# CISNE (Carmona-Bayonas) CISNE Status: LIVE Price: $0.005 USDC `GET /api/calc/cisne` HTML: https://magentlab.com/docs/cisne Markdown: https://magentlab.com/docs/cisne.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the Carmona-Bayonas 2015 CISNE weights for seemingly stable febrile neutropenia and return low (0), intermediate (1–2), or high (≥3). ## When to use When an agent needs the published CISNE point total and class and must not invent an outpatient-chemotherapy or discharge decision, and must not substitute MASCC. ## When not to use - Not a medical device and not an outpatient-chemotherapy or discharge order. magent does not examine the patient. - Applies only to seemingly stable adult solid-tumor febrile neutropenia as defined in Carmona-Bayonas 2015 (no organ dysfunction, no abnormal vital signs, no major infection). - magent does not assign ECOG, assay glucose, diagnose COPD, read an echocardiogram, grade mucositis, or count monocytes. All six inputs are caller-assigned flags. - NCI CTC mucositis grade ≥2 scores 1 point in Carmona-Bayonas 2015. It does not score 3. - This is CISNE, not MASCC. ## Formula ``` CISNE = ecog_ge_2 2 + stress_hyperglycemia 2 + copd 1 + chronic_cardiovascular_disease 1 + mucositis_nci_ge_2 1 + monocytes_lt_200 1; Carmona-Bayonas 2015; max 8; low 0, intermediate 1-2, high ≥3 ``` ## Citation [Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study](https://doi.org/10.1200/JCO.2014.57.2347) Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela Echaburu J, Antonio M, Font C, Biosca M, Ramchandani A, Martínez J, Hernando Cubero J, Espinosa J, Martínez de Castro E, Ghanem I, Beato C, Blasco A, Garrido M, Bonilla Y, Mondéjar R, Arcusa Lanza MÁ, Aragón Manrique I, Manzano A, Sevillano E, Castañón E, Cardona M, Gallardo Martín E, Pérez Armillas Q, Sánchez Lasheras F, Ayala de la Peña F J Clin Oncol. 2015;33(5):465-471 DOI: [10.1200/JCO.2014.57.2347](https://doi.org/10.1200/JCO.2014.57.2347) ## Worked example ### All flags false Given: `chronic_cardiovascular_disease=false, copd=false, ecog_ge_2=false, monocytes_lt_200=false, mucositis_nci_ge_2=false, stress_hyperglycemia=false` 1. All six caller-assigned flags false → 0 2. Score = 0 (max 8); cisne_band = low ### ECOG ≥2 and stress hyperglycemia Given: `chronic_cardiovascular_disease=false, copd=false, ecog_ge_2=true, monocytes_lt_200=false, mucositis_nci_ge_2=false, stress_hyperglycemia=true` 1. ecog_ge_2 → 2; stress_hyperglycemia → 2; remaining flags 0 2. Score = 4 (max 8); cisne_band = high (≥3) ## Also searched as - CISNE - Clinical Index of Stable Febrile Neutropenia - Carmona-Bayonas CISNE - stable febrile neutropenia score - FINITE CISNE - CISNE class ## Parameters - `ecog_ge_2` (boolean, required): ECOG performance status ≥2 as assigned by the caller (Carmona-Bayonas 2015). true scores 2. magent does not assign ECOG. - `stress_hyperglycemia` (boolean, required): Stress hyperglycemia as assigned by the caller (Carmona-Bayonas 2015). true scores 2. magent does not assay glucose. - `copd` (boolean, required): COPD as assigned by the caller (Carmona-Bayonas 2015). true scores 1. magent does not diagnose COPD. - `chronic_cardiovascular_disease` (boolean, required): Chronic cardiovascular disease as assigned by the caller (Carmona-Bayonas 2015). true scores 1. magent does not read an echocardiogram. - `mucositis_nci_ge_2` (boolean, required): NCI CTC mucositis grade ≥2 as assigned by the caller (Carmona-Bayonas 2015). true scores 1, not 3. magent does not grade mucositis. - `monocytes_lt_200` (boolean, required): Monocytes <200 per µL as assigned by the caller (Carmona-Bayonas 2015). true scores 1. magent does not count monocytes. ## 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/cisne` 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": [ { "chronic_cardiovascular_disease": "false", "copd": "false", "ecog_ge_2": "false", "monocytes_lt_200": "false", "mucositis_nci_ge_2": "false", "stress_hyperglycemia": "false" }, { "chronic_cardiovascular_disease": "false", "copd": "false", "ecog_ge_2": "false", "monocytes_lt_200": "false", "mucositis_nci_ge_2": "false", "stress_hyperglycemia": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/cisne Example 200: ```json { "count": 2, "path": "/api/calc/cisne", "items": [ { "components": [ { "factor": "ecog_ge_2", "points": 0, "present": false }, { "factor": "stress_hyperglycemia", "points": 0, "present": false }, { "factor": "copd", "points": 0, "present": false }, { "factor": "chronic_cardiovascular_disease", "points": 0, "present": false }, { "factor": "mucositis_nci_ge_2", "points": 0, "present": false }, { "factor": "monocytes_lt_200", "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": "Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela Echaburu J, Antonio M, Font C, Biosca M, Ramchandani A, Martínez J, Hernando Cubero J, Espinosa J, Martínez de Castro E, Ghanem I, Beato C, Blasco A, Garrido M, Bonilla Y, Mondéjar R, Arcusa Lanza MÁ, Aragón Manrique I, Manzano A, Sevillano E, Castañón E, Cardona M, Gallardo Martín E, Pérez Armillas Q, Sánchez Lasheras F, Ayala de la Peña F", "doi": "10.1200/JCO.2014.57.2347", "id": "carmona-bayonas-2015", "pmid": "25559804", "source": "J Clin Oncol. 2015;33(5):465-471", "title": "Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study" }, "formula": "cisne", "formula_expression": "CISNE = ecog_ge_2 2 + stress_hyperglycemia 2 + copd 1 + chronic_cardiovascular_disease 1 + mucositis_nci_ge_2 1 + monocytes_lt_200 1; Carmona-Bayonas 2015; max 8; low 0, intermediate 1-2, high ≥3", "max_score": 8, "score": 0, "cisne_band": "low" }, { "components": [ { "factor": "ecog_ge_2", "points": 0, "present": false }, { "factor": "stress_hyperglycemia", "points": 0, "present": false }, { "factor": "copd", "points": 0, "present": false }, { "factor": "chronic_cardiovascular_disease", "points": 0, "present": false }, { "factor": "mucositis_nci_ge_2", "points": 0, "present": false }, { "factor": "monocytes_lt_200", "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": "Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela Echaburu J, Antonio M, Font C, Biosca M, Ramchandani A, Martínez J, Hernando Cubero J, Espinosa J, Martínez de Castro E, Ghanem I, Beato C, Blasco A, Garrido M, Bonilla Y, Mondéjar R, Arcusa Lanza MÁ, Aragón Manrique I, Manzano A, Sevillano E, Castañón E, Cardona M, Gallardo Martín E, Pérez Armillas Q, Sánchez Lasheras F, Ayala de la Peña F", "doi": "10.1200/JCO.2014.57.2347", "id": "carmona-bayonas-2015", "pmid": "25559804", "source": "J Clin Oncol. 2015;33(5):465-471", "title": "Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study" }, "formula": "cisne", "formula_expression": "CISNE = ecog_ge_2 2 + stress_hyperglycemia 2 + copd 1 + chronic_cardiovascular_disease 1 + mucositis_nci_ge_2 1 + monocytes_lt_200 1; Carmona-Bayonas 2015; max 8; low 0, intermediate 1-2, high ≥3", "max_score": 8, "score": 0, "cisne_band": "low" } ] } ``` ## Response fields - `formula` (string): cisne - `formula_expression` (string): Exact expression used - `score` (integer): CISNE points 0-8 - `max_score` (integer): Always 8 - `cisne_band` (string): low when score is 0, intermediate when 1-2, high when ≥3 (Carmona-Bayonas 2015). Not MASCC and not an outpatient-chemotherapy or discharge order. - `components` (array): Per-factor points - `citation` (object): Carmona-Bayonas 2015 J Clin Oncol citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "ecog_ge_2", "points": 0, "present": false }, { "factor": "stress_hyperglycemia", "points": 0, "present": false }, { "factor": "copd", "points": 0, "present": false }, { "factor": "chronic_cardiovascular_disease", "points": 0, "present": false }, { "factor": "mucositis_nci_ge_2", "points": 0, "present": false }, { "factor": "monocytes_lt_200", "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": "Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela Echaburu J, Antonio M, Font C, Biosca M, Ramchandani A, Martínez J, Hernando Cubero J, Espinosa J, Martínez de Castro E, Ghanem I, Beato C, Blasco A, Garrido M, Bonilla Y, Mondéjar R, Arcusa Lanza MÁ, Aragón Manrique I, Manzano A, Sevillano E, Castañón E, Cardona M, Gallardo Martín E, Pérez Armillas Q, Sánchez Lasheras F, Ayala de la Peña F", "doi": "10.1200/JCO.2014.57.2347", "id": "carmona-bayonas-2015", "pmid": "25559804", "source": "J Clin Oncol. 2015;33(5):465-471", "title": "Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study" }, "formula": "cisne", "formula_expression": "CISNE = ecog_ge_2 2 + stress_hyperglycemia 2 + copd 1 + chronic_cardiovascular_disease 1 + mucositis_nci_ge_2 1 + monocytes_lt_200 1; Carmona-Bayonas 2015; max 8; low 0, intermediate 1-2, high ≥3", "max_score": 8, "score": 0, "cisne_band": "low" } ``` ## Errors - 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 - [MASCC](https://magentlab.com/docs/mascc) — Sum the Klastersky 2000 MASCC risk-index weights for febrile neutropenia and return low-risk (≥21) or high-risk (<21). - [ANC](https://magentlab.com/docs/anc) — Compute absolute neutrophil count from WBC and neutrophil plus band percents, plus a Bodey 1966 granulocyte band. - [SIRS](https://magentlab.com/docs/sirs) — Compute the Bone 1992 ACCP/SCCM SIRS criteria from temperature, heart rate, respiratory rate, and WBC, with optional PaCO2 and band percent. ## 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. - 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.