# ALBI grade

ALBI

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

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

## What it computes

Compute the Johnson 2015 albumin-bilirubin (ALBI) linear predictor and grade from total bilirubin and albumin.

## When to use

When an agent needs the published Johnson 2015 ALBI grade from bilirubin and albumin and must not invent Child–Pugh, a listing protocol, or a survival estimate.

## When not to use

- Not a medical device. Not a transplant listing protocol and not Child–Pugh.
- Johnson 2015 ALBI only. This is not mALBI, PALBI, EZ-ALBI, or later restatements that use albumin coefficient −0.0852.
- Does not return survival months or percents. Grade is from the unrounded linear predictor; albi_score is rounded to 4 decimals for JSON.

## Formula

```
albi_score = (log10(bilirubin_umol_l) * 0.66) + (albumin_g_l * -0.085)
```

## Citation

[Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade](https://doi.org/10.1200/JCO.2014.57.9151)
Johnson PJ, Berhane S, Kagebayashi C, et al.
J Clin Oncol. 2015;33(6):550-558
DOI: [10.1200/JCO.2014.57.9151](https://doi.org/10.1200/JCO.2014.57.9151)

## Worked example

### Bilirubin 10 µmol/L, albumin 40 g/L

Given: `albumin_g_l=40, bilirubin_umol_l=10`

1. log10(10) = 1
2. xb = 0.66 × 1 + 40 × (−0.085) = 0.66 − 3.4 = −2.74
3. −2.74 ≤ −2.60 → albi_grade 1


## Also searched as

- albumin-bilirubin grade
- ALBI score
- ALBI grade
- Johnson ALBI
- albumin bilirubin HCC
- ALBI hepatocellular carcinoma

## Parameters

- `bilirubin_umol_l` (number, optional): Total bilirubin in µmol/L (2-684). Provide this or bilirubin_mg_dl, not both. Johnson 2015 uses µmol/L in log10.
- `bilirubin_mg_dl` (number, optional): Total bilirubin in mg/dL (0.1-40). Converted as µmol/L = mg/dL × 17.1. Provide this or bilirubin_umol_l, not both.
- `albumin_g_l` (number, optional): Albumin in g/L (10-60). Provide this or albumin_g_dl, not both. Johnson 2015 uses g/L.
- `albumin_g_dl` (number, optional): Albumin in g/dL (1-6). Converted as g/L = g/dL × 10. Provide this or albumin_g_l, 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.

Method: `POST /api/calc/albi`
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": [
    {
      "albumin_g_l": "40",
      "bilirubin_umol_l": "10"
    },
    {
      "albumin_g_l": "40",
      "bilirubin_umol_l": "10"
    }
  ]
}
```

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

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/albi",
  "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": "Johnson PJ, Berhane S, Kagebayashi C, et al.",
        "doi": "10.1200/JCO.2014.57.9151",
        "id": "johnson-2015",
        "pmid": "25512453",
        "source": "J Clin Oncol. 2015;33(6):550-558",
        "title": "Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade"
      },
      "formula": "albi",
      "formula_expression": "albi_score = (log10(bilirubin_umol_l) * 0.66) + (albumin_g_l * -0.085)",
      "albi_grade": 1,
      "albumin_g_l": 40.0,
      "bilirubin_umol_l": 10.0,
      "albi_score": -2.74
    },
    {
      "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": "Johnson PJ, Berhane S, Kagebayashi C, et al.",
        "doi": "10.1200/JCO.2014.57.9151",
        "id": "johnson-2015",
        "pmid": "25512453",
        "source": "J Clin Oncol. 2015;33(6):550-558",
        "title": "Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade"
      },
      "formula": "albi",
      "formula_expression": "albi_score = (log10(bilirubin_umol_l) * 0.66) + (albumin_g_l * -0.085)",
      "albi_grade": 1,
      "albumin_g_l": 40.0,
      "bilirubin_umol_l": 10.0,
      "albi_score": -2.74
    }
  ]
}
```

## Response fields

- `formula` (string): albi
- `formula_expression` (string): Exact expression used
- `bilirubin_umol_l` (number): Total bilirubin used in µmol/L (after conversion)
- `albumin_g_l` (number): Albumin used in g/L (after conversion)
- `albi_score` (number): Johnson 2015 linear predictor, 4 decimal places
- `albi_grade` (integer): 1 if unrounded xb <= -2.60, 2 if unrounded xb <= -1.39, else 3. Equality at -2.60 is 1; equality at -1.39 is 2.
- `citation` (object): Johnson 2015 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "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": "Johnson PJ, Berhane S, Kagebayashi C, et al.",
    "doi": "10.1200/JCO.2014.57.9151",
    "id": "johnson-2015",
    "pmid": "25512453",
    "source": "J Clin Oncol. 2015;33(6):550-558",
    "title": "Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade"
  },
  "formula": "albi",
  "formula_expression": "albi_score = (log10(bilirubin_umol_l) * 0.66) + (albumin_g_l * -0.085)",
  "albi_grade": 1,
  "albumin_g_l": 40.0,
  "bilirubin_umol_l": 10.0,
  "albi_score": -2.74
}
```

## Errors

- HTTP 400 `invalid_bilirubin`: bilirubin_mg_dl (0.1-40) or bilirubin_umol_l (2-684) is required Returned before settlement; you are not charged.
- HTTP 400 `invalid_albumin`: albumin_g_dl (1-6) or albumin_g_l (10-60) is required 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

- [Child–Pugh](https://magentlab.com/docs/child-pugh) — Compute the Child–Turcotte–Pugh cirrhosis severity score from bilirubin, albumin, INR, encephalopathy, and ascites.
- [MELD-Na](https://magentlab.com/docs/meld-na) — Compute OPTN/UNOS 2016 MELD and MELD-Na from creatinine, bilirubin, INR, sodium, and dialysis.
- [FIB-4](https://magentlab.com/docs/fib4) — Compute the FIB-4 fibrosis index from age, AST, ALT, and platelets.

## 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 echoing accepted, payload, and extensions when present).
- 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.
- 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.