# Acute Stroke Dysphagia Screen Acute Stroke Dysphagia Screen Status: LIVE Price: $0.005 USDC `GET /api/calc/asds` HTML: https://magentlab.com/docs/asds Markdown: https://magentlab.com/docs/asds.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Apply the Edmiaston 2010 five-item Acute Stroke Dysphagia Screen and return whether all five criteria hold (asds_pass). ## When to use When an agent already has a caller-assigned total GCS 3-15 and the four bedside flags (facial, tongue, palatal, 3-ounce water-swallow aspiration signs) and needs the published fail-any screen result, not a swallow diagnosis or diet order. ## When not to use - Not a medical device. - Not a diagnosis of dysphagia and not a diet order. - The caller assigns GCS and the four bedside flags. magent does not examine cranial nerves, assign GCS, or administer a 3-ounce water swallow. - A fail is not a swallow-study order. A pass is not clearance for oral intake. ## Formula ``` asds_pass iff GCS >= 13 and no facial_asymmetry_or_weakness and no tongue_asymmetry_or_weakness and no palatal_asymmetry_or_weakness and no water_swallow_aspiration_signs (Edmiaston 2010 five-item fail-any) ``` ## Citation [Validation of a dysphagia screening tool in acute stroke patients](https://doi.org/10.4037/ajcc2009961) Edmiaston J, Connor LT, Loehr L, Nassief A Am J Crit Care. 2010;19(4):357-364 DOI: [10.4037/ajcc2009961](https://doi.org/10.4037/ajcc2009961) ## Worked example ### All five criteria met Given: `facial_asymmetry_or_weakness=false, gcs=15, palatal_asymmetry_or_weakness=false, tongue_asymmetry_or_weakness=false, water_swallow_aspiration_signs=false` 1. GCS 15 ≥ 13 2. Facial, tongue, and palatal asymmetry or weakness absent; no water-swallow aspiration signs 3. asds_pass ### GCS 12 fails the consciousness criterion Given: `facial_asymmetry_or_weakness=false, gcs=12, palatal_asymmetry_or_weakness=false, tongue_asymmetry_or_weakness=false, water_swallow_aspiration_signs=false` 1. GCS 12 is not ≥ 13 2. asds_pass is false ## Also searched as - stroke dysphagia screen - acute stroke dysphagia screen - 3 ounce water swallow - Edmiaston dysphagia screen - ASDS - acute stroke swallow screen - dysphagia screening tool ## Parameters - `gcs` (integer, required): Caller-assigned total GCS as an integer 3-15. Criterion met when GCS ≥ 13; 12 does not meet. magent does not assign GCS (use /api/calc/gcs for eye, verbal, and motor). - `facial_asymmetry_or_weakness` (boolean, required): Facial asymmetry or weakness. true or false as assigned by the caller. Criterion met when false. magent does not examine cranial nerves. - `tongue_asymmetry_or_weakness` (boolean, required): Tongue asymmetry or weakness. true or false as assigned by the caller. Criterion met when false. magent does not examine cranial nerves. - `palatal_asymmetry_or_weakness` (boolean, required): Palatal asymmetry or weakness. true or false as assigned by the caller. Criterion met when false. magent does not examine cranial nerves. - `water_swallow_aspiration_signs` (boolean, required): Signs of aspiration on a 3-ounce water swallow as assigned by the caller. true or false. Criterion met when false. magent does not administer a swallow test. ## 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/asds` 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": [ { "facial_asymmetry_or_weakness": "false", "gcs": "15", "palatal_asymmetry_or_weakness": "false", "tongue_asymmetry_or_weakness": "false", "water_swallow_aspiration_signs": "false" }, { "facial_asymmetry_or_weakness": "false", "gcs": "15", "palatal_asymmetry_or_weakness": "false", "tongue_asymmetry_or_weakness": "false", "water_swallow_aspiration_signs": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/asds Example 200: ```json { "count": 2, "path": "/api/calc/asds", "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": "Edmiaston J, Connor LT, Loehr L, Nassief A", "doi": "10.4037/ajcc2009961", "id": "edmiaston-2010", "pmid": "19875722", "source": "Am J Crit Care. 2010;19(4):357-364", "title": "Validation of a dysphagia screening tool in acute stroke patients" }, "formula": "asds", "formula_expression": "asds_pass iff GCS >= 13 and no facial_asymmetry_or_weakness and no tongue_asymmetry_or_weakness and no palatal_asymmetry_or_weakness and no water_swallow_aspiration_signs (Edmiaston 2010 five-item fail-any)", "criteria": [ { "value": 15, "factor": "gcs_ge_13", "met": true }, { "factor": "no_facial_asymmetry_or_weakness", "met": true }, { "factor": "no_tongue_asymmetry_or_weakness", "met": true }, { "factor": "no_palatal_asymmetry_or_weakness", "met": true }, { "factor": "no_water_swallow_aspiration_signs", "met": true } ], "asds_pass": 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": "Edmiaston J, Connor LT, Loehr L, Nassief A", "doi": "10.4037/ajcc2009961", "id": "edmiaston-2010", "pmid": "19875722", "source": "Am J Crit Care. 2010;19(4):357-364", "title": "Validation of a dysphagia screening tool in acute stroke patients" }, "formula": "asds", "formula_expression": "asds_pass iff GCS >= 13 and no facial_asymmetry_or_weakness and no tongue_asymmetry_or_weakness and no palatal_asymmetry_or_weakness and no water_swallow_aspiration_signs (Edmiaston 2010 five-item fail-any)", "criteria": [ { "value": 15, "factor": "gcs_ge_13", "met": true }, { "factor": "no_facial_asymmetry_or_weakness", "met": true }, { "factor": "no_tongue_asymmetry_or_weakness", "met": true }, { "factor": "no_palatal_asymmetry_or_weakness", "met": true }, { "factor": "no_water_swallow_aspiration_signs", "met": true } ], "asds_pass": true } ] } ``` ## Response fields - `formula` (string): asds - `formula_expression` (string): Edmiaston 2010 five-item fail-any pass rule - `asds_pass` (boolean): true only when all five criteria are met. Not a dysphagia diagnosis and not a diet order. - `criteria` (array): Per-factor rows with factor, met, and value when GCS - `citation` (object): Edmiaston 2010 Am J Crit Care 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": "Edmiaston J, Connor LT, Loehr L, Nassief A", "doi": "10.4037/ajcc2009961", "id": "edmiaston-2010", "pmid": "19875722", "source": "Am J Crit Care. 2010;19(4):357-364", "title": "Validation of a dysphagia screening tool in acute stroke patients" }, "formula": "asds", "formula_expression": "asds_pass iff GCS >= 13 and no facial_asymmetry_or_weakness and no tongue_asymmetry_or_weakness and no palatal_asymmetry_or_weakness and no water_swallow_aspiration_signs (Edmiaston 2010 five-item fail-any)", "criteria": [ { "value": 15, "factor": "gcs_ge_13", "met": true }, { "factor": "no_facial_asymmetry_or_weakness", "met": true }, { "factor": "no_tongue_asymmetry_or_weakness", "met": true }, { "factor": "no_palatal_asymmetry_or_weakness", "met": true }, { "factor": "no_water_swallow_aspiration_signs", "met": true } ], "asds_pass": true } ``` ## Errors - HTTP 400 `invalid_asds`: Acute Stroke Dysphagia Screen needs gcs and the four bedside flags (Edmiaston 2010). Returned before settlement; you are not charged. - HTTP 400 `invalid_gcs_total`: gcs must be an integer from 3 to 15. Returned before settlement; you are not charged. - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false 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 - [Glasgow Coma Scale](https://magentlab.com/docs/gcs) — Compute the Glasgow Coma Scale as the sum of caller-assigned eye, verbal, and motor integers. The 1974 or 1976 edition is required. - [NIHSS](https://magentlab.com/docs/nihss) — Sum Brott 1989 NIH stroke scale points from 15 caller-assigned examination integers, including pupillary response and plantar reflex. Weaker-limb motor arm and leg. Does not apply later total-score severity bands. ## 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.