# 2HELPS2B (Struck)

2HELPS2B

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/2helps2b`
HTML: https://magentlab.com/docs/2helps2b
Markdown: https://magentlab.com/docs/2helps2b.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Sum the Struck 2017 2HELPS2B EEG flags and return the published probable-seizure risk percent.

## When to use

When an agent already has the six Struck 2017 flags assigned from an EEG report and needs the published point total and seizure-risk percent, not a seizure diagnosis.

## When not to use

- Not a medical device and not a seizure diagnosis. magent does not read EEG.
- This tool is the Struck 2017 2HELPS2B score and published probable-seizure percents only. It is not a monitoring-duration protocol.
- Flags are caller-assigned. BIRDs, periodic or rhythmic patterns, frequency, plus features, and prior seizure must already be determined by the caller.

## Formula

```
2HELPS2B = birds (true 2) + lpd_lrda_bipd (true 1) + prior_seizure (true 1) + sporadic_epileptiform (true 1) + frequency_gt_2hz (true 1) + plus_features (true 1); Struck 2017; max 7; 0→5%, 1→12%, 2→27%, 3→50%, 4→73%, 5→88%, 6-7→>95%
```

## Citation

[Association of an electroencephalography-based risk score with seizure probability in hospitalized patients](https://doi.org/10.1001/jamaneurol.2017.2459)
Struck AF, Ustun B, Rodriguez Ruiz AA, Lee JW, LaRoche SM, Hirsch LJ, Gilmore EJ, Vlachy J, Haider HA, Rudin C, Westover MB
JAMA Neurol. 2017;74(12):1419-1424
DOI: [10.1001/jamaneurol.2017.2459](https://doi.org/10.1001/jamaneurol.2017.2459)

## Worked example

### All flags false

Given: `birds=false, frequency_gt_2hz=false, lpd_lrda_bipd=false, plus_features=false, prior_seizure=false, sporadic_epileptiform=false`

1. birds false → 0; remaining flags false → 0 each
2. Score = 0 (max 7); seizure_risk = 5%


### All flags true

Given: `birds=true, frequency_gt_2hz=true, lpd_lrda_bipd=true, plus_features=true, prior_seizure=true, sporadic_epileptiform=true`

1. birds true → 2; remaining flags true → 1 each
2. Score = 7 (max 7); seizure_risk = >95%


## Also searched as

- 2HELPS2B
- Struck 2017
- 2HELPS2B score
- EEG seizure risk
- BIRDs EEG
- LPD LRDA BIPD
- hospital EEG seizure probability
- 2 helps 2B
- brief ictal rhythmic discharges

## Parameters

- `birds` (boolean, required): Brief (ictal) rhythmic discharges (BIRDs) as assigned by the caller (Struck 2017). true scores 2. magent does not read EEG.
- `lpd_lrda_bipd` (boolean, required): LPD or LRDA or BIPD as assigned by the caller (Struck 2017). true scores 1. magent does not read EEG.
- `prior_seizure` (boolean, required): Prior seizure, acute or remote, as assigned by the caller (Struck 2017). true scores 1.
- `sporadic_epileptiform` (boolean, required): Sporadic epileptiform discharges as assigned by the caller (Struck 2017). true scores 1. magent does not read EEG.
- `frequency_gt_2hz` (boolean, required): Frequency >2.0 Hz for any periodic or rhythmic pattern as assigned by the caller (Struck 2017). true scores 1. magent does not read EEG.
- `plus_features` (boolean, required): Plus features (superimposed rhythmic, sharp, or fast activity) as assigned by the caller (Struck 2017). true scores 1. magent does not read EEG.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/2helps2b`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "birds": "false",
      "frequency_gt_2hz": "false",
      "lpd_lrda_bipd": "false",
      "plus_features": "false",
      "prior_seizure": "false",
      "sporadic_epileptiform": "false"
    },
    {
      "birds": "false",
      "frequency_gt_2hz": "false",
      "lpd_lrda_bipd": "false",
      "plus_features": "false",
      "prior_seizure": "false",
      "sporadic_epileptiform": "false"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/2helps2b

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/2helps2b",
  "items": [
    {
      "components": [
        {
          "factor": "birds",
          "points": 0,
          "present": false
        },
        {
          "factor": "lpd_lrda_bipd",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_seizure",
          "points": 0,
          "present": false
        },
        {
          "factor": "sporadic_epileptiform",
          "points": 0,
          "present": false
        },
        {
          "factor": "frequency_gt_2hz",
          "points": 0,
          "present": false
        },
        {
          "factor": "plus_features",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Struck AF, Ustun B, Rodriguez Ruiz AA, Lee JW, LaRoche SM, Hirsch LJ, Gilmore EJ, Vlachy J, Haider HA, Rudin C, Westover MB",
        "doi": "10.1001/jamaneurol.2017.2459",
        "id": "struck-2017",
        "pmid": "29052706",
        "source": "JAMA Neurol. 2017;74(12):1419-1424",
        "title": "Association of an electroencephalography-based risk score with seizure probability in hospitalized patients"
      },
      "formula": "2helps2b",
      "formula_expression": "2HELPS2B = birds (true 2) + lpd_lrda_bipd (true 1) + prior_seizure (true 1) + sporadic_epileptiform (true 1) + frequency_gt_2hz (true 1) + plus_features (true 1); Struck 2017; max 7; 0→5%, 1→12%, 2→27%, 3→50%, 4→73%, 5→88%, 6-7→>95%",
      "max_score": 7,
      "score": 0,
      "seizure_risk": "5%"
    },
    {
      "components": [
        {
          "factor": "birds",
          "points": 0,
          "present": false
        },
        {
          "factor": "lpd_lrda_bipd",
          "points": 0,
          "present": false
        },
        {
          "factor": "prior_seizure",
          "points": 0,
          "present": false
        },
        {
          "factor": "sporadic_epileptiform",
          "points": 0,
          "present": false
        },
        {
          "factor": "frequency_gt_2hz",
          "points": 0,
          "present": false
        },
        {
          "factor": "plus_features",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Struck AF, Ustun B, Rodriguez Ruiz AA, Lee JW, LaRoche SM, Hirsch LJ, Gilmore EJ, Vlachy J, Haider HA, Rudin C, Westover MB",
        "doi": "10.1001/jamaneurol.2017.2459",
        "id": "struck-2017",
        "pmid": "29052706",
        "source": "JAMA Neurol. 2017;74(12):1419-1424",
        "title": "Association of an electroencephalography-based risk score with seizure probability in hospitalized patients"
      },
      "formula": "2helps2b",
      "formula_expression": "2HELPS2B = birds (true 2) + lpd_lrda_bipd (true 1) + prior_seizure (true 1) + sporadic_epileptiform (true 1) + frequency_gt_2hz (true 1) + plus_features (true 1); Struck 2017; max 7; 0→5%, 1→12%, 2→27%, 3→50%, 4→73%, 5→88%, 6-7→>95%",
      "max_score": 7,
      "score": 0,
      "seizure_risk": "5%"
    }
  ]
}
```

## Response fields

- `formula` (string): 2helps2b
- `formula_expression` (string): Exact expression used
- `score` (integer): 2HELPS2B points 0-7
- `max_score` (integer): Always 7
- `seizure_risk` (string): Struck 2017 published probable seizure risk: 5%, 12%, 27%, 50%, 73%, 88%, or >95%. Not a seizure diagnosis.
- `components` (array): Per-flag points
- `citation` (object): Struck 2017 JAMA Neurol citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "factor": "birds",
      "points": 0,
      "present": false
    },
    {
      "factor": "lpd_lrda_bipd",
      "points": 0,
      "present": false
    },
    {
      "factor": "prior_seizure",
      "points": 0,
      "present": false
    },
    {
      "factor": "sporadic_epileptiform",
      "points": 0,
      "present": false
    },
    {
      "factor": "frequency_gt_2hz",
      "points": 0,
      "present": false
    },
    {
      "factor": "plus_features",
      "points": 0,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Struck AF, Ustun B, Rodriguez Ruiz AA, Lee JW, LaRoche SM, Hirsch LJ, Gilmore EJ, Vlachy J, Haider HA, Rudin C, Westover MB",
    "doi": "10.1001/jamaneurol.2017.2459",
    "id": "struck-2017",
    "pmid": "29052706",
    "source": "JAMA Neurol. 2017;74(12):1419-1424",
    "title": "Association of an electroencephalography-based risk score with seizure probability in hospitalized patients"
  },
  "formula": "2helps2b",
  "formula_expression": "2HELPS2B = birds (true 2) + lpd_lrda_bipd (true 1) + prior_seizure (true 1) + sporadic_epileptiform (true 1) + frequency_gt_2hz (true 1) + plus_features (true 1); Struck 2017; max 7; 0→5%, 1→12%, 2→27%, 3→50%, 4→73%, 5→88%, 6-7→>95%",
  "max_score": 7,
  "score": 0,
  "seizure_risk": "5%"
}
```

## Errors

- HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [Glasgow Coma Scale](https://magentlab.com/docs/gcs) — Compute the Glasgow Coma Scale as the sum of caller-assigned eye, verbal, and motor integers. The 1974 or 1976 edition is required.
- [CAM-ICU](https://magentlab.com/docs/cam-icu) — Apply the Ely 2001 CAM-ICU algorithm and return whether delirium is present from four caller-assigned features.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.