# DKA mortality prediction model (Efstathiou) DKA-MPM Status: LIVE Price: $0.005 USDC `GET /api/calc/dka_mpm` HTML: https://magentlab.com/docs/dka-mpm Markdown: https://magentlab.com/docs/dka-mpm.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the Efstathiou 2002 DKA-MPM flags (max 25) and return the published in-hospital death percents only for scores 0–14 (0.86%) and 19–25 (93.3%). ## When to use When an agent already has the six Efstathiou 2002 presentation and first-day flags and needs the published point total, not a DKA treatment order, insulin dose, pH or glucose assay, later 72-hour DKA score, or invented percents for scores 15–18. ## When not to use - Not a medical device and not a DKA treatment, fluid, or insulin-dose order. - magent does not assay pH or glucose. All six predictors are caller-assigned flags. - Efstathiou 2002 published in-hospital death of 0.86% for scores 0–14 and 93.3% for scores 19–25. Scores 15–18 return the point total without a percent. - Does not implement later 72-hour DKA mortality scores. Does not invent Low/High labels or intermediate percents that paper did not publish. ## Formula ``` DKA-MPM = severe_comorbidity 6 + ph_lt_7 4 + insulin_gt_50_12h 4 + glucose_gt_16_7_12h 4 + depressed_mental_24h 4 + fever_24h 3; Efstathiou 2002; max 25; published in-hospital death 0.86% scores 0-14 and 93.3% scores 19-25 ``` ## Citation [A mortality prediction model in diabetic ketoacidosis](https://doi.org/10.1046/j.1365-2265.2002.01636.x) Efstathiou SP, Tsioulos DI, Tsiakou AG, Gratsias YG, Pefanis AV, Mountokalakis TD Clin Endocrinol (Oxf). 2002;57(5):595-601 DOI: [10.1046/j.1365-2265.2002.01636.x](https://doi.org/10.1046/j.1365-2265.2002.01636.x) ## Worked example ### All flags false (score 0, published 0.86%) Given: `depressed_mental_24h=false, fever_24h=false, glucose_gt_16_7_12h=false, insulin_gt_50_12h=false, ph_lt_7=false, severe_comorbidity=false` 1. All six Efstathiou 2002 flags false → 0 2. score = 0 (max 25); scores 0-14 publish 0.86% in-hospital death ### Score 18 (no published percent) Given: `depressed_mental_24h=false, fever_24h=false, glucose_gt_16_7_12h=true, insulin_gt_50_12h=true, ph_lt_7=true, severe_comorbidity=true` 1. severe_comorbidity 6 + ph_lt_7 4 + insulin_gt_50_12h 4 + glucose_gt_16_7_12h 4 2. score = 18 (max 25); scores 15-18 omit observed_mortality_percent ### All flags true (score 25, published 93.3%) Given: `depressed_mental_24h=true, fever_24h=true, glucose_gt_16_7_12h=true, insulin_gt_50_12h=true, ph_lt_7=true, severe_comorbidity=true` 1. 6 + 4 + 4 + 4 + 4 + 3 2. score = 25 (max 25); scores 19-25 publish 93.3% in-hospital death ## Also searched as - DKA-MPM - DKA mortality prediction model - Efstathiou DKA score - diabetic ketoacidosis mortality score - DKA MPM - Efstathiou 2002 - ketoacidosis mortality prediction ## Parameters - `severe_comorbidity` (boolean, required): Severe coexisting disease at presentation as assigned by the caller (Efstathiou 2002). true scores 6. true or false. magent does not diagnose comorbidity. - `ph_lt_7` (boolean, required): Arterial pH < 7.0 at presentation as assigned by the caller (Efstathiou 2002). true scores 4. true or false. magent does not assay pH. - `insulin_gt_50_12h` (boolean, required): Regular insulin > 50 IU in the first 12 h as assigned by the caller (Efstathiou 2002). true scores 4. true or false. Not an insulin dose. magent does not order insulin. - `glucose_gt_16_7_12h` (boolean, required): Serum glucose > 16.7 mmol/L after 12 h as assigned by the caller (Efstathiou 2002). true scores 4. true or false. magent does not assay glucose. - `depressed_mental_24h` (boolean, required): Depressed mental state after 24 h as assigned by the caller (Efstathiou 2002). true scores 4. true or false. magent does not examine the patient. - `fever_24h` (boolean, required): Fever after 24 h as assigned by the caller (Efstathiou 2002). true scores 3. true or false. magent does not take temperature. ## 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/dka_mpm` 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": [ { "depressed_mental_24h": "false", "fever_24h": "false", "glucose_gt_16_7_12h": "false", "insulin_gt_50_12h": "false", "ph_lt_7": "false", "severe_comorbidity": "false" }, { "depressed_mental_24h": "false", "fever_24h": "false", "glucose_gt_16_7_12h": "false", "insulin_gt_50_12h": "false", "ph_lt_7": "false", "severe_comorbidity": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/dka-mpm Example 200: ```json { "count": 2, "path": "/api/calc/dka_mpm", "items": [ { "components": [ { "factor": "severe_comorbidity", "points": 0, "present": false }, { "factor": "ph_lt_7", "points": 0, "present": false }, { "factor": "insulin_gt_50_12h", "points": 0, "present": false }, { "factor": "glucose_gt_16_7_12h", "points": 0, "present": false }, { "factor": "depressed_mental_24h", "points": 0, "present": false }, { "factor": "fever_24h", "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": "Efstathiou SP, Tsioulos DI, Tsiakou AG, Gratsias YG, Pefanis AV, Mountokalakis TD", "doi": "10.1046/j.1365-2265.2002.01636.x", "id": "efstathiou-2002", "pmid": "12390332", "source": "Clin Endocrinol (Oxf). 2002;57(5):595-601", "title": "A mortality prediction model in diabetic ketoacidosis" }, "formula": "dka_mpm", "formula_expression": "DKA-MPM = severe_comorbidity 6 + ph_lt_7 4 + insulin_gt_50_12h 4 + glucose_gt_16_7_12h 4 + depressed_mental_24h 4 + fever_24h 3; Efstathiou 2002; max 25; published in-hospital death 0.86% scores 0-14 and 93.3% scores 19-25", "max_score": 25, "score": 0, "observed_mortality_percent": 0.86 }, { "components": [ { "factor": "severe_comorbidity", "points": 0, "present": false }, { "factor": "ph_lt_7", "points": 0, "present": false }, { "factor": "insulin_gt_50_12h", "points": 0, "present": false }, { "factor": "glucose_gt_16_7_12h", "points": 0, "present": false }, { "factor": "depressed_mental_24h", "points": 0, "present": false }, { "factor": "fever_24h", "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": "Efstathiou SP, Tsioulos DI, Tsiakou AG, Gratsias YG, Pefanis AV, Mountokalakis TD", "doi": "10.1046/j.1365-2265.2002.01636.x", "id": "efstathiou-2002", "pmid": "12390332", "source": "Clin Endocrinol (Oxf). 2002;57(5):595-601", "title": "A mortality prediction model in diabetic ketoacidosis" }, "formula": "dka_mpm", "formula_expression": "DKA-MPM = severe_comorbidity 6 + ph_lt_7 4 + insulin_gt_50_12h 4 + glucose_gt_16_7_12h 4 + depressed_mental_24h 4 + fever_24h 3; Efstathiou 2002; max 25; published in-hospital death 0.86% scores 0-14 and 93.3% scores 19-25", "max_score": 25, "score": 0, "observed_mortality_percent": 0.86 } ] } ``` ## Response fields - `formula` (string): dka_mpm - `formula_expression` (string): Exact expression used - `score` (integer): Efstathiou 2002 DKA-MPM points 0-25 - `max_score` (integer): Always 25 - `observed_mortality_percent` (number): Efstathiou 2002 published in-hospital death: 0.86 when score is 0-14, 93.3 when score is 19-25. Omitted for scores 15-18; those scores are not given invented percents. - `components` (array): Per-factor Efstathiou 2002 points - `citation` (object): Efstathiou et al. Clin Endocrinol (Oxf) 2002 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "severe_comorbidity", "points": 0, "present": false }, { "factor": "ph_lt_7", "points": 0, "present": false }, { "factor": "insulin_gt_50_12h", "points": 0, "present": false }, { "factor": "glucose_gt_16_7_12h", "points": 0, "present": false }, { "factor": "depressed_mental_24h", "points": 0, "present": false }, { "factor": "fever_24h", "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": "Efstathiou SP, Tsioulos DI, Tsiakou AG, Gratsias YG, Pefanis AV, Mountokalakis TD", "doi": "10.1046/j.1365-2265.2002.01636.x", "id": "efstathiou-2002", "pmid": "12390332", "source": "Clin Endocrinol (Oxf). 2002;57(5):595-601", "title": "A mortality prediction model in diabetic ketoacidosis" }, "formula": "dka_mpm", "formula_expression": "DKA-MPM = severe_comorbidity 6 + ph_lt_7 4 + insulin_gt_50_12h 4 + glucose_gt_16_7_12h 4 + depressed_mental_24h 4 + fever_24h 3; Efstathiou 2002; max 25; published in-hospital death 0.86% scores 0-14 and 93.3% scores 19-25", "max_score": 25, "score": 0, "observed_mortality_percent": 0.86 } ``` ## Errors - HTTP 400 `invalid_dka_mpm`: DKA-MPM inputs must match Efstathiou 2002 presentation and first-day binary predictors from that paper. 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 - [Anion gap](https://magentlab.com/docs/anion-gap) — Compute the serum anion gap from sodium, chloride, and bicarbonate, with or without potassium, using the Emmett–Narins 1977 formulas. formula is required. ## 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.