1994 Duke criteria for infective endocarditis

Duke

Apply the Durack 1994 original Duke criteria for infective endocarditis and return definite, possible, or rejected from caller-assigned pathologic, major, minor, and rejected flags.

LIVE $0.005 USDC GET /api/calc/duke

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

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

What it computes

Apply the Durack 1994 original Duke criteria for infective endocarditis and return definite, possible, or rejected from caller-assigned pathologic, major, minor, and rejected flags.

When to use

When an agent already has caller-assigned 1994 Duke pathologic, major, minor, and rejected flags and needs the published definite / possible / rejected classification. magent does not examine the patient, read an echocardiogram, or interpret cultures.

When not to use

Not a medical device and not a diagnosis of infective endocarditis.
Durack 1994 original Duke criteria only. Not Li 2000 modified Duke. Not ISCVID 2023.
magent does not examine the patient, read an echocardiogram, or interpret cultures. The caller assigns every flag.
Possible is the leftover 1994 category (findings consistent with IE that are neither definite nor rejected). It is not the Li 2000 1-major-plus-1-minor or 3-minor possible thresholds.

Formula

definite iff pathologic_definite or clinical_definite; clinical_definite iff major_count >= 2 or (major_count >= 1 and minor_count >= 3) or minor_count >= 5; else rejected if any rejected flag; else possible (Durack 1994 original Duke). minor_suggestive_echo is not counted when major_positive_echo is true; minor_suggestive_micro is not counted when major_typical_blood_culture is true. Not Li 2000. Not ISCVID 2023

Citation

Title: New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service
Authors: Durack DT, Lukes AS, Bright DK
Source: Am J Med. 1994;96(3):200-209
DOI: 10.1016/0002-9343(94)90143-0

Worked example

Two major criteria

Given: major_positive_echo=truemajor_typical_blood_culture=trueminor_fever=falseminor_immunologic_phenomena=falseminor_predisposition=falseminor_suggestive_echo=falseminor_suggestive_micro=falseminor_vascular_phenomena=falsepathologic_definite=falserejected_firm_alternate_diagnosis=falserejected_no_pathology_le_4_days_antibiotics=falserejected_resolved_le_4_days_antibiotics=false

major_typical_blood_culture is true
major_positive_echo is true
major_count is 2 and minor_count is 0
clinical_definite holds, so classification is definite

Major echo without double-counting suggestive echo

Given: major_positive_echo=truemajor_typical_blood_culture=falseminor_fever=falseminor_immunologic_phenomena=falseminor_predisposition=falseminor_suggestive_echo=trueminor_suggestive_micro=falseminor_vascular_phenomena=falsepathologic_definite=falserejected_firm_alternate_diagnosis=falserejected_no_pathology_le_4_days_antibiotics=falserejected_resolved_le_4_days_antibiotics=false

major_positive_echo is true so major_count is 1
minor_suggestive_echo is true but is not added to minor_count
minor_count is 0, so clinical_definite does not hold
no rejected flag is true, so classification is possible

Also searched as

Duke criteria
Duke endocarditis
Durack 1994
infective endocarditis criteria
Duke IE criteria
1994 Duke criteria
Duke major minor criteria
pathologic definite IE

Try

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

/api/calc/duke?pathologic_definite=false&major_typical_blood_culture=true&major_positive_echo=true&minor_predisposition=false&minor_fever=false&minor_vascular_phenomena=false&minor_immunologic_phenomena=false&minor_suggestive_echo=false&minor_suggestive_micro=false&rejected_firm_alternate_diagnosis=false&rejected_resolved_le_4_days_antibiotics=false&rejected_no_pathology_le_4_days_antibiotics=false

Full URL: https://api.magentlab.com/api/calc/duke?pathologic_definite=false&major_typical_blood_culture=true&major_positive_echo=true&minor_predisposition=false&minor_fever=false&minor_vascular_phenomena=false&minor_immunologic_phenomena=false&minor_suggestive_echo=false&minor_suggestive_micro=false&rejected_firm_alternate_diagnosis=false&rejected_resolved_le_4_days_antibiotics=false&rejected_no_pathology_le_4_days_antibiotics=false

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/duke?pathologic_definite=false&major_typical_blood_culture=true&major_positive_echo=true&minor_predisposition=false&minor_fever=false&minor_vascular_phenomena=false&minor_immunologic_phenomena=false&minor_suggestive_echo=false&minor_suggestive_micro=false&rejected_firm_alternate_diagnosis=false&rejected_resolved_le_4_days_antibiotics=false&rejected_no_pathology_le_4_days_antibiotics=false"

Parameters

Name	Type	Required	Description
`pathologic_definite`	boolean	required	Microorganisms demonstrated by culture or histology in a vegetation, embolus, or intracardiac abscess, or pathologic lesions (vegetation or abscess) confirmed by histology showing active endocarditis (Durack 1994 pathologic definite). true or false as assigned by the caller. magent does not examine tissue.
`major_typical_blood_culture`	boolean	required	Typical microorganism from two separate blood cultures, or persistently positive blood cultures, as assigned by the caller (Durack 1994 major typical blood culture). true or false. magent does not interpret cultures.
`major_positive_echo`	boolean	required	Positive echocardiogram for IE: oscillating mass or vegetation, abscess, new partial dehiscence of a prosthetic valve, or new valvular regurgitation (Durack 1994 major). true or false as assigned by the caller. magent does not read an echocardiogram.
`minor_predisposition`	boolean	required	Predisposing heart condition or intravenous drug use (Durack 1994 minor). true or false as assigned by the caller. magent does not take a history.
`minor_fever`	boolean	required	Fever ≥38.0 C (Durack 1994 minor). true or false as assigned by the caller. magent does not measure temperature.
`minor_vascular_phenomena`	boolean	required	Vascular phenomena (Durack 1994 minor): major arterial emboli, septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhages, or Janeway lesions, as assigned by the caller. magent does not examine the patient.
`minor_immunologic_phenomena`	boolean	required	Immunologic phenomena (Durack 1994 minor): glomerulonephritis, Osler nodes, Roth spots, or rheumatoid factor, as assigned by the caller. magent does not examine the patient.
`minor_suggestive_echo`	boolean	required	Echocardiogram consistent with IE but not meeting the major echo definition (Durack 1994 minor). true or false as assigned by the caller. Not counted in minor_count when major_positive_echo is true. magent does not read an echocardiogram.
`minor_suggestive_micro`	boolean	required	Microbiologic evidence not meeting the major culture definition (Durack 1994 minor). true or false as assigned by the caller. Not counted in minor_count when major_typical_blood_culture is true. magent does not interpret cultures.
`rejected_firm_alternate_diagnosis`	boolean	required	Firm alternate diagnosis explaining evidence of IE (Durack 1994 rejected). true or false as assigned by the caller. Classification is rejected only when definite does not hold.
`rejected_resolved_le_4_days_antibiotics`	boolean	required	Manifestations of IE resolved with antibiotic therapy for 4 days or less (Durack 1994 rejected). true or false as assigned by the caller.
`rejected_no_pathology_le_4_days_antibiotics`	boolean	required	No pathologic evidence of IE at surgery or autopsy after antibiotic therapy for 4 days or less (Durack 1994 rejected). true or false as assigned by the caller. magent does not examine tissue.

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/duke 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": [
    {
      "major_positive_echo": "true",
      "major_typical_blood_culture": "true",
      "minor_fever": "false",
      "minor_immunologic_phenomena": "false",
      "minor_predisposition": "false",
      "minor_suggestive_echo": "false",
      "minor_suggestive_micro": "false",
      "minor_vascular_phenomena": "false",
      "pathologic_definite": "false",
      "rejected_firm_alternate_diagnosis": "false",
      "rejected_no_pathology_le_4_days_antibiotics": "false",
      "rejected_resolved_le_4_days_antibiotics": "false"
    },
    {
      "major_positive_echo": "true",
      "major_typical_blood_culture": "true",
      "minor_fever": "false",
      "minor_immunologic_phenomena": "false",
      "minor_predisposition": "false",
      "minor_suggestive_echo": "false",
      "minor_suggestive_micro": "false",
      "minor_vascular_phenomena": "false",
      "pathologic_definite": "false",
      "rejected_firm_alternate_diagnosis": "false",
      "rejected_no_pathology_le_4_days_antibiotics": "false",
      "rejected_resolved_le_4_days_antibiotics": "false"
    }
  ]
}

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/duke",
  "items": [
    {
      "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": "Durack DT, Lukes AS, Bright DK",
        "doi": "10.1016/0002-9343(94)90143-0",
        "id": "durack-1994",
        "pmid": "8154507",
        "source": "Am J Med. 1994;96(3):200-209",
        "title": "New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service"
      },
      "formula": "duke",
      "formula_expression": "definite iff pathologic_definite or clinical_definite; clinical_definite iff major_count >= 2 or (major_count >= 1 and minor_count >= 3) or minor_count >= 5; else rejected if any rejected flag; else possible (Durack 1994 original Duke). minor_suggestive_echo is not counted when major_positive_echo is true; minor_suggestive_micro is not counted when major_typical_blood_culture is true. Not Li 2000. Not ISCVID 2023",
      "criteria": [
        {
          "factor": "pathologic_definite",
          "met": false
        },
        {
          "factor": "major_typical_blood_culture",
          "met": true
        },
        {
          "factor": "major_positive_echo",
          "met": true
        },
        {
          "factor": "minor_predisposition",
          "met": false
        },
        {
          "factor": "minor_fever",
          "met": false
        },
        {
          "factor": "minor_vascular_phenomena",
          "met": false
        },
        {
          "factor": "minor_immunologic_phenomena",
          "met": false
        },
        {
          "factor": "minor_suggestive_echo",
          "met": false
        },
        {
          "factor": "minor_suggestive_micro",
          "met": false
        },
        {
          "factor": "rejected_firm_alternate_diagnosis",
          "met": false
        },
        {
          "factor": "rejected_resolved_le_4_days_antibiotics",
          "met": false
        },
        {
          "factor": "rejected_no_pathology_le_4_days_antibiotics",
          "met": false
        },
        {
          "factor": "clinical_definite",
          "met": true
        },
        {
          "factor": "rejected",
          "met": false
        }
      ],
      "classification": "definite",
      "major_count": 2,
      "minor_count": 0
    },
    {
      "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": "Durack DT, Lukes AS, Bright DK",
        "doi": "10.1016/0002-9343(94)90143-0",
        "id": "durack-1994",
        "pmid": "8154507",
        "source": "Am J Med. 1994;96(3):200-209",
        "title": "New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service"
      },
      "formula": "duke",
      "formula_expression": "definite iff pathologic_definite or clinical_definite; clinical_definite iff major_count >= 2 or (major_count >= 1 and minor_count >= 3) or minor_count >= 5; else rejected if any rejected flag; else possible (Durack 1994 original Duke). minor_suggestive_echo is not counted when major_positive_echo is true; minor_suggestive_micro is not counted when major_typical_blood_culture is true. Not Li 2000. Not ISCVID 2023",
      "criteria": [
        {
          "factor": "pathologic_definite",
          "met": false
        },
        {
          "factor": "major_typical_blood_culture",
          "met": true
        },
        {
          "factor": "major_positive_echo",
          "met": true
        },
        {
          "factor": "minor_predisposition",
          "met": false
        },
        {
          "factor": "minor_fever",
          "met": false
        },
        {
          "factor": "minor_vascular_phenomena",
          "met": false
        },
        {
          "factor": "minor_immunologic_phenomena",
          "met": false
        },
        {
          "factor": "minor_suggestive_echo",
          "met": false
        },
        {
          "factor": "minor_suggestive_micro",
          "met": false
        },
        {
          "factor": "rejected_firm_alternate_diagnosis",
          "met": false
        },
        {
          "factor": "rejected_resolved_le_4_days_antibiotics",
          "met": false
        },
        {
          "factor": "rejected_no_pathology_le_4_days_antibiotics",
          "met": false
        },
        {
          "factor": "clinical_definite",
          "met": true
        },
        {
          "factor": "rejected",
          "met": false
        }
      ],
      "classification": "definite",
      "major_count": 2,
      "minor_count": 0
    }
  ]
}

Response

Field	Type	Description
`formula`	string	duke
`formula_expression`	string	Durack 1994 original Duke: definite if pathologic_definite or clinical_definite (2 major, or 1 major plus 3 minor, or 5 minor); else rejected if any rejected flag; else possible. Suggestive echo and suggestive micro are not double-counted with the matching major.
`major_count`	integer	Count of true Durack 1994 major flags among major_typical_blood_culture and major_positive_echo (0-2)
`minor_count`	integer	Count of counted Durack 1994 minor flags (0-6). minor_suggestive_echo is omitted when major_positive_echo is true; minor_suggestive_micro is omitted when major_typical_blood_culture is true
`classification`	string	definite, possible, or rejected (Durack 1994). possible is the leftover category. Not Li 2000. Not a diagnosis.
`criteria`	array	Per-flag rows for pathologic_definite, two majors, six minors, and three rejected flags, plus clinical_definite and rejected aggregates (factor and met)
`citation`	object	Durack 1994 Am J Med citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "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": "Durack DT, Lukes AS, Bright DK",
    "doi": "10.1016/0002-9343(94)90143-0",
    "id": "durack-1994",
    "pmid": "8154507",
    "source": "Am J Med. 1994;96(3):200-209",
    "title": "New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service"
  },
  "formula": "duke",
  "formula_expression": "definite iff pathologic_definite or clinical_definite; clinical_definite iff major_count >= 2 or (major_count >= 1 and minor_count >= 3) or minor_count >= 5; else rejected if any rejected flag; else possible (Durack 1994 original Duke). minor_suggestive_echo is not counted when major_positive_echo is true; minor_suggestive_micro is not counted when major_typical_blood_culture is true. Not Li 2000. Not ISCVID 2023",
  "criteria": [
    {
      "factor": "pathologic_definite",
      "met": false
    },
    {
      "factor": "major_typical_blood_culture",
      "met": true
    },
    {
      "factor": "major_positive_echo",
      "met": true
    },
    {
      "factor": "minor_predisposition",
      "met": false
    },
    {
      "factor": "minor_fever",
      "met": false
    },
    {
      "factor": "minor_vascular_phenomena",
      "met": false
    },
    {
      "factor": "minor_immunologic_phenomena",
      "met": false
    },
    {
      "factor": "minor_suggestive_echo",
      "met": false
    },
    {
      "factor": "minor_suggestive_micro",
      "met": false
    },
    {
      "factor": "rejected_firm_alternate_diagnosis",
      "met": false
    },
    {
      "factor": "rejected_resolved_le_4_days_antibiotics",
      "met": false
    },
    {
      "factor": "rejected_no_pathology_le_4_days_antibiotics",
      "met": false
    },
    {
      "factor": "clinical_definite",
      "met": true
    },
    {
      "factor": "rejected",
      "met": false
    }
  ],
  "classification": "definite",
  "major_count": 2,
  "minor_count": 0
}

Client errors (HTTP 400)

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

HTTP	Code	When
400	`invalid_flag`	boolean clinical flags must be true or false Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

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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.