ACR/EULAR Sjögren classification criteria

ACR/EULAR Sjögren

Apply the 2016 ACR/EULAR classification criteria for primary Sjögren's syndrome (Shiboski Table 3): require published inclusion and no exclusion, then return the five-item weighted score and whether the ≥4 cut point classifies primary Sjögren's syndrome. Not a diagnosis.

LIVE $0.005 USDC GET /api/calc/acr_eular_sjogren

Markdown: /docs/acr-eular-sjogren.md · Canonical: https://magentlab.com/docs/acr-eular-sjogren

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

What it computes

When to use

When an agent already has caller-assigned Shiboski 2016 inclusion, exclusion, and the five criteria items and needs the published primary Sjögren classification result for research, not a diagnosis.

When not to use

Not a medical device and not a diagnosis of Sjögren's syndrome. Classification criteria for research, not AECG 2002 and not 2012 ACR-only criteria.
Inclusion (inclusion_met true) and exclusion (exclusion_present false) must be met or the request is HTTP 400 and is not scored.
magent does not stain eyes, measure saliva, assay anti-SSA/Ro, or read labial salivary gland biopsies. Anti-SSB/La without SSA is not an item.
Classification criteria for research, not a treatment decision.

Formula

ACR/EULAR 2016 primary Sjögren classification (Shiboski Table 3): required inclusion_met true and exclusion_present false (else do not score). Score = labial_biopsy_fs_ge_1 3 + anti_ssa_ro 3 + ocular_staining 1 + schirmer 1 + uws 1; max 9; classified iff score ≥4. Not a diagnosis. Not AECG 2002. Not 2012 ACR-only criteria

Citation

Title: 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren's Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts
Authors: Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, Rasmussen A, Scofield H, Vitali C, Bowman SJ, Mariette X, the International Sjögren's Syndrome Criteria Working Group
Source: Arthritis Rheumatol. 2017;69(1):35-45
DOI: 10.1002/art.39859

Worked example

Labial biopsy and ocular staining, classified

Given: anti_ssa_ro=falseexclusion_present=falseinclusion_met=truelabial_biopsy_fs_ge_1=trueocular_staining=trueschirmer=falseuws=false

Required: inclusion_met true, exclusion_present false
labial_biopsy_fs_ge_1 3 + ocular_staining 1; anti_ssa_ro, schirmer, and uws 0
score = 4 (max 9) ≥4; classified true

Inclusion met, no items, not classified

Given: anti_ssa_ro=falseexclusion_present=falseinclusion_met=truelabial_biopsy_fs_ge_1=falseocular_staining=falseschirmer=falseuws=false

Scoring flags false
Score = 0 (max 9) <4; classified false

Anti-SSA/Ro only, not classified

Given: anti_ssa_ro=trueexclusion_present=falseinclusion_met=truelabial_biopsy_fs_ge_1=falseocular_staining=falseschirmer=falseuws=false

anti_ssa_ro 3; remaining items 0
Score = 3 (max 9) <4; classified false. Anti-SSB/La without SSA is not an item.

All five items, classified

Given: anti_ssa_ro=trueexclusion_present=falseinclusion_met=truelabial_biopsy_fs_ge_1=trueocular_staining=trueschirmer=trueuws=true

labial_biopsy_fs_ge_1 3 + anti_ssa_ro 3 + ocular_staining 1 + schirmer 1 + uws 1
Score = 9 (max 9) ≥4; classified true

Also searched as

ACR EULAR Sjögren
2016 Sjögren classification criteria
Shiboski 2016 Sjögren
primary Sjögren syndrome classification
ACR/EULAR 2016 pSS
anti-SSA/Ro Sjögren
labial salivary gland focus score
Schirmer unstimulated saliva Sjögren

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/acr_eular_sjogren?inclusion_met=true&exclusion_present=false&labial_biopsy_fs_ge_1=true&anti_ssa_ro=false&ocular_staining=true&schirmer=false&uws=false

Full URL: https://api.magentlab.com/api/calc/acr_eular_sjogren?inclusion_met=true&exclusion_present=false&labial_biopsy_fs_ge_1=true&anti_ssa_ro=false&ocular_staining=true&schirmer=false&uws=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/acr_eular_sjogren?inclusion_met=true&exclusion_present=false&labial_biopsy_fs_ge_1=true&anti_ssa_ro=false&ocular_staining=true&schirmer=false&uws=false"

Parameters

Name	Type	Required	Description
`inclusion_met`	boolean	required	Must be true. Shiboski 2016 inclusion as assigned by the caller: at least one AECG ocular or oral dryness question positive, or suspicion of Sjögren's syndrome from ESSDAI with at least one positive domain item. false is invalid and is not scored. magent does not take a dryness history.
`exclusion_present`	boolean	required	Must be false. Shiboski 2016 exclusion as assigned by the caller: none of head and neck radiation, active HCV with PCR confirmation, AIDS, sarcoidosis, amyloidosis, graft-versus-host disease, or IgG4-related disease. true is invalid and is not scored. magent does not diagnose exclusion conditions.
`labial_biopsy_fs_ge_1`	boolean	required	Labial salivary gland with focal lymphocytic sialadenitis and focus score ≥1 foci/4 mm² (Shiboski 2016 Table 3). true scores 3; false scores 0. magent does not read biopsies.
`anti_ssa_ro`	boolean	required	Anti-SSA/Ro positive as assigned by the caller (Shiboski 2016 Table 3). true scores 3; false scores 0. Anti-SSB/La without SSA is not an item. magent does not assay autoantibodies.
`ocular_staining`	boolean	required	Ocular staining score ≥5 or van Bijsterveld ≥4 in at least one eye (Shiboski 2016 Table 3). true scores 1; false scores 0. magent does not stain eyes.
`schirmer`	boolean	required	Schirmer's test ≤5 mm/5 minutes in at least one eye (Shiboski 2016 Table 3). true scores 1; false scores 0. magent does not perform Schirmer testing.
`uws`	boolean	required	Unstimulated whole saliva flow rate ≤0.1 ml/minute (Shiboski 2016 Table 3). true scores 1; false scores 0. magent does not measure saliva.

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.

POST /api/calc/acr_eular_sjogren Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 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 (fixture)

{
  "items": [
    {
      "anti_ssa_ro": "false",
      "exclusion_present": "false",
      "inclusion_met": "true",
      "labial_biopsy_fs_ge_1": "true",
      "ocular_staining": "true",
      "schirmer": "false",
      "uws": "false"
    },
    {
      "anti_ssa_ro": "false",
      "exclusion_present": "false",
      "inclusion_met": "true",
      "labial_biopsy_fs_ge_1": "true",
      "ocular_staining": "true",
      "schirmer": "false",
      "uws": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/acr_eular_sjogren",
  "items": [
    {
      "components": [
        {
          "factor": "labial_biopsy_fs_ge_1",
          "points": 3,
          "present": true
        },
        {
          "factor": "anti_ssa_ro",
          "points": 0,
          "present": false
        },
        {
          "factor": "ocular_staining",
          "points": 1,
          "present": true
        },
        {
          "factor": "schirmer",
          "points": 0,
          "present": false
        },
        {
          "factor": "uws",
          "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": "Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, Rasmussen A, Scofield H, Vitali C, Bowman SJ, Mariette X, the International Sjögren's Syndrome Criteria Working Group",
        "doi": "10.1002/art.39859",
        "id": "shiboski-2016",
        "pmid": "27785888",
        "source": "Arthritis Rheumatol. 2017;69(1):35-45",
        "title": "2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren's Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts"
      },
      "formula": "acr_eular_sjogren",
      "formula_expression": "ACR/EULAR 2016 primary Sjögren classification (Shiboski Table 3): required inclusion_met true and exclusion_present false (else do not score). Score = labial_biopsy_fs_ge_1 3 + anti_ssa_ro 3 + ocular_staining 1 + schirmer 1 + uws 1; max 9; classified iff score ≥4. Not a diagnosis. Not AECG 2002. Not 2012 ACR-only criteria",
      "max_score": 9,
      "score": 4,
      "classified": true
    },
    {
      "components": [
        {
          "factor": "labial_biopsy_fs_ge_1",
          "points": 3,
          "present": true
        },
        {
          "factor": "anti_ssa_ro",
          "points": 0,
          "present": false
        },
        {
          "factor": "ocular_staining",
          "points": 1,
          "present": true
        },
        {
          "factor": "schirmer",
          "points": 0,
          "present": false
        },
        {
          "factor": "uws",
          "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": "Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, Rasmussen A, Scofield H, Vitali C, Bowman SJ, Mariette X, the International Sjögren's Syndrome Criteria Working Group",
        "doi": "10.1002/art.39859",
        "id": "shiboski-2016",
        "pmid": "27785888",
        "source": "Arthritis Rheumatol. 2017;69(1):35-45",
        "title": "2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren's Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts"
      },
      "formula": "acr_eular_sjogren",
      "formula_expression": "ACR/EULAR 2016 primary Sjögren classification (Shiboski Table 3): required inclusion_met true and exclusion_present false (else do not score). Score = labial_biopsy_fs_ge_1 3 + anti_ssa_ro 3 + ocular_staining 1 + schirmer 1 + uws 1; max 9; classified iff score ≥4. Not a diagnosis. Not AECG 2002. Not 2012 ACR-only criteria",
      "max_score": 9,
      "score": 4,
      "classified": true
    }
  ]
}

Response

Field	Type	Description
`formula`	string	acr_eular_sjogren
`formula_expression`	string	Shiboski 2016 ACR/EULAR primary Sjögren classification expression
`score`	integer	Shiboski 2016 Table 3 points. Integer 0–9.
`max_score`	integer	9
`classified`	boolean	true iff score ≥4. Classification criteria for research, not a diagnosis of Sjögren's syndrome. Not AECG 2002. Not 2012 ACR-only criteria.
`components`	array	Per-item Shiboski 2016 points
`citation`	object	Shiboski 2016 Arthritis Rheumatol citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "factor": "labial_biopsy_fs_ge_1",
      "points": 3,
      "present": true
    },
    {
      "factor": "anti_ssa_ro",
      "points": 0,
      "present": false
    },
    {
      "factor": "ocular_staining",
      "points": 1,
      "present": true
    },
    {
      "factor": "schirmer",
      "points": 0,
      "present": false
    },
    {
      "factor": "uws",
      "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": "Shiboski CH, Shiboski SC, Seror R, Criswell LA, Labetoulle M, Lietman TM, Rasmussen A, Scofield H, Vitali C, Bowman SJ, Mariette X, the International Sjögren's Syndrome Criteria Working Group",
    "doi": "10.1002/art.39859",
    "id": "shiboski-2016",
    "pmid": "27785888",
    "source": "Arthritis Rheumatol. 2017;69(1):35-45",
    "title": "2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren's Syndrome: A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts"
  },
  "formula": "acr_eular_sjogren",
  "formula_expression": "ACR/EULAR 2016 primary Sjögren classification (Shiboski Table 3): required inclusion_met true and exclusion_present false (else do not score). Score = labial_biopsy_fs_ge_1 3 + anti_ssa_ro 3 + ocular_staining 1 + schirmer 1 + uws 1; max 9; classified iff score ≥4. Not a diagnosis. Not AECG 2002. Not 2012 ACR-only criteria",
  "max_score": 9,
  "score": 4,
  "classified": true
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_sjogren`	inclusion_met must be true and exclusion_present must be false (Shiboski 2016 ACR/EULAR primary Sjögren inclusion and exclusion). Returned before settlement; you are not charged.
400	`invalid_flag`	boolean clinical flags must be true or false Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

ACR/EULAR gout — Apply the 2015 ACR/EULAR gout classification criteria (Neogi Table 2): require the entry episode, classify immediately if MSU crystals are present, otherwise return the Step 3 score (max 23) and whether score ≥8 classifies gout. Not a gout diagnosis.
ACR/EULAR PMR — Apply the 2012 EULAR/ACR polymyalgia rheumatica classification criteria (Dasgupta Table 4): require age ≥50, bilateral shoulder aching, and abnormal CRP and/or ESR, then return the clinical score with or without optional ultrasound and whether the published cut point classifies PMR. Not a PMR diagnosis.

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. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /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.