# Bova PE score

Bova

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

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

## What it computes

Compute the Bova 2014 seven-point index (SBP 90-100 mm Hg, elevated troponin, RV dysfunction, heart rate ≥110) for confirmed acute PE that is not hypotensive, and return the published Table 6 stage band.

## When to use

When an agent already has confirmed acute symptomatic pulmonary embolism that is not hypotensive and needs the published Bova 2014 point total and stage band, without inventing a thrombolysis decision.

## When not to use

- Not a medical device. magent does not diagnose pulmonary embolism.
- Not a thrombolysis order and not a reperfusion protocol. Stage bands are published Bova 2014 Table 6 groups (0-2 / 3-4 / >4), not treatment instructions.
- Only for confirmed acute PE that is not hypotensive. The derivation cohort was normotensive (SBP >90). SBP <90 is rejected; SBP 90-100 inclusive scores 2.
- magent does not grade troponin assays. elevated_troponin is the caller-assigned lab cutoff; magent does not interpret ng/mL.
- RV dysfunction is caller-assigned from echocardiography or CT. Mortality percents are not returned.

## Formula

```
BOVA = 2*(systolic_mm_hg in 90-100) + 2*elevated_troponin + 2*rv_dysfunction + 1*(heart_rate_bpm>=110); max 7; bands 0-2 / 3-4 / >4 (stages I / II / III)
```

## Citation

[Identification of intermediate-risk patients with acute symptomatic pulmonary embolism](https://doi.org/10.1183/09031936.00006114)
Bova C, Sanchez O, Prandoni P, et al.
Eur Respir J. 2014;44(3):694-703
DOI: [10.1183/09031936.00006114](https://doi.org/10.1183/09031936.00006114)

## Worked example

### SBP 120, no troponin, no RV dysfunction, HR 80

Given: `elevated_troponin=false, heart_rate_bpm=80, rv_dysfunction=false, systolic_mm_hg=120`

1. SBP 120 is not 90-100 → 0; elevated_troponin false → 0; rv_dysfunction false → 0; HR 80 is not ≥110 → 0
2. Score = 0 (max 7); bova_band 0-2 (stage I)


### SBP 95, elevated troponin, RV dysfunction, HR 110

Given: `elevated_troponin=true, heart_rate_bpm=110, rv_dysfunction=true, systolic_mm_hg=95`

1. SBP 95 is 90-100 → 2; elevated_troponin → 2; rv_dysfunction → 2; HR 110 ≥110 → 1
2. Score = 7 (max 7); bova_band >4 (stage III)


## Also searched as

- Bova score
- Bova PE score
- Bova pulmonary embolism
- Bova 2014
- intermediate-risk PE
- PE complication score
- normotensive PE risk

## Parameters

- `systolic_mm_hg` (number, required): Systolic blood pressure in mm Hg (90-250). Scores 2 when 90-100 inclusive (Bova 2014 Table 5). SBP 100 scores; SBP 101 does not. SBP <90 is rejected (normotensive PE cohort).
- `elevated_troponin` (boolean, required): Elevated cardiac troponin as assigned by the caller at the local lab cutoff (Bova 2014). true or false. 2 points if true. magent does not grade troponin ng/mL.
- `rv_dysfunction` (boolean, required): Right-ventricular dysfunction on echocardiography or CT as assigned by the caller (Bova 2014). true or false. 2 points if true.
- `heart_rate_bpm` (integer, required): Heart rate in beats per minute (integer 30-220). Scores 1 when ≥110 (Bova 2014 Table 5). HR 110 scores; HR 109 does not.

## 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/bova`
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": [
    {
      "elevated_troponin": "false",
      "heart_rate_bpm": "80",
      "rv_dysfunction": "false",
      "systolic_mm_hg": "120"
    },
    {
      "elevated_troponin": "false",
      "heart_rate_bpm": "80",
      "rv_dysfunction": "false",
      "systolic_mm_hg": "120"
    }
  ]
}
```

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

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/bova",
  "items": [
    {
      "components": [
        {
          "value": 120.0,
          "factor": "systolic_mm_hg_90_100",
          "points": 0,
          "present": false
        },
        {
          "factor": "elevated_troponin",
          "points": 0,
          "present": false
        },
        {
          "factor": "rv_dysfunction",
          "points": 0,
          "present": false
        },
        {
          "value": 80,
          "factor": "heart_rate_ge_110",
          "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": "Bova C, Sanchez O, Prandoni P, et al.",
        "doi": "10.1183/09031936.00006114",
        "id": "bova-2014",
        "pmid": "24696111",
        "source": "Eur Respir J. 2014;44(3):694-703",
        "title": "Identification of intermediate-risk patients with acute symptomatic pulmonary embolism"
      },
      "formula": "bova",
      "formula_expression": "BOVA = 2*(systolic_mm_hg in 90-100) + 2*elevated_troponin + 2*rv_dysfunction + 1*(heart_rate_bpm>=110); max 7; bands 0-2 / 3-4 / >4 (stages I / II / III)",
      "max_score": 7,
      "score": 0,
      "systolic_mm_hg": 120.0,
      "heart_rate_bpm": 80,
      "bova_band": "0-2",
      "elevated_troponin": false,
      "rv_dysfunction": false
    },
    {
      "components": [
        {
          "value": 120.0,
          "factor": "systolic_mm_hg_90_100",
          "points": 0,
          "present": false
        },
        {
          "factor": "elevated_troponin",
          "points": 0,
          "present": false
        },
        {
          "factor": "rv_dysfunction",
          "points": 0,
          "present": false
        },
        {
          "value": 80,
          "factor": "heart_rate_ge_110",
          "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": "Bova C, Sanchez O, Prandoni P, et al.",
        "doi": "10.1183/09031936.00006114",
        "id": "bova-2014",
        "pmid": "24696111",
        "source": "Eur Respir J. 2014;44(3):694-703",
        "title": "Identification of intermediate-risk patients with acute symptomatic pulmonary embolism"
      },
      "formula": "bova",
      "formula_expression": "BOVA = 2*(systolic_mm_hg in 90-100) + 2*elevated_troponin + 2*rv_dysfunction + 1*(heart_rate_bpm>=110); max 7; bands 0-2 / 3-4 / >4 (stages I / II / III)",
      "max_score": 7,
      "score": 0,
      "systolic_mm_hg": 120.0,
      "heart_rate_bpm": 80,
      "bova_band": "0-2",
      "elevated_troponin": false,
      "rv_dysfunction": false
    }
  ]
}
```

## Response fields

- `formula` (string): bova
- `formula_expression` (string): Exact expression used
- `score` (integer): Bova points 0-7
- `max_score` (integer): 7
- `bova_band` (string): Bova 2014 Table 6 stage band: 0-2 (stage I), 3-4 (stage II), or >4 (stage III, scores 5-7). Mortality percents are not returned. Not a thrombolysis order.
- `systolic_mm_hg` (number): Systolic BP used, mm Hg
- `elevated_troponin` (boolean): Caller-assigned elevated troponin flag used
- `rv_dysfunction` (boolean): Caller-assigned RV dysfunction flag used
- `heart_rate_bpm` (integer): Heart rate used, bpm
- `components` (array): Per-factor points
- `citation` (object): Bova 2014 Eur Respir J citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": 120.0,
      "factor": "systolic_mm_hg_90_100",
      "points": 0,
      "present": false
    },
    {
      "factor": "elevated_troponin",
      "points": 0,
      "present": false
    },
    {
      "factor": "rv_dysfunction",
      "points": 0,
      "present": false
    },
    {
      "value": 80,
      "factor": "heart_rate_ge_110",
      "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": "Bova C, Sanchez O, Prandoni P, et al.",
    "doi": "10.1183/09031936.00006114",
    "id": "bova-2014",
    "pmid": "24696111",
    "source": "Eur Respir J. 2014;44(3):694-703",
    "title": "Identification of intermediate-risk patients with acute symptomatic pulmonary embolism"
  },
  "formula": "bova",
  "formula_expression": "BOVA = 2*(systolic_mm_hg in 90-100) + 2*elevated_troponin + 2*rv_dysfunction + 1*(heart_rate_bpm>=110); max 7; bands 0-2 / 3-4 / >4 (stages I / II / III)",
  "max_score": 7,
  "score": 0,
  "systolic_mm_hg": 120.0,
  "heart_rate_bpm": 80,
  "bova_band": "0-2",
  "elevated_troponin": false,
  "rv_dysfunction": false
}
```

## Errors

- HTTP 400 `invalid_bova_systolic`: systolic_mm_hg must be 90-250 (Bova 2014 is for normotensive PE; SBP <90 is not scored). 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_heart_rate`: heart_rate_bpm must be an integer from 30 to 220 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

- [PESI](https://magentlab.com/docs/pesi) — Compute the Aujesky 2005 Pulmonary Embolism Severity Index (PESI) from age, sex, comorbidities, vital signs, and altered mental status.
- [sPESI](https://magentlab.com/docs/spesi) — Compute the Jiménez 2010 simplified Pulmonary Embolism Severity Index (sPESI) from age and five caller-assigned findings.

## 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.