ADHERE CART in-hospital mortality risk

ADHERE

Apply the Fonarow 2005 ADHERE classification and regression tree for in-hospital mortality risk in acutely decompensated heart failure from admission BUN, systolic blood pressure, and serum creatinine.

LIVE $0.005 USDC GET /api/calc/adhere

Markdown: /docs/adhere.md · Canonical: https://magentlab.com/docs/adhere

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

What it computes

When to use

When an agent has caller-supplied admission BUN, systolic BP, and creatinine and needs the published ADHERE CART terminal group, not the paper's logistic regression, not GWTG-HF, and not a treatment or ICU order.

When not to use

Not a medical device. magent does not examine the patient and does not measure BUN, blood pressure, or creatinine.
Not a heart-failure diagnosis or treatment/ICU order. This is the Fonarow 2005 CART bedside tree only, not the paper's logistic regression.
This is not GWTG-HF.

Formula

high: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl >= 2.75; intermediate_1: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl < 2.75; intermediate_2: bun_mg_dl >= 43 AND systolic_bp_mm_hg >= 115; intermediate_3: bun_mg_dl < 43 AND systolic_bp_mm_hg < 115; low: bun_mg_dl < 43 AND systolic_bp_mm_hg >= 115 (Fonarow 2005 CART)

Citation

Title: Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis
Authors: Fonarow GC, Adams KF Jr, Abraham WT, Yancy CW, Boscardin WJ; ADHERE Scientific Advisory Committee, Study Group, and Investigators
Source: JAMA. 2005;293(5):572-580
DOI: 10.1001/jama.293.5.572

Worked example

BUN 20 mg/dL, SBP 140 mm Hg, creatinine 1.0 mg/dL

Given: bun_mg_dl=20creatinine_mg_dl=1.0systolic_bp_mm_hg=140

BUN 20 mg/dL is < 43 and SBP 140 mm Hg is >= 115
Creatinine is not consulted
low

BUN 50 mg/dL, SBP 100 mm Hg, creatinine 3.0 mg/dL

Given: bun_mg_dl=50creatinine_mg_dl=3.0systolic_bp_mm_hg=100

BUN 50 mg/dL is >= 43, SBP 100 mm Hg is < 115, and creatinine 3.0 mg/dL is >= 2.75
high

Also searched as

ADHERE CART
ADHERE risk tree
Fonarow 2005 ADHERE
acutely decompensated heart failure mortality
ADHERE BUN SBP creatinine
in-hospital mortality heart failure CART
ADHERE classification tree
Fonarow heart failure tree

Try

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

/api/calc/adhere?bun_mg_dl=20&systolic_bp_mm_hg=140&creatinine_mg_dl=1.0

Full URL: https://api.magentlab.com/api/calc/adhere?bun_mg_dl=20&systolic_bp_mm_hg=140&creatinine_mg_dl=1.0

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/adhere?bun_mg_dl=20&systolic_bp_mm_hg=140&creatinine_mg_dl=1.0"

Parameters

Name	Type	Required	Description
`bun_mg_dl`	number	required	Admission blood urea nitrogen in mg/dL (1-200). Fonarow 2005 CART first split is BUN >= 43. magent does not measure BUN.
`systolic_bp_mm_hg`	integer	required	Admission systolic blood pressure in mm Hg (integer 50-250). Fonarow 2005 CART second split is SBP < 115. magent does not measure blood pressure.
`creatinine_mg_dl`	number	optional	Admission serum creatinine in mg/dL (0.1-20). Provide this or creatinine_umol_l, not both. Fonarow 2005 CART consults creatinine only when BUN >= 43 and SBP < 115; the split is creatinine >= 2.75. magent does not measure creatinine.
`creatinine_umol_l`	number	optional	Admission serum creatinine in µmol/L (9-1768). Converted as mg/dL = µmol/L / 88.42. Provide this or creatinine_mg_dl, not both.

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/adhere 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": [
    {
      "bun_mg_dl": "20",
      "creatinine_mg_dl": "1.0",
      "systolic_bp_mm_hg": "140"
    },
    {
      "bun_mg_dl": "20",
      "creatinine_mg_dl": "1.0",
      "systolic_bp_mm_hg": "140"
    }
  ]
}

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/adhere",
  "items": [
    {
      "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": "Fonarow GC, Adams KF Jr, Abraham WT, Yancy CW, Boscardin WJ; ADHERE Scientific Advisory Committee, Study Group, and Investigators",
        "doi": "10.1001/jama.293.5.572",
        "id": "fonarow-2005",
        "pmid": "15687312",
        "source": "JAMA. 2005;293(5):572-580",
        "title": "Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis"
      },
      "formula": "adhere",
      "formula_expression": "high: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl >= 2.75; intermediate_1: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl < 2.75; intermediate_2: bun_mg_dl >= 43 AND systolic_bp_mm_hg >= 115; intermediate_3: bun_mg_dl < 43 AND systolic_bp_mm_hg < 115; low: bun_mg_dl < 43 AND systolic_bp_mm_hg >= 115 (Fonarow 2005 CART)",
      "creatinine_mg_dl": 1.0,
      "adhere_risk": "low",
      "bun_mg_dl": 20.0,
      "systolic_bp_mm_hg": 140
    },
    {
      "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": "Fonarow GC, Adams KF Jr, Abraham WT, Yancy CW, Boscardin WJ; ADHERE Scientific Advisory Committee, Study Group, and Investigators",
        "doi": "10.1001/jama.293.5.572",
        "id": "fonarow-2005",
        "pmid": "15687312",
        "source": "JAMA. 2005;293(5):572-580",
        "title": "Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis"
      },
      "formula": "adhere",
      "formula_expression": "high: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl >= 2.75; intermediate_1: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl < 2.75; intermediate_2: bun_mg_dl >= 43 AND systolic_bp_mm_hg >= 115; intermediate_3: bun_mg_dl < 43 AND systolic_bp_mm_hg < 115; low: bun_mg_dl < 43 AND systolic_bp_mm_hg >= 115 (Fonarow 2005 CART)",
      "creatinine_mg_dl": 1.0,
      "adhere_risk": "low",
      "bun_mg_dl": 20.0,
      "systolic_bp_mm_hg": 140
    }
  ]
}

Response

Field	Type	Description
`formula`	string	adhere
`formula_expression`	string	Fonarow 2005 ADHERE CART bedside-tree terminal groups in paper units
`bun_mg_dl`	number	Admission BUN used in mg/dL
`systolic_bp_mm_hg`	integer	Admission systolic blood pressure used in mm Hg
`creatinine_mg_dl`	number	Admission serum creatinine used in mg/dL (after µmol/L conversion when supplied)
`adhere_risk`	string	high, intermediate_1, intermediate_2, intermediate_3, or low (Fonarow 2005 CART). Not a logistic-model score.
`citation`	object	Fonarow 2005 JAMA citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "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": "Fonarow GC, Adams KF Jr, Abraham WT, Yancy CW, Boscardin WJ; ADHERE Scientific Advisory Committee, Study Group, and Investigators",
    "doi": "10.1001/jama.293.5.572",
    "id": "fonarow-2005",
    "pmid": "15687312",
    "source": "JAMA. 2005;293(5):572-580",
    "title": "Risk stratification for in-hospital mortality in acutely decompensated heart failure: classification and regression tree analysis"
  },
  "formula": "adhere",
  "formula_expression": "high: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl >= 2.75; intermediate_1: bun_mg_dl >= 43 AND systolic_bp_mm_hg < 115 AND creatinine_mg_dl < 2.75; intermediate_2: bun_mg_dl >= 43 AND systolic_bp_mm_hg >= 115; intermediate_3: bun_mg_dl < 43 AND systolic_bp_mm_hg < 115; low: bun_mg_dl < 43 AND systolic_bp_mm_hg >= 115 (Fonarow 2005 CART)",
  "creatinine_mg_dl": 1.0,
  "adhere_risk": "low",
  "bun_mg_dl": 20.0,
  "systolic_bp_mm_hg": 140
}

Client errors (HTTP 400)

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

HTTP	Code	When
400	`invalid_bun`	bun_mg_dl must be a number from 1 to 200. Returned before settlement; you are not charged.
400	`invalid_systolic_bp`	systolic_mm_hg or systolic_bp_mm_hg must be a number from 50 to 250. Returned before settlement; you are not charged.
400	`invalid_creatinine`	creatinine_mg_dl (0.1-20) or creatinine_umol_l (9-1768) is required 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

CPO — Compute Fincke 2004 cardiac power output in watts from mean arterial pressure and cardiac output.
Diastolic shock index — Compute the Ospina-Tascón diastolic shock index as heart rate in bpm divided by cuff diastolic pressure in mm Hg.

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.
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.