# Glasgow alcoholic hepatitis score GAHS Status: LIVE Price: $0.005 USDC `GET /api/calc/gahs` HTML: https://magentlab.com/docs/gahs Markdown: https://magentlab.com/docs/gahs.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Forrest 2005 Glasgow alcoholic hepatitis score (5-12) and the published ≥9 band. ## When to use When an agent needs the published GAHS total and must not invent a corticosteroid decision. ## When not to use - Not a diagnosis or a steroid/pentoxifylline order. Forrest 2005 associated day-1 GAHS ≥9 with poorer outcome; magent returns lt_9 or ge_9 as a band. - PT ratio is the paper variable (not INR). Age uses magent's adult 18-120 clamp. Urea may be entered as mmol/L or BUN mg/dL (÷ 2.8). ## Formula ``` GAHS = age_points + wbc_points + urea_points + pt_ratio_points + bilirubin_points; range 5-12 ``` ## Citation [Analysis of factors predictive of mortality in alcoholic hepatitis and derivation and validation of the Glasgow alcoholic hepatitis score](https://doi.org/10.1136/gut.2004.050781) Forrest EH, Evans CD, Stewart S, et al. Gut. 2005;54(8):1174-1179 DOI: [10.1136/gut.2004.050781](https://doi.org/10.1136/gut.2004.050781) ## Worked example ### Age 40, WBC 8, urea 4, PT ratio 1.2, bilirubin 80 µmol/L Given: `age=40, bilirubin_umol_l=80, pt_ratio=1.2, urea_mmol_l=4, wbc_k_ul=8` 1. age <50 → 1; WBC <15 → 1; urea <5 → 1; PT ratio <1.5 → 1; bilirubin <125 → 1 2. score = 5 3. band lt_9 ### Age 55, WBC 16, urea 8, PT ratio 2.2, bilirubin 300 µmol/L Given: `age=55, bilirubin_umol_l=300, pt_ratio=2.2, urea_mmol_l=8, wbc_k_ul=16` 1. age ≥50 → 2; WBC ≥15 → 2; urea ≥5 → 2; PT ratio >2.0 → 3; bilirubin >250 → 3 2. score = 12 3. band ge_9 ## Also searched as - Glasgow alcoholic hepatitis score - GAHS - Forrest score - alcoholic hepatitis score - GAHS ≥9 ## Parameters - `age` (integer, required): Age in years (18-120). <50 scores 1; ≥50 scores 2 (Forrest 2005). - `wbc_k_ul` (number, optional): WBC in 10^3/µL (same as 10^9/L). Provide wbc_k_ul or wbc_ul. <15 scores 1; ≥15 scores 2. - `wbc_ul` (number, optional): WBC in cells/µL. Converted as K/µL = cells/µL / 1000. - `urea_mmol_l` (number, optional): Urea in mmol/L (1-50). Provide this or bun_mg_dl, not both. <5 scores 1; ≥5 scores 2. - `bun_mg_dl` (number, optional): BUN in mg/dL (3-140). Converted as urea_mmol_l = bun_mg_dl / 2.8. - `pt_ratio` (number, required): Prothrombin-time ratio (0.8-10). <1.5 scores 1; 1.5-2.0 scores 2; >2.0 scores 3. - `bilirubin_umol_l` (number, optional): Total bilirubin in µmol/L (2-684). Provide this or bilirubin_mg_dl. <125 scores 1; 125-250 scores 2; >250 scores 3. - `bilirubin_mg_dl` (number, optional): Total bilirubin in mg/dL (0.1-40). Converted as µmol/L = mg/dL × 17.1. ## 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/gahs` 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": [ { "age": "40", "bilirubin_umol_l": "80", "pt_ratio": "1.2", "urea_mmol_l": "4", "wbc_k_ul": "8" }, { "age": "40", "bilirubin_umol_l": "80", "pt_ratio": "1.2", "urea_mmol_l": "4", "wbc_k_ul": "8" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/gahs Example 200: ```json { "count": 2, "path": "/api/calc/gahs", "items": [ { "components": [ { "value": 40, "factor": "age", "points": 1, "present": false }, { "value": 8.0, "factor": "wbc", "points": 1, "present": false }, { "value": 4.0, "factor": "urea", "points": 1, "present": false }, { "value": 1.2, "factor": "pt_ratio", "points": 1, "present": false }, { "value": 80.0, "factor": "bilirubin", "points": 1, "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": "Forrest EH, Evans CD, Stewart S, et al.", "doi": "10.1136/gut.2004.050781", "id": "forrest-2005", "source": "Gut. 2005;54(8):1174-1179", "title": "Analysis of factors predictive of mortality in alcoholic hepatitis and derivation and validation of the Glasgow alcoholic hepatitis score" }, "formula": "gahs", "formula_expression": "GAHS = age_points + wbc_points + urea_points + pt_ratio_points + bilirubin_points; range 5-12", "max_score": 12, "score": 5, "age_years": 40, "bilirubin_umol_l": 80.0, "gahs_band": "lt_9", "min_score": 5, "pt_ratio": 1.2, "urea_mmol_l": 4.0, "wbc_k_ul": 8.0 }, { "components": [ { "value": 40, "factor": "age", "points": 1, "present": false }, { "value": 8.0, "factor": "wbc", "points": 1, "present": false }, { "value": 4.0, "factor": "urea", "points": 1, "present": false }, { "value": 1.2, "factor": "pt_ratio", "points": 1, "present": false }, { "value": 80.0, "factor": "bilirubin", "points": 1, "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": "Forrest EH, Evans CD, Stewart S, et al.", "doi": "10.1136/gut.2004.050781", "id": "forrest-2005", "source": "Gut. 2005;54(8):1174-1179", "title": "Analysis of factors predictive of mortality in alcoholic hepatitis and derivation and validation of the Glasgow alcoholic hepatitis score" }, "formula": "gahs", "formula_expression": "GAHS = age_points + wbc_points + urea_points + pt_ratio_points + bilirubin_points; range 5-12", "max_score": 12, "score": 5, "age_years": 40, "bilirubin_umol_l": 80.0, "gahs_band": "lt_9", "min_score": 5, "pt_ratio": 1.2, "urea_mmol_l": 4.0, "wbc_k_ul": 8.0 } ] } ``` ## Response fields - `formula` (string): gahs - `formula_expression` (string): Exact expression used - `score` (integer): GAHS 5-12 - `max_score` (integer): 12 - `min_score` (integer): 5 - `gahs_band` (string): lt_9 or ge_9 (Forrest 2005 day-1 cutoff). A band, not a steroid order. - `age_years` (integer): Age used - `wbc_k_ul` (number): WBC in 10^9/L used - `urea_mmol_l` (number): Urea in mmol/L used - `pt_ratio` (number): PT ratio used - `bilirubin_umol_l` (number): Bilirubin in µmol/L used - `components` (array): Per-variable points - `citation` (object): Forrest et al. Gut 2005 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 40, "factor": "age", "points": 1, "present": false }, { "value": 8.0, "factor": "wbc", "points": 1, "present": false }, { "value": 4.0, "factor": "urea", "points": 1, "present": false }, { "value": 1.2, "factor": "pt_ratio", "points": 1, "present": false }, { "value": 80.0, "factor": "bilirubin", "points": 1, "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": "Forrest EH, Evans CD, Stewart S, et al.", "doi": "10.1136/gut.2004.050781", "id": "forrest-2005", "source": "Gut. 2005;54(8):1174-1179", "title": "Analysis of factors predictive of mortality in alcoholic hepatitis and derivation and validation of the Glasgow alcoholic hepatitis score" }, "formula": "gahs", "formula_expression": "GAHS = age_points + wbc_points + urea_points + pt_ratio_points + bilirubin_points; range 5-12", "max_score": 12, "score": 5, "age_years": 40, "bilirubin_umol_l": 80.0, "gahs_band": "lt_9", "min_score": 5, "pt_ratio": 1.2, "urea_mmol_l": 4.0, "wbc_k_ul": 8.0 } ``` ## Errors - HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged. - HTTP 400 `invalid_wbc`: wbc_k_ul (0.01-500) or wbc_ul (10-500000) is required Returned before settlement; you are not charged. - HTTP 400 `invalid_urea`: urea_mmol_l (1-50) or bun_mg_dl (3-140) is required, not both. Returned before settlement; you are not charged. - HTTP 400 `invalid_gahs_pt_ratio`: pt_ratio must be a number from 0.8 to 10. Returned before settlement; you are not charged. - HTTP 400 `invalid_bilirubin`: bilirubin_mg_dl (0.1-40) or bilirubin_umol_l (2-684) is required 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 - [Maddrey DF](https://magentlab.com/docs/maddrey) — Compute the 1978 Maddrey discriminant function from patient PT, control PT, and bilirubin. - [Child–Pugh](https://magentlab.com/docs/child-pugh) — Compute the Child–Turcotte–Pugh cirrhosis severity score from bilirubin, albumin, INR, encephalopathy, and ascites. - [MELD-Na](https://magentlab.com/docs/meld-na) — Compute OPTN/UNOS 2016 MELD and MELD-Na from creatinine, bilirubin, INR, sodium, and dialysis. ## 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 echoing accepted, payload, and extensions when present). - 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. - 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.