Emergency · LIVE

CRASH chemotherapy toxicity score

CRASH

Sum Extermann 2012 Table 4 CRASH points into hematologic (0–6), nonhematologic (0–8), and combined (0–12, Chemotox once) scores with published four-level risk bands.

LIVE $0.005 USDC GET /api/calc/crash

Markdown: /docs/crash.md · Canonical: https://magentlab.com/docs/crash

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

What it computes

Sum Extermann 2012 Table 4 CRASH points into hematologic (0–6), nonhematologic (0–8), and combined (0–12, Chemotox once) scores with published four-level risk bands.

When to use

When an agent already has caller-assigned CRASH inputs for an older patient considered for chemotherapy and needs the published hematologic, nonhematologic, and combined scores, not a chemotherapy order, not CARG-TT, and not the trauma CRASH score. magent does not look up regimens or assay LDH.

When not to use

• Not a medical device.
• Not a chemotherapy order. This tool does not start, stop, or choose cancer treatment. Not CARG-TT.
• Not the trauma CRASH score (MRC CRASH head-injury trial). This is the Extermann 2012 Chemotherapy Risk Assessment Scale for High-Age Patients.
• Hematologic, nonhematologic, and combined incidences (7/23/54/100%, 33/46/67/93%, 50/58/77/79%) are derivation-cohort observations, not patient-specific probabilities.
• Chemotox is caller-assigned MAX2 (0–1). magent does not look up regimens.
• Caller assigns diastolic BP, IADL (10–29), LDH and LDH ULN, ECOG, Mini-Mental Status, and Mini-Nutritional Assessment. magent does not measure blood pressure, interview, or assay LDH.
• Combined score counts Chemotox once (max 12, not 14). LDH awards 0 or 2 points only (empty 1-point column in Table 4).

Formula

CRASH (Extermann 2012 Table 4) hematologic = diastolic_mm_hg (<=72 0, >72 1) + iadl (26-29 0, 10-25 1) + ldh (ldh_u_l > 0.74 * ldh_uln_u_l 2 else 0; empty 1-point column) + chemotox (0-0.44 0, 0.45-0.57 1, >0.57 2); max 6; nonhematologic = ecog (0 → 0, 1-2 → 1, 3-4 → 2) + mms (30 → 0, <30 → 2) + mna (28-30 → 0, <28 → 2) + chemotox (same); max 8; combined = hematologic + nonhematologic - chemotox (count Chemotox once; max 12 not 14); H 0-1 low 7%, 2-3 medium_low 23%, 4-5 medium_high 54%, 6 high 100%; NH 0-2 low 33%, 3-4 medium_low 46%, 5-6 medium_high 67%, 7-8 high 93%; combined 0-3 low 50%, 4-6 medium_low 58%, 7-9 medium_high 77%, 10-12 high 79%; not trauma CRASH; not CARG-TT; Chemotox is caller-assigned MAX2

Citation

Title

Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score

Authors

Extermann M, Boler I, Reich RR, et al.

Source

Cancer. 2012;118(13):3377-3386

DOI

10.1002/cncr.26646

Worked example

Also searched as

• CRASH score
• CRASH chemotherapy toxicity
• Extermann CRASH
• Chemotherapy Risk Assessment Scale for High-Age Patients
• Chemotox CRASH
• MAX2 Chemotox
• chemotherapy toxicity older patients
• CRASH hematologic score

Try

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

/api/calc/crash?diastolic_mm_hg=80&iadl=20&ldh_u_l=500&ldh_uln_u_l=618&chemotox=0.50&ecog=1&mms=28&mna=26

Full URL: https://api.magentlab.com/api/calc/crash?diastolic_mm_hg=80&iadl=20&ldh_u_l=500&ldh_uln_u_l=618&chemotox=0.50&ecog=1&mms=28&mna=26

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/crash?diastolic_mm_hg=80&iadl=20&ldh_u_l=500&ldh_uln_u_l=618&chemotox=0.50&ecog=1&mms=28&mna=26"

Parameters

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/crash 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": [
    {
      "chemotox": "0.50",
      "diastolic_mm_hg": "80",
      "ecog": "1",
      "iadl": "20",
      "ldh_u_l": "500",
      "ldh_uln_u_l": "618",
      "mms": "28",
      "mna": "26"
    },
    {
      "chemotox": "0.50",
      "diastolic_mm_hg": "80",
      "ecog": "1",
      "iadl": "20",
      "ldh_u_l": "500",
      "ldh_uln_u_l": "618",
      "mms": "28",
      "mna": "26"
    }
  ]
}

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/crash",
  "items": [
    {
      "components": [
        {
          "value": 80.0,
          "factor": "diastolic_mm_hg",
          "points": 1,
          "present": true
        },
        {
          "value": 20,
          "factor": "iadl",
          "points": 1,
          "present": true
        },
        {
          "value": 500.0,
          "factor": "ldh",
          "points": 2,
          "present": true
        },
        {
          "value": 0.5,
          "factor": "chemotox",
          "points": 1,
          "present": true
        },
        {
          "value": 1,
          "factor": "ecog",
          "points": 1,
          "present": true
        },
        {
          "value": 28,
          "factor": "mms",
          "points": 2,
          "present": true
        },
        {
          "value": 26,
          "factor": "mna",
          "points": 2,
          "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": "Extermann M, Boler I, Reich RR, et al.",
        "doi": "10.1002/cncr.26646",
        "id": "extermann-2012",
        "pmid": "22072065",
        "source": "Cancer. 2012;118(13):3377-3386",
        "title": "Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score"
      },
      "formula": "crash",
      "formula_expression": "CRASH (Extermann 2012 Table 4) hematologic = diastolic_mm_hg (<=72 0, >72 1) + iadl (26-29 0, 10-25 1) + ldh (ldh_u_l > 0.74 * ldh_uln_u_l 2 else 0; empty 1-point column) + chemotox (0-0.44 0, 0.45-0.57 1, >0.57 2); max 6; nonhematologic = ecog (0 → 0, 1-2 → 1, 3-4 → 2) + mms (30 → 0, <30 → 2) + mna (28-30 → 0, <28 → 2) + chemotox (same); max 8; combined = hematologic + nonhematologic - chemotox (count Chemotox once; max 12 not 14); H 0-1 low 7%, 2-3 medium_low 23%, 4-5 medium_high 54%, 6 high 100%; NH 0-2 low 33%, 3-4 medium_low 46%, 5-6 medium_high 67%, 7-8 high 93%; combined 0-3 low 50%, 4-6 medium_low 58%, 7-9 medium_high 77%, 10-12 high 79%; not trauma CRASH; not CARG-TT; Chemotox is caller-assigned MAX2",
      "diastolic_mm_hg": 80.0,
      "ecog": 1,
      "chemotox": 0.5,
      "combined_incidence_percent": 79,
      "combined_risk": "high",
      "combined_score": 10,
      "hematologic_incidence_percent": 54,
      "hematologic_risk": "medium_high",
      "hematologic_score": 5,
      "iadl": 20,
      "ldh_u_l": 500.0,
      "ldh_uln_u_l": 618.0,
      "max_combined_score": 12,
      "max_hematologic_score": 6,
      "max_nonhematologic_score": 8,
      "mms": 28,
      "mna": 26,
      "nonhematologic_incidence_percent": 67,
      "nonhematologic_risk": "medium_high",
      "nonhematologic_score": 6
    },
    {
      "components": [
        {
          "value": 80.0,
          "factor": "diastolic_mm_hg",
          "points": 1,
          "present": true
        },
        {
          "value": 20,
          "factor": "iadl",
          "points": 1,
          "present": true
        },
        {
          "value": 500.0,
          "factor": "ldh",
          "points": 2,
          "present": true
        },
        {
          "value": 0.5,
          "factor": "chemotox",
          "points": 1,
          "present": true
        },
        {
          "value": 1,
          "factor": "ecog",
          "points": 1,
          "present": true
        },
        {
          "value": 28,
          "factor": "mms",
          "points": 2,
          "present": true
        },
        {
          "value": 26,
          "factor": "mna",
          "points": 2,
          "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": "Extermann M, Boler I, Reich RR, et al.",
        "doi": "10.1002/cncr.26646",
        "id": "extermann-2012",
        "pmid": "22072065",
        "source": "Cancer. 2012;118(13):3377-3386",
        "title": "Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score"
      },
      "formula": "crash",
      "formula_expression": "CRASH (Extermann 2012 Table 4) hematologic = diastolic_mm_hg (<=72 0, >72 1) + iadl (26-29 0, 10-25 1) + ldh (ldh_u_l > 0.74 * ldh_uln_u_l 2 else 0; empty 1-point column) + chemotox (0-0.44 0, 0.45-0.57 1, >0.57 2); max 6; nonhematologic = ecog (0 → 0, 1-2 → 1, 3-4 → 2) + mms (30 → 0, <30 → 2) + mna (28-30 → 0, <28 → 2) + chemotox (same); max 8; combined = hematologic + nonhematologic - chemotox (count Chemotox once; max 12 not 14); H 0-1 low 7%, 2-3 medium_low 23%, 4-5 medium_high 54%, 6 high 100%; NH 0-2 low 33%, 3-4 medium_low 46%, 5-6 medium_high 67%, 7-8 high 93%; combined 0-3 low 50%, 4-6 medium_low 58%, 7-9 medium_high 77%, 10-12 high 79%; not trauma CRASH; not CARG-TT; Chemotox is caller-assigned MAX2",
      "diastolic_mm_hg": 80.0,
      "ecog": 1,
      "chemotox": 0.5,
      "combined_incidence_percent": 79,
      "combined_risk": "high",
      "combined_score": 10,
      "hematologic_incidence_percent": 54,
      "hematologic_risk": "medium_high",
      "hematologic_score": 5,
      "iadl": 20,
      "ldh_u_l": 500.0,
      "ldh_uln_u_l": 618.0,
      "max_combined_score": 12,
      "max_hematologic_score": 6,
      "max_nonhematologic_score": 8,
      "mms": 28,
      "mna": 26,
      "nonhematologic_incidence_percent": 67,
      "nonhematologic_risk": "medium_high",
      "nonhematologic_score": 6
    }
  ]
}

Response

Example JSON

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

{
  "components": [
    {
      "value": 80.0,
      "factor": "diastolic_mm_hg",
      "points": 1,
      "present": true
    },
    {
      "value": 20,
      "factor": "iadl",
      "points": 1,
      "present": true
    },
    {
      "value": 500.0,
      "factor": "ldh",
      "points": 2,
      "present": true
    },
    {
      "value": 0.5,
      "factor": "chemotox",
      "points": 1,
      "present": true
    },
    {
      "value": 1,
      "factor": "ecog",
      "points": 1,
      "present": true
    },
    {
      "value": 28,
      "factor": "mms",
      "points": 2,
      "present": true
    },
    {
      "value": 26,
      "factor": "mna",
      "points": 2,
      "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": "Extermann M, Boler I, Reich RR, et al.",
    "doi": "10.1002/cncr.26646",
    "id": "extermann-2012",
    "pmid": "22072065",
    "source": "Cancer. 2012;118(13):3377-3386",
    "title": "Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score"
  },
  "formula": "crash",
  "formula_expression": "CRASH (Extermann 2012 Table 4) hematologic = diastolic_mm_hg (<=72 0, >72 1) + iadl (26-29 0, 10-25 1) + ldh (ldh_u_l > 0.74 * ldh_uln_u_l 2 else 0; empty 1-point column) + chemotox (0-0.44 0, 0.45-0.57 1, >0.57 2); max 6; nonhematologic = ecog (0 → 0, 1-2 → 1, 3-4 → 2) + mms (30 → 0, <30 → 2) + mna (28-30 → 0, <28 → 2) + chemotox (same); max 8; combined = hematologic + nonhematologic - chemotox (count Chemotox once; max 12 not 14); H 0-1 low 7%, 2-3 medium_low 23%, 4-5 medium_high 54%, 6 high 100%; NH 0-2 low 33%, 3-4 medium_low 46%, 5-6 medium_high 67%, 7-8 high 93%; combined 0-3 low 50%, 4-6 medium_low 58%, 7-9 medium_high 77%, 10-12 high 79%; not trauma CRASH; not CARG-TT; Chemotox is caller-assigned MAX2",
  "diastolic_mm_hg": 80.0,
  "ecog": 1,
  "chemotox": 0.5,
  "combined_incidence_percent": 79,
  "combined_risk": "high",
  "combined_score": 10,
  "hematologic_incidence_percent": 54,
  "hematologic_risk": "medium_high",
  "hematologic_score": 5,
  "iadl": 20,
  "ldh_u_l": 500.0,
  "ldh_uln_u_l": 618.0,
  "max_combined_score": 12,
  "max_hematologic_score": 6,
  "max_nonhematologic_score": 8,
  "mms": 28,
  "mna": 26,
  "nonhematologic_incidence_percent": 67,
  "nonhematologic_risk": "medium_high",
  "nonhematologic_score": 6
}

Client errors (HTTP 400)

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

Related tools

• G8 — Sum the eight Bellera 2012 G8 items (seven MNA items A, B, C, E, F, H, P plus age) and return whether the published ≤14 impaired-screen cutoff is met.
• CARG-TT — Sum Hurria 2011 Table 5 CARG chemotherapy-toxicity weights and return low (0-5, 30%), intermediate (6-9, 52%), or high (10-19, 83%) grade 3-5 toxicity risk.

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.