# Dutch Lipid Clinic Network FH Dutch FH Status: LIVE Price: $0.005 USDC `GET /api/calc/dutch_fh` HTML: https://magentlab.com/docs/dutch-fh Markdown: https://magentlab.com/docs/dutch-fh.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Apply the Nordestgaard 2013 Table 1 Dutch Lipid Clinic Network score from caller-supplied LDL cholesterol plus family, clinical, physical, and DNA flags, and return the 0–26 score and definite, probable, possible, or unlikely classification. Not a diagnosis. ## When to use When an agent already has untreated LDL cholesterol and caller-assigned Dutch Lipid Clinic Network Table 1 family, clinical, physical, and DNA flags and needs the published adult DLCN score and classification. magent does not assay lipids, examine tendons or arcus, or sequence genes. ## When not to use - Not a medical device and not a diagnosis of familial hypercholesterolaemia. - magent does not assay lipids, examine tendons or arcus, or sequence genes. The caller supplies exactly one LDL value and assigns every flag. - Adult Dutch Lipid Clinic Network Table 1 (Nordestgaard 2013 EAS consensus) only. Not Simon Broome, not MEDPED, and not homozygous FH. - Per group only the highest applicable score is counted. Family, clinical, and physical items do not add within a group. ## Formula ``` DLCN (Nordestgaard 2013 Table 1) = family + clinical + physical + ldl + dna (per group only the highest); family: first_degree_xanthoma_or_arcus or child_ldl_gt_95th -> 2 else first_degree_premature_chd or first_degree_ldl_gt_95th -> 1; clinical: premature_chd -> 2 else premature_cerebral_or_pvd -> 1; physical: tendon_xanthoma -> 6 else corneal_arcus_age_lt_45 -> 4; ldl mmol/L: >8.5 -> 8, 6.5-8.4 -> 5, 5.0-6.4 -> 3, 4.0-4.9 -> 1; dna causative_mutation_ldlr_apob_pcsk9 -> 8; max 26; definite >8, probable 6-8, possible 3-5, unlikely 0-2 ``` ## Citation [Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society](https://doi.org/10.1093/eurheartj/eht273) Nordestgaard BG, Chapman MJ, Humphries SE, et al. Eur Heart J. 2013;34(45):3478-3490 DOI: [10.1093/eurheartj/eht273](https://doi.org/10.1093/eurheartj/eht273) ## Worked example ### LDL 9.0 mmol/L with tendon xanthoma is definite FH Given: `causative_mutation_ldlr_apob_pcsk9=false, child_ldl_gt_95th=false, corneal_arcus_age_lt_45=false, first_degree_ldl_gt_95th=false, first_degree_premature_chd=false, first_degree_xanthoma_or_arcus=false, ldl_mmol_l=9.0, premature_cerebral_or_pvd=false, premature_chd=false, tendon_xanthoma=true` 1. ldl_mmol_l 9.0 > 8.5 → ldl_points 8 2. tendon_xanthoma true → physical_points 6 (max of the physical group) 3. family, clinical, and DNA groups 0 → score 14 (max 26); classification definite ## Also searched as - Dutch Lipid Clinic Network - DLCN - Dutch FH criteria - familial hypercholesterolaemia score - Nordestgaard FH - DLCN FH - Dutch lipid clinic - familial hypercholesterolemia criteria ## Parameters - `ldl_mmol_l` (number, optional): LDL cholesterol in mmol/L (1-20). Nordestgaard 2013 Table 1 bands: >8.5 → 8, 6.5-8.4 → 5, 5.0-6.4 → 3, 4.0-4.9 → 1. Provide exactly one of ldl_mmol_l or ldl_mg_dl. magent does not assay lipids. - `ldl_mg_dl` (number, optional): LDL cholesterol in mg/dL (40-800). Converted to mmol/L as mg/dL / 38.67, then scored on the mmol/L bands. Provide exactly one lipid parameter. - `first_degree_premature_chd` (boolean, required): First-degree relative with premature coronary heart disease (Nordestgaard 2013 Table 1 family history, 1 point). true or false as assigned by the caller. magent does not take a pedigree. Either this or first_degree_ldl_gt_95th scores 1 for the family group; a 2-point family item still yields family 2, not 3. - `first_degree_ldl_gt_95th` (boolean, required): First-degree relative with LDL cholesterol above the 95th percentile (Nordestgaard 2013 Table 1 family history, 1 point). true or false as assigned by the caller. magent does not assay lipids or take a pedigree. - `first_degree_xanthoma_or_arcus` (boolean, required): First-degree relative with tendon xanthoma and/or arcus cornealis (Nordestgaard 2013 Table 1 family history, 2 points). true or false as assigned by the caller. magent does not examine relatives. Either this or child_ldl_gt_95th scores 2 for the family group (max of family items). - `child_ldl_gt_95th` (boolean, required): Child under 18 years with LDL cholesterol above the 95th percentile (Nordestgaard 2013 Table 1 family history, 2 points). true or false as assigned by the caller. magent does not assay lipids or take a pedigree. - `premature_chd` (boolean, required): Premature coronary heart disease in the subject (Nordestgaard 2013 Table 1 clinical history, 2 points; men <55 years / women <60 years as assigned by the caller). true or false. magent does not diagnose CHD or compute age or sex. If premature_cerebral_or_pvd is also true, the clinical group is 2, not 3. - `premature_cerebral_or_pvd` (boolean, required): Premature cerebral or peripheral vascular disease in the subject (Nordestgaard 2013 Table 1 clinical history, 1 point). true or false as assigned by the caller. magent does not diagnose vascular disease. - `tendon_xanthoma` (boolean, required): Tendon xanthoma in the subject (Nordestgaard 2013 Table 1 physical examination, 6 points). true or false as assigned by the caller. magent does not examine tendons. If corneal_arcus_age_lt_45 is also true, the physical group is 6, not 10. - `corneal_arcus_age_lt_45` (boolean, required): Arcus cornealis before age 45 years (Nordestgaard 2013 Table 1 physical examination, 4 points). true or false as assigned by the caller. magent does not examine the cornea or compute age. - `causative_mutation_ldlr_apob_pcsk9` (boolean, required): Causative mutation in LDLR, APOB, or PCSK9 as assigned by the caller (Nordestgaard 2013 Table 1 DNA analysis, 8 points). true or false. magent does not sequence genes. Mutation alone is probable (score 8), not definite. ## 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/dutch_fh` 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": [ { "causative_mutation_ldlr_apob_pcsk9": "false", "child_ldl_gt_95th": "false", "corneal_arcus_age_lt_45": "false", "first_degree_ldl_gt_95th": "false", "first_degree_premature_chd": "false", "first_degree_xanthoma_or_arcus": "false", "ldl_mmol_l": "9.0", "premature_cerebral_or_pvd": "false", "premature_chd": "false", "tendon_xanthoma": "true" }, { "causative_mutation_ldlr_apob_pcsk9": "false", "child_ldl_gt_95th": "false", "corneal_arcus_age_lt_45": "false", "first_degree_ldl_gt_95th": "false", "first_degree_premature_chd": "false", "first_degree_xanthoma_or_arcus": "false", "ldl_mmol_l": "9.0", "premature_cerebral_or_pvd": "false", "premature_chd": "false", "tendon_xanthoma": "true" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/dutch-fh Example 200: ```json { "count": 2, "path": "/api/calc/dutch_fh", "items": [ { "components": [ { "factor": "family", "points": 0, "present": false }, { "factor": "clinical", "points": 0, "present": false }, { "factor": "physical", "points": 6, "present": true }, { "value": 9.0, "factor": "ldl", "points": 8, "present": true }, { "factor": "dna", "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": "Nordestgaard BG, Chapman MJ, Humphries SE, et al.", "doi": "10.1093/eurheartj/eht273", "id": "nordestgaard-2013", "pmid": "23956253", "source": "Eur Heart J. 2013;34(45):3478-3490", "title": "Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society" }, "formula": "dutch_fh", "formula_expression": "DLCN (Nordestgaard 2013 Table 1) = family + clinical + physical + ldl + dna (per group only the highest); family: first_degree_xanthoma_or_arcus or child_ldl_gt_95th -> 2 else first_degree_premature_chd or first_degree_ldl_gt_95th -> 1; clinical: premature_chd -> 2 else premature_cerebral_or_pvd -> 1; physical: tendon_xanthoma -> 6 else corneal_arcus_age_lt_45 -> 4; ldl mmol/L: >8.5 -> 8, 6.5-8.4 -> 5, 5.0-6.4 -> 3, 4.0-4.9 -> 1; dna causative_mutation_ldlr_apob_pcsk9 -> 8; max 26; definite >8, probable 6-8, possible 3-5, unlikely 0-2", "max_score": 26, "score": 14, "clinical_points": 0, "classification": "definite", "dna_points": 0, "family_points": 0, "ldl_mmol_l": 9.0, "ldl_points": 8, "physical_points": 6 }, { "components": [ { "factor": "family", "points": 0, "present": false }, { "factor": "clinical", "points": 0, "present": false }, { "factor": "physical", "points": 6, "present": true }, { "value": 9.0, "factor": "ldl", "points": 8, "present": true }, { "factor": "dna", "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": "Nordestgaard BG, Chapman MJ, Humphries SE, et al.", "doi": "10.1093/eurheartj/eht273", "id": "nordestgaard-2013", "pmid": "23956253", "source": "Eur Heart J. 2013;34(45):3478-3490", "title": "Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society" }, "formula": "dutch_fh", "formula_expression": "DLCN (Nordestgaard 2013 Table 1) = family + clinical + physical + ldl + dna (per group only the highest); family: first_degree_xanthoma_or_arcus or child_ldl_gt_95th -> 2 else first_degree_premature_chd or first_degree_ldl_gt_95th -> 1; clinical: premature_chd -> 2 else premature_cerebral_or_pvd -> 1; physical: tendon_xanthoma -> 6 else corneal_arcus_age_lt_45 -> 4; ldl mmol/L: >8.5 -> 8, 6.5-8.4 -> 5, 5.0-6.4 -> 3, 4.0-4.9 -> 1; dna causative_mutation_ldlr_apob_pcsk9 -> 8; max 26; definite >8, probable 6-8, possible 3-5, unlikely 0-2", "max_score": 26, "score": 14, "clinical_points": 0, "classification": "definite", "dna_points": 0, "family_points": 0, "ldl_mmol_l": 9.0, "ldl_points": 8, "physical_points": 6 } ] } ``` ## Response fields - `formula` (string): dutch_fh - `formula_expression` (string): Nordestgaard 2013 Table 1 Dutch Lipid Clinic Network expression - `score` (integer): DLCN points 0-26 - `max_score` (integer): Always 26 - `classification` (string): definite when score >8; probable when 6, 7, or 8; possible when 3, 4, or 5; unlikely when 0, 1, or 2. Score 8 (including mutation alone) is probable, not definite. Not a diagnosis. - `ldl_mmol_l` (number): The supplied LDL converted to mmol/L (mg/dL / 38.67 when ldl_mg_dl is used), rounded - `ldl_points` (integer): LDL group points: 8, 5, 3, 1, or 0 - `family_points` (integer): Family-history group points: 2, 1, or 0 (max of family items) - `clinical_points` (integer): Clinical-history group points: 2, 1, or 0 (max of clinical items) - `physical_points` (integer): Physical-examination group points: 6, 4, or 0 (max of physical items) - `dna_points` (integer): DNA-analysis group points: 8 if a causative LDLR/APOB/PCSK9 mutation, else 0 - `components` (array): Five group rows (family, clinical, physical, ldl, dna) with factor, present, points, and value on the ldl row - `citation` (object): Nordestgaard 2013 Eur Heart J EAS consensus citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "family", "points": 0, "present": false }, { "factor": "clinical", "points": 0, "present": false }, { "factor": "physical", "points": 6, "present": true }, { "value": 9.0, "factor": "ldl", "points": 8, "present": true }, { "factor": "dna", "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": "Nordestgaard BG, Chapman MJ, Humphries SE, et al.", "doi": "10.1093/eurheartj/eht273", "id": "nordestgaard-2013", "pmid": "23956253", "source": "Eur Heart J. 2013;34(45):3478-3490", "title": "Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society" }, "formula": "dutch_fh", "formula_expression": "DLCN (Nordestgaard 2013 Table 1) = family + clinical + physical + ldl + dna (per group only the highest); family: first_degree_xanthoma_or_arcus or child_ldl_gt_95th -> 2 else first_degree_premature_chd or first_degree_ldl_gt_95th -> 1; clinical: premature_chd -> 2 else premature_cerebral_or_pvd -> 1; physical: tendon_xanthoma -> 6 else corneal_arcus_age_lt_45 -> 4; ldl mmol/L: >8.5 -> 8, 6.5-8.4 -> 5, 5.0-6.4 -> 3, 4.0-4.9 -> 1; dna causative_mutation_ldlr_apob_pcsk9 -> 8; max 26; definite >8, probable 6-8, possible 3-5, unlikely 0-2", "max_score": 26, "score": 14, "clinical_points": 0, "classification": "definite", "dna_points": 0, "family_points": 0, "ldl_mmol_l": 9.0, "ldl_points": 8, "physical_points": 6 } ``` ## Errors - HTTP 400 `invalid_dutch_ldl`: provide exactly one of ldl_mmol_l (1-20) or ldl_mg_dl (40-800) (Nordestgaard 2013 DLCN). Returned before settlement; you are not charged. - 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 - [Simon Broome](https://magentlab.com/docs/simon-broome) — Apply the 1991 Simon Broome Register adult definite familial hypercholesterolaemia rule and return definite or not_definite from one lipid value plus a caller-assigned tendon-xanthoma flag. - [MEDPED](https://magentlab.com/docs/medped) — Apply the Williams 1993 US MEDPED total cholesterol tables and return whether caller-supplied total cholesterol exceeds the cutoff for that age and relative degree. Not a diagnosis. ## 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.