Neurology · LIVE

ALSFRS-R

Sum twelve caller-assigned Cedarbaum 1999 ALSFRS-R items (each integer 0-4, including three respiratory) and return the published 0-48 total. Does not apply later total-score severity bands or percent of maximum.

LIVE $0.005 USDC GET /api/calc/alsfrs_r

Markdown: /docs/alsfrs-r.md · Canonical: https://magentlab.com/docs/alsfrs-r

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

What it computes

When to use

When an agent already has Cedarbaum 1999 integers 0-4 for the twelve ALSFRS-R items and needs the published total. magent does not examine the patient, diagnose ALS, score original 10-item ALSFRS, score Karnofsky or ECOG, or apply later percent-of-max or staging cutoffs.

When not to use

Not a medical device and not an ALS diagnosis or treatment order.
Each of the twelve items is a caller-assigned integer 0-4. magent does not examine the patient.
This is Cedarbaum 1999 ALSFRS-R only (twelve items including dyspnea, orthopnea, and respiratory_insufficiency; max 48). magent does not score original 10-item ALSFRS, Karnofsky, or ECOG.
cutting_food is one 0-4 slot. Patients without gastrostomy and patients with gastrostomy share that slot; the caller assigns 0-4 from whichever Cedarbaum 1999 Table 1 column applies. magent does not branch on gastrostomy.
Cedarbaum 1999 published no total-score severity bands. This tool returns score and max_score only. It does not apply later percent-of-max, mild/moderate/severe, or staging website or review cutoffs.

Formula

ALSFRS-R = speech + salivation + swallowing + handwriting + cutting_food + dressing_hygiene + turning_in_bed + walking + climbing_stairs + dyspnea + orthopnea + respiratory_insufficiency; each caller-assigned 0-4; Cedarbaum 1999 twelve items including three respiratory; cutting_food is one 0-4 slot for with or without gastrostomy; max 48; no total-score severity bands

Citation

Title: The ALSFRS-R: a revised ALS functional rating scale that incorporates assessments of respiratory function. BDNF Study Group (Phase III)
Authors: Cedarbaum JM, Stambler N, Malta E, Fuller C, Hilt D, Thurmond B, Nakanishi A
Source: J Neurol Sci. 1999;169(1-2):13-21
DOI: 10.1016/s0022-510x(99)00210-5

Worked example

All items 0

Given: climbing_stairs=0cutting_food=0dressing_hygiene=0dyspnea=0handwriting=0orthopnea=0respiratory_insufficiency=0salivation=0speech=0swallowing=0turning_in_bed=0walking=0

speech, salivation, swallowing, handwriting, cutting_food, dressing_hygiene, turning_in_bed, walking, climbing_stairs, dyspnea, orthopnea, and respiratory_insufficiency are 0 as assigned by the caller
Score = 0 (max 48). Cedarbaum 1999 published no total-score severity band.

All items 4

Given: climbing_stairs=4cutting_food=4dressing_hygiene=4dyspnea=4handwriting=4orthopnea=4respiratory_insufficiency=4salivation=4speech=4swallowing=4turning_in_bed=4walking=4

each of the twelve Cedarbaum 1999 ALSFRS-R items is 4 as assigned by the caller
Score = 48 (max 48). No total-score severity band.

Also searched as

ALSFRS-R
Revised ALS Functional Rating Scale
Cedarbaum 1999 ALSFRS-R
ALSFRS-R score
12-item ALSFRS-R
amyotrophic lateral sclerosis functional rating
ALSFRS revised respiratory
revised ALSFRS

Try

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

/api/calc/alsfrs_r?speech=0&salivation=0&swallowing=0&handwriting=0&cutting_food=0&dressing_hygiene=0&turning_in_bed=0&walking=0&climbing_stairs=0&dyspnea=0&orthopnea=0&respiratory_insufficiency=0

Full URL: https://api.magentlab.com/api/calc/alsfrs_r?speech=0&salivation=0&swallowing=0&handwriting=0&cutting_food=0&dressing_hygiene=0&turning_in_bed=0&walking=0&climbing_stairs=0&dyspnea=0&orthopnea=0&respiratory_insufficiency=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/alsfrs_r?speech=0&salivation=0&swallowing=0&handwriting=0&cutting_food=0&dressing_hygiene=0&turning_in_bed=0&walking=0&climbing_stairs=0&dyspnea=0&orthopnea=0&respiratory_insufficiency=0"

Parameters

Name	Type	Required	Description
`speech`	integer	required	Caller-assigned Cedarbaum 1999 speech (integer 0-4): 4 normal speech processes; 3 detectable speech disturbance; 2 intelligible with repeating; 1 speech combined with nonvocal communication; 0 loss of useful speech. magent does not examine the patient.
`salivation`	integer	required	Caller-assigned Cedarbaum 1999 salivation (integer 0-4): 4 normal; 3 slight but definite excess of saliva in mouth, may have nighttime drooling; 2 moderately excessive saliva, may have minimal drooling; 1 marked excess of saliva with some drooling; 0 marked drooling, requires constant tissue or handkerchief. magent does not examine the patient.
`swallowing`	integer	required	Caller-assigned Cedarbaum 1999 swallowing (integer 0-4): 4 normal eating habits; 3 early eating problems, occasional choking; 2 dietary consistency changes; 1 needs supplemental tube feeding; 0 NPO (exclusively parenteral or enteral feeding). magent does not examine the patient.
`handwriting`	integer	required	Caller-assigned Cedarbaum 1999 handwriting (integer 0-4): 4 normal; 3 slow or sloppy, all words are legible; 2 not all words are legible; 1 able to grip pen but unable to write; 0 unable to grip pen. magent does not examine the patient.
`cutting_food`	integer	required	Caller-assigned Cedarbaum 1999 cutting food and handling utensils (integer 0-4). Patients without gastrostomy and patients with gastrostomy share this single 0-4 slot; the caller assigns 0-4 from whichever Table 1 column applies. Without gastrostomy: 4 normal; 3 somewhat slow and clumsy, but no help needed; 2 can cut most foods, although slow and clumsy, some help needed; 1 food must be cut by someone, but can still feed slowly; 0 needs to be fed. With gastrostomy: 4 normal; 3 clumsy but able to perform all manipulations independently; 2 some help needed with closures and fasteners; 1 provides minimal assistance to caregiver; 0 unable to perform any aspect of task. magent does not examine the patient.
`dressing_hygiene`	integer	required	Caller-assigned Cedarbaum 1999 dressing and hygiene (integer 0-4): 4 normal function; 3 independent and complete self-care with effort or decreased efficiency; 2 intermittent assistance or substitute methods; 1 needs attendant for self-care; 0 total dependence. magent does not examine the patient.
`turning_in_bed`	integer	required	Caller-assigned Cedarbaum 1999 turning in bed and adjusting bed clothes (integer 0-4): 4 normal; 3 somewhat slow and clumsy, but no help needed; 2 can turn alone or adjust sheets, but with great difficulty; 1 can initiate, but not turn or adjust sheets alone; 0 helpless. magent does not examine the patient.
`walking`	integer	required	Caller-assigned Cedarbaum 1999 walking (integer 0-4): 4 normal; 3 early ambulation difficulties; 2 walks with assistance; 1 nonambulatory functional movement only; 0 no purposeful leg movement. magent does not examine the patient.
`climbing_stairs`	integer	required	Caller-assigned Cedarbaum 1999 climbing stairs (integer 0-4): 4 normal; 3 slow; 2 mild unsteadiness or fatigue; 1 needs assistance; 0 cannot do. magent does not examine the patient.
`dyspnea`	integer	required	Caller-assigned Cedarbaum 1999 dyspnea (integer 0-4): 4 none; 3 occurs when walking; 2 occurs with one or more of eating, bathing, dressing (ADL); 1 occurs at rest, difficulty breathing when either sitting or lying; 0 significant difficulty, considering using mechanical respiratory support. magent does not examine the patient.
`orthopnea`	integer	required	Caller-assigned Cedarbaum 1999 orthopnea (integer 0-4): 4 none; 3 some difficulty sleeping at night due to shortness of breath, does not routinely use more than two pillows; 2 needs extra pillows in order to sleep (more than two); 1 can only sleep sitting up; 0 unable to sleep. magent does not examine the patient.
`respiratory_insufficiency`	integer	required	Caller-assigned Cedarbaum 1999 respiratory insufficiency (integer 0-4): 4 none; 3 intermittent use of NIPPV; 2 continuous use of NIPPV during the night; 1 continuous use of NIPPV during the night and day; 0 invasive mechanical ventilation by intubation or tracheostomy. magent does not examine the patient.

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/alsfrs_r 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": [
    {
      "climbing_stairs": "0",
      "cutting_food": "0",
      "dressing_hygiene": "0",
      "dyspnea": "0",
      "handwriting": "0",
      "orthopnea": "0",
      "respiratory_insufficiency": "0",
      "salivation": "0",
      "speech": "0",
      "swallowing": "0",
      "turning_in_bed": "0",
      "walking": "0"
    },
    {
      "climbing_stairs": "0",
      "cutting_food": "0",
      "dressing_hygiene": "0",
      "dyspnea": "0",
      "handwriting": "0",
      "orthopnea": "0",
      "respiratory_insufficiency": "0",
      "salivation": "0",
      "speech": "0",
      "swallowing": "0",
      "turning_in_bed": "0",
      "walking": "0"
    }
  ]
}

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/alsfrs_r",
  "items": [
    {
      "components": [
        {
          "value": 0,
          "factor": "speech",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "salivation",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "swallowing",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "handwriting",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "cutting_food",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "dressing_hygiene",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "turning_in_bed",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "walking",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "climbing_stairs",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "dyspnea",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "orthopnea",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "respiratory_insufficiency",
          "points": 0,
          "present": 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": "Cedarbaum JM, Stambler N, Malta E, Fuller C, Hilt D, Thurmond B, Nakanishi A",
        "doi": "10.1016/s0022-510x(99)00210-5",
        "id": "cedarbaum-1999",
        "pmid": "10540002",
        "source": "J Neurol Sci. 1999;169(1-2):13-21",
        "title": "The ALSFRS-R: a revised ALS functional rating scale that incorporates assessments of respiratory function. BDNF Study Group (Phase III)"
      },
      "formula": "alsfrs_r",
      "formula_expression": "ALSFRS-R = speech + salivation + swallowing + handwriting + cutting_food + dressing_hygiene + turning_in_bed + walking + climbing_stairs + dyspnea + orthopnea + respiratory_insufficiency; each caller-assigned 0-4; Cedarbaum 1999 twelve items including three respiratory; cutting_food is one 0-4 slot for with or without gastrostomy; max 48; no total-score severity bands",
      "max_score": 48,
      "score": 0
    },
    {
      "components": [
        {
          "value": 0,
          "factor": "speech",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "salivation",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "swallowing",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "handwriting",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "cutting_food",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "dressing_hygiene",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "turning_in_bed",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "walking",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "climbing_stairs",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "dyspnea",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "orthopnea",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "respiratory_insufficiency",
          "points": 0,
          "present": 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": "Cedarbaum JM, Stambler N, Malta E, Fuller C, Hilt D, Thurmond B, Nakanishi A",
        "doi": "10.1016/s0022-510x(99)00210-5",
        "id": "cedarbaum-1999",
        "pmid": "10540002",
        "source": "J Neurol Sci. 1999;169(1-2):13-21",
        "title": "The ALSFRS-R: a revised ALS functional rating scale that incorporates assessments of respiratory function. BDNF Study Group (Phase III)"
      },
      "formula": "alsfrs_r",
      "formula_expression": "ALSFRS-R = speech + salivation + swallowing + handwriting + cutting_food + dressing_hygiene + turning_in_bed + walking + climbing_stairs + dyspnea + orthopnea + respiratory_insufficiency; each caller-assigned 0-4; Cedarbaum 1999 twelve items including three respiratory; cutting_food is one 0-4 slot for with or without gastrostomy; max 48; no total-score severity bands",
      "max_score": 48,
      "score": 0
    }
  ]
}

Response

Field	Type	Description
`formula`	string	alsfrs_r
`formula_expression`	string	Exact expression used
`score`	integer	Cedarbaum 1999 ALSFRS-R sum of twelve caller-assigned 0-4 items (total 0-48)
`max_score`	integer	Always 48
`components`	array	Per-item caller-assigned points
`citation`	object	Cedarbaum J Neurol Sci 1999 citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "components": [
    {
      "value": 0,
      "factor": "speech",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "salivation",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "swallowing",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "handwriting",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "cutting_food",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "dressing_hygiene",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "turning_in_bed",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "walking",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "climbing_stairs",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "dyspnea",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "orthopnea",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "respiratory_insufficiency",
      "points": 0,
      "present": 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": "Cedarbaum JM, Stambler N, Malta E, Fuller C, Hilt D, Thurmond B, Nakanishi A",
    "doi": "10.1016/s0022-510x(99)00210-5",
    "id": "cedarbaum-1999",
    "pmid": "10540002",
    "source": "J Neurol Sci. 1999;169(1-2):13-21",
    "title": "The ALSFRS-R: a revised ALS functional rating scale that incorporates assessments of respiratory function. BDNF Study Group (Phase III)"
  },
  "formula": "alsfrs_r",
  "formula_expression": "ALSFRS-R = speech + salivation + swallowing + handwriting + cutting_food + dressing_hygiene + turning_in_bed + walking + climbing_stairs + dyspnea + orthopnea + respiratory_insufficiency; each caller-assigned 0-4; Cedarbaum 1999 twelve items including three respiratory; cutting_food is one 0-4 slot for with or without gastrostomy; max 48; no total-score severity bands",
  "max_score": 48,
  "score": 0
}

Client errors (HTTP 400)

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

HTTP	Code	When
400	`invalid_alsfrs`	ALSFRS-R needs the twelve Cedarbaum 1999 items each as an integer 0-4. Returned before settlement; you are not charged.
400	`invalid_alsfrs_item`	each ALSFRS-R item must be an integer from 0 to 4 (Cedarbaum 1999). 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

Karnofsky — Return the Karnofsky 1949 Performance Status 10-100 from a caller-assigned integer, with a stable label.
Barthel Index — Sum ten caller-assigned Mahoney 1965 Barthel Index item points and return the published 0-100 total.

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.