis' judgement, unlike the Wells score) are each assigned points and summed for a total ranging 0-25.
Clinical probability
| Score | Probability | Approx. PE prevalence |
|---|---|---|
| 0-3 | Low | ~8% |
| 4-10 | Intermediate | ~28% |
| ≥ 11 | High | ~74% |
Clinical use
- An alternative to the Wells score for pre-test probability of pulmonary embolism, built entirely from objective criteria rather than including a subjective gestalt judgement.
- Low probability with a negative D-dimer is generally considered sufficient to rule out PE without imaging in appropriate patients.
- Intermediate or high probability categories generally warrant CT pulmonary angiography (or V/Q scanning where CT is contraindicated) regardless of D-dimer result.
Frequently asked questions
How is the Revised Geneva Score different from the Wells score?
The Revised Geneva Score uses only objective clinical criteria (age, history, examination findings, heart rate), while the Wells score includes a subjective item — whether PE is the most likely diagnosis — based on clinical gestalt.
What does 'unilateral lower limb pain' mean in this score?
Pain localised to one leg, as opposed to bilateral or generalised leg discomfort — intended to reflect a possible underlying DVT as the source of embolism.
Can the Revised Geneva Score rule out PE on its own?
No — it stratifies pre-test probability to guide the next step (D-dimer testing versus direct imaging), and is used alongside D-dimer results and clinical judgement, not as a standalone rule-out test.
References
- Le Gal G, et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med. 2006;144(3):165-171.
- Klok FA, et al. Simplification of the revised Geneva score for assessing clinical probability of pulmonary embolism. Arch Intern Med. 2008.