# CIWA-Ar CIWA-Ar Status: LIVE Price: $0.005 USDC `GET /api/calc/ciwa_ar` HTML: https://magentlab.com/docs/ciwa-ar Markdown: https://magentlab.com/docs/ciwa-ar.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the ten Sullivan 1989 CIWA-Ar items (nine caller-assigned 0-7 plus orientation 0-4) and return the published total (max 67). ## When to use When an agent has already assigned Sullivan 1989 item integers and needs the published CIWA-Ar total, not a later benzodiazepine protocol cutoff. ## When not to use - Not a diagnosis and not a benzodiazepine, symptom-triggered, or treatment order. - Items are caller-assigned Sullivan 1989 integers. magent does not observe the patient. - Nine items (nausea_vomiting, tremor, paroxysmal_sweats, anxiety, agitation, tactile, auditory, visual, headache) are 0-7. orientation is 0-4 and is not a 0-7 item. - Sullivan 1989 published the instrument and item ranges only. magent does not apply later protocol treatment cutoffs. ## Formula ``` CIWA-Ar = nausea_vomiting + tremor + paroxysmal_sweats + anxiety + agitation + tactile + auditory + visual + headache + orientation; nine items 0-7, orientation 0-4; max 67 ``` ## Citation [Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)](https://doi.org/10.1111/j.1360-0443.1989.tb00737.x) Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM Br J Addict. 1989;84(11):1353-1357 DOI: [10.1111/j.1360-0443.1989.tb00737.x](https://doi.org/10.1111/j.1360-0443.1989.tb00737.x) ## Worked example ### All items 0 Given: `agitation=0, anxiety=0, auditory=0, headache=0, nausea_vomiting=0, orientation=0, paroxysmal_sweats=0, tactile=0, tremor=0, visual=0` 1. nausea_vomiting 0 + tremor 0 + paroxysmal_sweats 0 + anxiety 0 + agitation 0 + tactile 0 + auditory 0 + visual 0 + headache 0 + orientation 0 2. Score = 0 (max 67) ## Also searched as - CIWA-Ar - CIWA Ar - Clinical Institute Withdrawal Assessment - alcohol withdrawal scale - Sullivan CIWA-Ar - CIWA-Ar score - revised CIWA ## Parameters - `nausea_vomiting` (integer, required): Caller-assigned Sullivan 1989 nausea and vomiting points (integer 0-7). magent does not observe the patient. - `tremor` (integer, required): Caller-assigned Sullivan 1989 tremor points (integer 0-7). magent does not observe the patient. - `paroxysmal_sweats` (integer, required): Caller-assigned Sullivan 1989 paroxysmal sweats points (integer 0-7). magent does not observe the patient. - `anxiety` (integer, required): Caller-assigned Sullivan 1989 anxiety points (integer 0-7). magent does not observe the patient. - `agitation` (integer, required): Caller-assigned Sullivan 1989 agitation points (integer 0-7). magent does not observe the patient. - `tactile` (integer, required): Caller-assigned Sullivan 1989 tactile disturbances points (integer 0-7). magent does not observe the patient. - `auditory` (integer, required): Caller-assigned Sullivan 1989 auditory disturbances points (integer 0-7). magent does not observe the patient. - `visual` (integer, required): Caller-assigned Sullivan 1989 visual disturbances points (integer 0-7). magent does not observe the patient. - `headache` (integer, required): Caller-assigned Sullivan 1989 headache / fullness in head points (integer 0-7). magent does not observe the patient. - `orientation` (integer, required): Caller-assigned Sullivan 1989 orientation and clouding of sensorium (integer 0-4). This item is not 0-7. magent does not observe 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. Method: `POST /api/calc/ciwa_ar` 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": [ { "agitation": "0", "anxiety": "0", "auditory": "0", "headache": "0", "nausea_vomiting": "0", "orientation": "0", "paroxysmal_sweats": "0", "tactile": "0", "tremor": "0", "visual": "0" }, { "agitation": "0", "anxiety": "0", "auditory": "0", "headache": "0", "nausea_vomiting": "0", "orientation": "0", "paroxysmal_sweats": "0", "tactile": "0", "tremor": "0", "visual": "0" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/ciwa-ar Example 200: ```json { "count": 2, "path": "/api/calc/ciwa_ar", "items": [ { "components": [ { "value": 0, "factor": "nausea_vomiting", "points": 0, "present": true }, { "value": 0, "factor": "tremor", "points": 0, "present": true }, { "value": 0, "factor": "paroxysmal_sweats", "points": 0, "present": true }, { "value": 0, "factor": "anxiety", "points": 0, "present": true }, { "value": 0, "factor": "agitation", "points": 0, "present": true }, { "value": 0, "factor": "tactile", "points": 0, "present": true }, { "value": 0, "factor": "auditory", "points": 0, "present": true }, { "value": 0, "factor": "visual", "points": 0, "present": true }, { "value": 0, "factor": "headache", "points": 0, "present": true }, { "value": 0, "factor": "orientation", "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": "Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM", "doi": "10.1111/j.1360-0443.1989.tb00737.x", "id": "sullivan-1989", "pmid": "2597811", "source": "Br J Addict. 1989;84(11):1353-1357", "title": "Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)" }, "formula": "ciwa_ar", "formula_expression": "CIWA-Ar = nausea_vomiting + tremor + paroxysmal_sweats + anxiety + agitation + tactile + auditory + visual + headache + orientation; nine items 0-7, orientation 0-4; max 67", "max_score": 67, "score": 0 }, { "components": [ { "value": 0, "factor": "nausea_vomiting", "points": 0, "present": true }, { "value": 0, "factor": "tremor", "points": 0, "present": true }, { "value": 0, "factor": "paroxysmal_sweats", "points": 0, "present": true }, { "value": 0, "factor": "anxiety", "points": 0, "present": true }, { "value": 0, "factor": "agitation", "points": 0, "present": true }, { "value": 0, "factor": "tactile", "points": 0, "present": true }, { "value": 0, "factor": "auditory", "points": 0, "present": true }, { "value": 0, "factor": "visual", "points": 0, "present": true }, { "value": 0, "factor": "headache", "points": 0, "present": true }, { "value": 0, "factor": "orientation", "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": "Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM", "doi": "10.1111/j.1360-0443.1989.tb00737.x", "id": "sullivan-1989", "pmid": "2597811", "source": "Br J Addict. 1989;84(11):1353-1357", "title": "Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)" }, "formula": "ciwa_ar", "formula_expression": "CIWA-Ar = nausea_vomiting + tremor + paroxysmal_sweats + anxiety + agitation + tactile + auditory + visual + headache + orientation; nine items 0-7, orientation 0-4; max 67", "max_score": 67, "score": 0 } ] } ``` ## Response fields - `formula` (string): ciwa_ar - `formula_expression` (string): Exact expression used - `score` (integer): CIWA-Ar points 0-67 - `max_score` (integer): 67 - `components` (array): Per-item caller-assigned points - `citation` (object): Sullivan et al. Br J Addict 1989 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 0, "factor": "nausea_vomiting", "points": 0, "present": true }, { "value": 0, "factor": "tremor", "points": 0, "present": true }, { "value": 0, "factor": "paroxysmal_sweats", "points": 0, "present": true }, { "value": 0, "factor": "anxiety", "points": 0, "present": true }, { "value": 0, "factor": "agitation", "points": 0, "present": true }, { "value": 0, "factor": "tactile", "points": 0, "present": true }, { "value": 0, "factor": "auditory", "points": 0, "present": true }, { "value": 0, "factor": "visual", "points": 0, "present": true }, { "value": 0, "factor": "headache", "points": 0, "present": true }, { "value": 0, "factor": "orientation", "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": "Sullivan JT, Sykora K, Schneiderman J, Naranjo CA, Sellers EM", "doi": "10.1111/j.1360-0443.1989.tb00737.x", "id": "sullivan-1989", "pmid": "2597811", "source": "Br J Addict. 1989;84(11):1353-1357", "title": "Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)" }, "formula": "ciwa_ar", "formula_expression": "CIWA-Ar = nausea_vomiting + tremor + paroxysmal_sweats + anxiety + agitation + tactile + auditory + visual + headache + orientation; nine items 0-7, orientation 0-4; max 67", "max_score": 67, "score": 0 } ``` ## Errors - HTTP 400 `invalid_ciwa_item`: nausea_vomiting, tremor, paroxysmal_sweats, anxiety, agitation, tactile, auditory, visual, and headache must each be an integer from 0 to 7 (Sullivan 1989). Returned before settlement; you are not charged. - HTTP 400 `invalid_ciwa_orientation`: orientation must be an integer from 0 to 4 (Sullivan 1989). 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 - [CAGE](https://magentlab.com/docs/cage) — Sum the four Ewing 1984 CAGE items and return whether two or more answers are affirmative. - [AUDIT-C](https://magentlab.com/docs/audit-c) — Sum three caller-assigned Bush 1998 AUDIT-C integers (0-4) and return this paper's ≥3 and ≥4 screens. ## 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.