# Fong clinical score (colorectal liver metastases) Fong Status: LIVE Price: $0.005 USDC `GET /api/calc/fong` HTML: https://magentlab.com/docs/fong Markdown: https://magentlab.com/docs/fong.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the five Fong 1999 preoperative criteria for colorectal liver metastases and return the 0–5 clinical score and whether it is potentially favorable (≤2). ## When to use When an agent already has the five published Fong 1999 flags assigned and must not invent a resectability decision, adjuvant protocol, or numeric CEA, size, or interval. ## When not to use - Not a medical device. - Not a resectability decision or adjuvant protocol. - magent does not interpret imaging or pathology. Each flag is caller-assigned after the published inequalities (disease-free interval <12 months, more than one hepatic tumor, largest tumor >5 cm, CEA >200 ng/mL). Equality at 12 months, 5 cm, or 200 ng/mL does not meet Fong's "<" / ">". ## Formula ``` Fong = node_positive_primary + dfi_lt_12_months + more_than_one_hepatic_tumor + largest_tumor_gt_5_cm + cea_gt_200; each 1; max 5 ``` ## Citation [Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases](https://doi.org/10.1097/00000658-199909000-00004) Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH Ann Surg. 1999;230(3):309-318 DOI: [10.1097/00000658-199909000-00004](https://doi.org/10.1097/00000658-199909000-00004) ## Worked example ### No criteria Given: `cea_gt_200=false, dfi_lt_12_months=false, largest_tumor_gt_5_cm=false, more_than_one_hepatic_tumor=false, node_positive_primary=false` 1. score = 0 2. favorable true (threshold is ≤2) ### Three criteria Given: `cea_gt_200=false, dfi_lt_12_months=true, largest_tumor_gt_5_cm=false, more_than_one_hepatic_tumor=true, node_positive_primary=true` 1. score = 3 2. favorable false ## Also searched as - Fong score - Fong clinical risk score - colorectal liver metastasis score - Fong CRS - hepatic resection colorectal metastases - Fong 1999 - CRLM clinical score ## Parameters - `node_positive_primary` (boolean, required): Node-positive primary (Fong 1999). true or false as assigned by the caller. magent does not interpret pathology. - `dfi_lt_12_months` (boolean, required): Disease-free interval from primary to metastases <12 months (Fong 1999). Caller already applied the published threshold; equality at 12 months does not meet. true or false. - `more_than_one_hepatic_tumor` (boolean, required): More than one hepatic tumor (Fong 1999). true or false as assigned by the caller. magent does not interpret imaging. - `largest_tumor_gt_5_cm` (boolean, required): Largest hepatic tumor >5 cm (Fong 1999). Caller already applied the published threshold; equality at 5 cm does not meet. true or false. - `cea_gt_200` (boolean, required): CEA >200 ng/mL (Fong 1999). Caller already applied the published threshold; equality at 200 ng/mL does not meet. true or false. ## 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/fong` 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": [ { "cea_gt_200": "false", "dfi_lt_12_months": "false", "largest_tumor_gt_5_cm": "false", "more_than_one_hepatic_tumor": "false", "node_positive_primary": "false" }, { "cea_gt_200": "false", "dfi_lt_12_months": "false", "largest_tumor_gt_5_cm": "false", "more_than_one_hepatic_tumor": "false", "node_positive_primary": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/fong Example 200: ```json { "count": 2, "path": "/api/calc/fong", "items": [ { "components": [ { "factor": "node_positive_primary", "points": 0, "present": false }, { "factor": "dfi_lt_12_months", "points": 0, "present": false }, { "factor": "more_than_one_hepatic_tumor", "points": 0, "present": false }, { "factor": "largest_tumor_gt_5_cm", "points": 0, "present": false }, { "factor": "cea_gt_200", "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": "Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH", "doi": "10.1097/00000658-199909000-00004", "id": "fong-1999", "pmid": "10493478", "source": "Ann Surg. 1999;230(3):309-318", "title": "Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases" }, "formula": "fong", "formula_expression": "Fong = node_positive_primary + dfi_lt_12_months + more_than_one_hepatic_tumor + largest_tumor_gt_5_cm + cea_gt_200; each 1; max 5", "max_score": 5, "score": 0, "favorable": true }, { "components": [ { "factor": "node_positive_primary", "points": 0, "present": false }, { "factor": "dfi_lt_12_months", "points": 0, "present": false }, { "factor": "more_than_one_hepatic_tumor", "points": 0, "present": false }, { "factor": "largest_tumor_gt_5_cm", "points": 0, "present": false }, { "factor": "cea_gt_200", "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": "Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH", "doi": "10.1097/00000658-199909000-00004", "id": "fong-1999", "pmid": "10493478", "source": "Ann Surg. 1999;230(3):309-318", "title": "Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases" }, "formula": "fong", "formula_expression": "Fong = node_positive_primary + dfi_lt_12_months + more_than_one_hepatic_tumor + largest_tumor_gt_5_cm + cea_gt_200; each 1; max 5", "max_score": 5, "score": 0, "favorable": true } ] } ``` ## Response fields - `formula` (string): fong - `formula_expression` (string): Exact expression used - `score` (integer): Fong points 0-5 - `max_score` (integer): 5 - `favorable` (boolean): true iff score ≤2 (Fong 1999: up to two criteria potentially favorable). Not a resectability decision. - `components` (array): Per-factor points - `citation` (object): Fong et al. Ann Surg 1999 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "node_positive_primary", "points": 0, "present": false }, { "factor": "dfi_lt_12_months", "points": 0, "present": false }, { "factor": "more_than_one_hepatic_tumor", "points": 0, "present": false }, { "factor": "largest_tumor_gt_5_cm", "points": 0, "present": false }, { "factor": "cea_gt_200", "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": "Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH", "doi": "10.1097/00000658-199909000-00004", "id": "fong-1999", "pmid": "10493478", "source": "Ann Surg. 1999;230(3):309-318", "title": "Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases" }, "formula": "fong", "formula_expression": "Fong = node_positive_primary + dfi_lt_12_months + more_than_one_hepatic_tumor + largest_tumor_gt_5_cm + cea_gt_200; each 1; max 5", "max_score": 5, "score": 0, "favorable": true } ``` ## Errors - 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 - [Child–Pugh](https://magentlab.com/docs/child-pugh) — Compute the Child–Turcotte–Pugh cirrhosis severity score from bilirubin, albumin, INR, encephalopathy, and ascites. ## 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.