Clinical Decision Making Tool

CHA₂DS₂-VASc Score Calculator

Congestive heart failure
Hypertension
Age ≥75 years
Diabetes mellitus
Prior stroke/TIA/TE
Vascular disease
Age 65–74 years
Sex: Female
Score: 0 → Low risk (no anticoagulation usually needed).
Estimated yearly stroke risk: 0%

HAS-BLED Score Calculator

Hypertension SBP >160 mmHg
Abnormal renal function Dialysis, transplant, Cr ≥2.26
Abnormal liver function Cirrosis or bilirubin/enzymes >3× normal
Prior stroke
Bleeding history / predisposition
Labile INR Unstable/high INRs, TTR <60%
Age >65 years
Drugs Antiplatelets / NSAIDs
Alcohol use ≥8 drinks/week
Score: 0 → Low risk of bleeding.

Wells PE Score

Clinical signs of DVT
Alternative diagnosis less likely than PE
Heart rate >100 bpm
Immobilization ≥3 days / surgery in past 4 weeks
Previous PE or DVT
Hemoptysis
Malignancy Ongoing treatment / <6 mo / palliative
Score: 0 → Low probability of PE.

CURB-65 Score

Confusion
Urea >7 mmol/L (~20 mg/dL)
Respiratory rate ≥30/min
Systolic BP <90 or Diastolic ≤60 mmHg
Age ≥65 years
Score: 0 → Low risk → Outpatient treatment usually appropriate.

Wells Score for DVT

Active cancer (treatment within 6 months or palliative)
Paralysis/paresis or recent plaster immobilization of lower extremity
Bedridden >3 days or major surgery within 12 weeks
Localized tenderness along deep venous system
Entire leg swollen
Calf swelling >3 cm compared to other leg (measured 10 cm below tibial tuberosity)
Pitting edema confined to symptomatic leg
Collateral superficial veins (non-varicose)
Previously documented DVT
Alternative diagnosis at least as likely as DVT
Score 0 → Low probability (two-tier: Unlikely)
Three-tier: ≤0 Low, 1–2 Moderate, ≥3 High. Two-tier: <2 Unlikely, ≥2 Likely.

Modified Geneva Score Calculator

Age >65
Previous DVT or PE
Surgery or fracture (past month)
Active malignancy Active or cured <1 year
Unilateral lower limb pain
Hemoptysis
Heart rate
Palpation pain + unilateral edema
Score: 0 → Low probability of PE.

HEART Score Calculator

History
EKG 0: normal; 1: LBBB/LVH/rep changes; 2: ST deviation
Age
Risk factors HTN, DM, BMI>30, smoking, FHx, CAD, etc.
Initial troponin
Score: 0 → Low risk → Outpatient management possible.

TIMI Risk Score Calculator

Age ≥65 years
≥3 risk factors for CAD
Known CAD (stenosis ≥50%)
Aspirin use in last 7 days
≥2 angina events in last 24 hrs
ST deviation ≥0.5 mm
Elevated cardiac markers
Score: 0 → Low risk → Consider outpatient management or routine care.

San Francisco Syncope Rule

History of CHF
Hematocrit <30%
Abnormal ECG
Shortness of breath
Systolic BP <90 mmHg
Negative → Low risk, discharge may be safe.

NEXUS C-spine Rule

No midline cervical tenderness
No focal neurologic deficit
Normal alertness
Not intoxicated
No distracting injury
Not all criteria met → Consider imaging for C-spine.

VAN Score

Visual disturbance (e.g., field cut, diplopia)
Aphasia (word-finding difficulty or comprehension deficit)
Neglect (inattention to one side)
Motor weakness (any arm drift or leg weakness)
VAN negative → Low likelihood of LVO.

New Orleans CT Rule

Headache
Vomiting
Age > 60
Intoxication
Persistent neurologic deficit
Retrograde amnesia > 30 min
No criteria → Low risk. CT scan may not be required.

SIRS Criteria

Temperature <36°C or >38°C
Heart rate >90 bpm
Respiratory rate >20/min or PaCO₂ <32 mmHg
WBC <4 or >12 ×10⁹/L, or >10% bands
0/4 criteria → SIRS negative (low risk).

qSOFA Score

SBP ≤100 mmHg
Respiratory rate ≥22/min
Altered mentation (GCS <15)
Score 0 → qSOFA negative (lower risk).

MELD Score

Serum bilirubin (mg/dL)
INR
Serum creatinine (mg/dL)
Formula: 3.78·ln(bili) + 11.2·ln(INR) + 9.57·ln(creat) + 6.43. (Labs are clamped to ≥1.0 for stability.)

Lille Score

Age (years)
Albumin (g/dL)
Bilirubin Day 0 (mg/dL)
Bilirubin Day 7 (mg/dL)
Creatinine (mg/dL)
Prothrombin time (sec)
Simplified Lille estimate. Threshold: <0.45 good steroid response; ≥0.45 poor response.

Maddrey’s Discriminant Function

Prothrombin Time (PT) patient (s)
PT control (s)
Bilirubin (mg/dL)
DF = 4.6 × (PTpatient − PTcontrol) + bilirubin (mg/dL). Threshold: ≥32 → severe.

Child-Pugh Score

Bilirubin (mg/dL)
Albumin (g/dL)
INR
Ascites
Encephalopathy
Class A: 5–6 • Class B: 7–9 • Class C: 10–15.
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