# AAP 2022 phototherapy threshold (Kemper) AAP 2022 phototherapy threshold (Kemper) Status: LIVE Price: $0.005 USDC `GET /api/calc/aap_tsb` HTML: https://magentlab.com/docs/aap-tsb Markdown: https://magentlab.com/docs/aap-tsb.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Return the AAP 2022 Kemper KAS 10 intensive phototherapy threshold from Supplemental Table 1 (no extra neurotoxicity risk factors other than gestational age) or Supplemental Table 2 (any additional listed factor), with TSB minus that threshold and whether TSB is at or above it. ## When to use When an agent already has completed gestational age ≥35 weeks, age in hours, TSB, and caller-assigned extra neurotoxicity risk factors and needs the published hour-specific phototherapy threshold. magent does not assay TSB or order phototherapy. Gestational age <38 weeks is already in the GA-specific curve; use Table 2 only when an additional listed factor is assigned. ## When not to use - Not a medical device and not a phototherapy or exchange-transfusion order. magent does not assay TSB. - Published for newborn infants 35 or more weeks of gestation only (Kemper 2022). Ages under 1 hour and after 336 hours are rejected. - Use total serum bilirubin. Do not subtract direct-reacting or conjugated bilirubin. - Neurotoxicity risk factors other than gestational age are caller-assigned (isoimmune hemolytic disease, G6PD deficiency or other hemolytic conditions, sepsis, albumin <3.0 g/dL, significant clinical instability in the previous 24 hours). magent does not determine those factors or assign race or ethnicity. - This tool is Supplemental Tables 1 and 2 only. It is not Bhutani 1999 percentile zones and is not an exchange-transfusion threshold. ## Formula ``` Kemper 2022 KAS 10 intensive phototherapy threshold (mg/dL) from Supplemental Table 1 when the caller assigns no neurotoxicity risk factors other than gestational age, or Supplemental Table 2 when any additional listed factor is assigned. Table 1 curves are completed GA 35, 36, 37, 38, 39, and ≥40 weeks. Table 2 curves are 35, 36, 37, and ≥38 weeks. Age is in hours (tabulated hourly from 1 through 336); interpolate linearly between adjacent tabulated hours. Use total serum bilirubin; do not subtract direct-reacting or conjugated bilirubin. Gestational age <38 weeks is already in the GA-specific curve — do not apply Table 2 solely for prematurity. Not a phototherapy or exchange order. magent does not assay TSB ``` ## Citation [Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation](https://doi.org/10.1542/peds.2022-058859) Kemper AR, Newman TB, Slaughter JL, et al. Pediatrics. 2022;150(3):e2022058859 DOI: [10.1542/peds.2022-058859](https://doi.org/10.1542/peds.2022-058859) ## Worked example ### 40 weeks, no extra risk factors, age 48 hours, TSB 17 (Table 1, at threshold) Given: `age_hours=48, albumin_lt_3=false, clinical_instability_24h=false, g6pd_deficiency=false, gestational_age_weeks=40, isoimmune_hemolytic_disease=false, other_hemolytic_condition=false, sepsis=false, tsb_mg_dl=17` 1. No additional neurotoxicity risk factor → Supplemental Table 1, ≥40-week curve 2. Age 48 hours is tabulated; printed threshold is 17.0 mg/dL 3. TSB 17.0 − 17.0 = 0.0; above_phototherapy_threshold true (at or above). Not a phototherapy order ### Same infant, TSB 16.9 (below the printed 17.0 threshold) Given: `age_hours=48, albumin_lt_3=false, clinical_instability_24h=false, g6pd_deficiency=false, gestational_age_weeks=40, isoimmune_hemolytic_disease=false, other_hemolytic_condition=false, sepsis=false, tsb_mg_dl=16.9` 1. Table 1 ≥40 weeks at 48 hours remains 17.0 mg/dL 2. TSB 16.9 − 17.0 = −0.1; above_phototherapy_threshold false ### 40 weeks with caller-assigned sepsis, age 48 hours, TSB 14 (Table 2) Given: `age_hours=48, albumin_lt_3=false, clinical_instability_24h=false, g6pd_deficiency=false, gestational_age_weeks=40, isoimmune_hemolytic_disease=false, other_hemolytic_condition=false, sepsis=true, tsb_mg_dl=14` 1. Any additional neurotoxicity risk factor → Supplemental Table 2, ≥38-week curve 2. Age 48 hours is tabulated; printed threshold is 14.0 mg/dL 3. TSB 14.0 − 14.0 = 0.0; above_phototherapy_threshold true ### 35 weeks, no extra risk factors, age 72 hours, TSB 16.8 (Table 1, at threshold) Given: `age_hours=72, albumin_lt_3=false, clinical_instability_24h=false, g6pd_deficiency=false, gestational_age_weeks=35, isoimmune_hemolytic_disease=false, other_hemolytic_condition=false, sepsis=false, tsb_mg_dl=16.8` 1. No additional factor → Supplemental Table 1, 35-week curve 2. Age 72 hours is tabulated; printed threshold is 16.8 mg/dL 3. TSB 16.8 − 16.8 = 0.0; above_phototherapy_threshold true ## Also searched as - AAP 2022 phototherapy threshold - Kemper hyperbilirubinemia phototherapy - neonatal TSB phototherapy threshold - intensive phototherapy KAS 10 - Supplemental Table 1 phototherapy - hour-specific phototherapy threshold - neurotoxicity risk factor phototherapy ## Parameters - `gestational_age_weeks` (integer, required): Completed gestational age in weeks, integer 35-45. Table 1 uses distinct curves for 35, 36, 37, 38, 39, and ≥40. Table 2 groups ≥38 together. magent does not convert days. - `age_hours` (number, required): Chronologic age in hours (1-336). Supplemental Tables 1 and 2 are tabulated hourly; ages between adjacent hours are linearly interpolated. Hour 0 is not tabulated. magent does not convert days. - `tsb_mg_dl` (number, required): Total serum bilirubin in mg/dL (0-40). Use TSB; do not subtract direct-reacting or conjugated bilirubin. magent does not assay TSB. - `isoimmune_hemolytic_disease` (boolean, required): Caller-assigned isoimmune hemolytic disease (positive direct antiglobulin test) from Kemper 2022 Table 2. true or false. magent does not interpret DAT. - `g6pd_deficiency` (boolean, required): Caller-assigned glucose-6-phosphate dehydrogenase (G6PD) deficiency from Kemper 2022 Table 2. true or false. magent does not assay G6PD. - `other_hemolytic_condition` (boolean, required): Caller-assigned other hemolytic condition (Kemper 2022 Table 2, same neurotoxicity-risk row as isoimmune disease and G6PD deficiency). true or false. - `sepsis` (boolean, required): Caller-assigned sepsis or suspected sepsis from Kemper 2022 Table 2. true or false. magent does not diagnose sepsis. - `albumin_lt_3` (boolean, required): Caller-assigned albumin <3.0 g/dL from Kemper 2022 Table 2. true or false. magent does not assay albumin. - `clinical_instability_24h` (boolean, required): Caller-assigned significant clinical instability in the previous 24 hours from Kemper 2022 Table 2. true or false. magent does not examine the infant. ## 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/aap_tsb` 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": [ { "age_hours": "48", "albumin_lt_3": "false", "clinical_instability_24h": "false", "g6pd_deficiency": "false", "gestational_age_weeks": "40", "isoimmune_hemolytic_disease": "false", "other_hemolytic_condition": "false", "sepsis": "false", "tsb_mg_dl": "17" }, { "age_hours": "48", "albumin_lt_3": "false", "clinical_instability_24h": "false", "g6pd_deficiency": "false", "gestational_age_weeks": "40", "isoimmune_hemolytic_disease": "false", "other_hemolytic_condition": "false", "sepsis": "false", "tsb_mg_dl": "17" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/aap-tsb Example 200: ```json { "count": 2, "path": "/api/calc/aap_tsb", "items": [ { "components": [ { "factor": "any_neurotoxicity_risk_factor", "met": false }, { "value": 17.0, "factor": "above_phototherapy_threshold", "met": true } ], "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": "Kemper AR, Newman TB, Slaughter JL, et al.", "doi": "10.1542/peds.2022-058859", "id": "kemper-2022-aap-hyperbilirubinemia", "pmid": "35927462", "source": "Pediatrics. 2022;150(3):e2022058859", "title": "Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation" }, "formula": "aap_tsb", "formula_expression": "Kemper 2022 KAS 10 intensive phototherapy threshold (mg/dL) from Supplemental Table 1 when the caller assigns no neurotoxicity risk factors other than gestational age, or Supplemental Table 2 when any additional listed factor is assigned. Table 1 curves are completed GA 35, 36, 37, 38, 39, and ≥40 weeks. Table 2 curves are 35, 36, 37, and ≥38 weeks. Age is in hours (tabulated hourly from 1 through 336); interpolate linearly between adjacent tabulated hours. Use total serum bilirubin; do not subtract direct-reacting or conjugated bilirubin. Gestational age <38 weeks is already in the GA-specific curve — do not apply Table 2 solely for prematurity. Not a phototherapy or exchange order. magent does not assay TSB", "above_phototherapy_threshold": true, "age_hours": 48, "albumin_lt_3": false, "any_neurotoxicity_risk_factor": false, "clinical_instability_24h": false, "g6pd_deficiency": false, "gestational_age_group": "40_or_more", "gestational_age_weeks": 40, "isoimmune_hemolytic_disease": false, "other_hemolytic_condition": false, "phototherapy_threshold_mg_dl": 17.0, "sepsis": false, "supplemental_table": 1, "tsb_mg_dl": 17.0, "tsb_minus_threshold": 0.0 }, { "components": [ { "factor": "any_neurotoxicity_risk_factor", "met": false }, { "value": 17.0, "factor": "above_phototherapy_threshold", "met": true } ], "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": "Kemper AR, Newman TB, Slaughter JL, et al.", "doi": "10.1542/peds.2022-058859", "id": "kemper-2022-aap-hyperbilirubinemia", "pmid": "35927462", "source": "Pediatrics. 2022;150(3):e2022058859", "title": "Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation" }, "formula": "aap_tsb", "formula_expression": "Kemper 2022 KAS 10 intensive phototherapy threshold (mg/dL) from Supplemental Table 1 when the caller assigns no neurotoxicity risk factors other than gestational age, or Supplemental Table 2 when any additional listed factor is assigned. Table 1 curves are completed GA 35, 36, 37, 38, 39, and ≥40 weeks. Table 2 curves are 35, 36, 37, and ≥38 weeks. Age is in hours (tabulated hourly from 1 through 336); interpolate linearly between adjacent tabulated hours. Use total serum bilirubin; do not subtract direct-reacting or conjugated bilirubin. Gestational age <38 weeks is already in the GA-specific curve — do not apply Table 2 solely for prematurity. Not a phototherapy or exchange order. magent does not assay TSB", "above_phototherapy_threshold": true, "age_hours": 48, "albumin_lt_3": false, "any_neurotoxicity_risk_factor": false, "clinical_instability_24h": false, "g6pd_deficiency": false, "gestational_age_group": "40_or_more", "gestational_age_weeks": 40, "isoimmune_hemolytic_disease": false, "other_hemolytic_condition": false, "phototherapy_threshold_mg_dl": 17.0, "sepsis": false, "supplemental_table": 1, "tsb_mg_dl": 17.0, "tsb_minus_threshold": 0.0 } ] } ``` ## Response fields - `formula` (string): aap_tsb - `formula_expression` (string): Published Kemper 2022 Supplemental Table 1 or 2 lookup - `gestational_age_weeks` (integer): Echo of completed gestational age in weeks - `gestational_age_group` (string): Guideline curve group: 35, 36, 37, 38, 39, or 40_or_more on Table 1; 35, 36, 37, or 38_or_more on Table 2 - `age_hours` (number): Echo of age in hours - `tsb_mg_dl` (number): Echo of total serum bilirubin in mg/dL - `isoimmune_hemolytic_disease` (boolean): Echo of caller-assigned isoimmune hemolytic disease - `g6pd_deficiency` (boolean): Echo of caller-assigned G6PD deficiency - `other_hemolytic_condition` (boolean): Echo of caller-assigned other hemolytic condition - `sepsis` (boolean): Echo of caller-assigned sepsis - `albumin_lt_3` (boolean): Echo of caller-assigned albumin <3.0 g/dL - `clinical_instability_24h` (boolean): Echo of caller-assigned significant clinical instability in the previous 24 hours - `any_neurotoxicity_risk_factor` (boolean): true when any additional neurotoxicity risk factor other than GA is assigned (Supplemental Table 2) - `supplemental_table` (integer): 1 when Table 1 (no extra factors); 2 when Table 2 (any extra factor) - `phototherapy_threshold_mg_dl` (number): Printed (or linearly interpolated) intensive phototherapy threshold in mg/dL - `tsb_minus_threshold` (number): TSB minus phototherapy threshold in mg/dL (negative when below threshold) - `above_phototherapy_threshold` (boolean): true when TSB is at or above the phototherapy threshold. Not a treatment order - `components` (array): Tree rows for any_neurotoxicity_risk_factor and above_phototherapy_threshold (value is the threshold in mg/dL) - `citation` (object): Kemper 2022 Pediatrics citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "any_neurotoxicity_risk_factor", "met": false }, { "value": 17.0, "factor": "above_phototherapy_threshold", "met": true } ], "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": "Kemper AR, Newman TB, Slaughter JL, et al.", "doi": "10.1542/peds.2022-058859", "id": "kemper-2022-aap-hyperbilirubinemia", "pmid": "35927462", "source": "Pediatrics. 2022;150(3):e2022058859", "title": "Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation" }, "formula": "aap_tsb", "formula_expression": "Kemper 2022 KAS 10 intensive phototherapy threshold (mg/dL) from Supplemental Table 1 when the caller assigns no neurotoxicity risk factors other than gestational age, or Supplemental Table 2 when any additional listed factor is assigned. Table 1 curves are completed GA 35, 36, 37, 38, 39, and ≥40 weeks. Table 2 curves are 35, 36, 37, and ≥38 weeks. Age is in hours (tabulated hourly from 1 through 336); interpolate linearly between adjacent tabulated hours. Use total serum bilirubin; do not subtract direct-reacting or conjugated bilirubin. Gestational age <38 weeks is already in the GA-specific curve — do not apply Table 2 solely for prematurity. Not a phototherapy or exchange order. magent does not assay TSB", "above_phototherapy_threshold": true, "age_hours": 48, "albumin_lt_3": false, "any_neurotoxicity_risk_factor": false, "clinical_instability_24h": false, "g6pd_deficiency": false, "gestational_age_group": "40_or_more", "gestational_age_weeks": 40, "isoimmune_hemolytic_disease": false, "other_hemolytic_condition": false, "phototherapy_threshold_mg_dl": 17.0, "sepsis": false, "supplemental_table": 1, "tsb_mg_dl": 17.0, "tsb_minus_threshold": 0.0 } ``` ## Errors - HTTP 400 `invalid_aap_tsb`: AAP 2022 phototherapy-threshold inputs must match gestational age, age in hours, total serum bilirubin, and caller-assigned neurotoxicity risk factors. 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 - [Rebound hyperbilirubinemia](https://magentlab.com/docs/rebound-hyperbilirubinemia) — Return the Chang 2017 three-variable rebound hyperbilirubinemia prediction score after inpatient phototherapy from gestational age, age at phototherapy initiation in days, TSB at termination, and a caller-supplied AAP phototherapy threshold. Scores <20 correspond to a <4% probability of rebound in that paper. ## 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.