# GI-GPA GI-GPA Status: LIVE Price: $0.005 USDC `GET /api/calc/gi_gpa` HTML: https://magentlab.com/docs/gi-gpa Markdown: https://magentlab.com/docs/gi-gpa.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Sperduto 2019 updated GI-GPA (graded prognostic assessment for gastrointestinal cancers with brain metastases) from caller-assigned KPS, age, extracranial metastases, and number of brain metastases, and report the published GPA group and median survival. ## When to use When an agent already has Karnofsky Performance Status (decades 10-100), age, presence or absence of extracranial metastases, and brain-metastasis count, and must not invent GI-GPA points, assign KPS, or treat the score as a treatment order or lung-molGPA. ## When not to use - Not a medical device and not a treatment order. - Sperduto 2019 Table 4 footnote lists median survival 3, 9, 12, 17 months; magent uses the abstract/Kaplan-Meier figures 3, 7, 11, 17 months for GPA groups 0-1.0, 1.5-2.0, 2.5-3.0, and 3.5-4.0. - Not lung-molGPA. This is the updated GI-GPA for gastrointestinal cancers with brain metastases (Sperduto 2019), not the lung-molGPA index. - The caller assigns KPS 10-100 by tens. magent does not assign KPS or examine the patient. ## Formula ``` GI-GPA = kps_pts + age_pts + extracranial_pts + brain_met_pts; KPS <80 (10-70) 0, 80 1.0, 90-100 2.0; age >=60 0, <60 0.5; extracranial mets present 0, absent 0.5; brain mets >3 0, 2-3 0.5, 1 1.0; groups 0-1.0 / 1.5-2.0 / 2.5-3.0 / 3.5-4.0; max 4.0 (Sperduto 2019 Table 4; median survival from abstract/KM 3, 7, 11, 17 months) ``` ## Citation [Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA)](https://doi.org/10.1016/j.ctro.2019.06.007) Sperduto PW, Fang P, Li J, et al. Clin Transl Radiat Oncol. 2019;18:39-45 DOI: [10.1016/j.ctro.2019.06.007](https://doi.org/10.1016/j.ctro.2019.06.007) ## Worked example ### KPS 100, age 50, no extracranial mets, one brain met Given: `age=50, brain_metastasis_count=1, extracranial_metastases=false, kps=100` 1. KPS 100 is 90-100 → 2.0; age 50 is <60 → 0.5; extracranial mets absent → 0.5; one brain met → 1.0 2. Score = 4.0 (max 4.0); gpa_group 3.5-4.0; median survival 17 months (abstract/KM) ### KPS 70, age 70, extracranial mets, five brain mets Given: `age=70, brain_metastasis_count=5, extracranial_metastases=true, kps=70` 1. KPS 70 is <80 → 0; age 70 is >=60 → 0; extracranial mets present → 0; five brain mets >3 → 0 2. Score = 0 (max 4.0); gpa_group 0-1.0; median survival 3 months (abstract/KM) ### KPS 80, age 55, no extracranial mets, two brain mets Given: `age=55, brain_metastasis_count=2, extracranial_metastases=false, kps=80` 1. KPS 80 → 1.0; age 55 is <60 → 0.5; extracranial mets absent → 0.5; two brain mets → 0.5 2. Score = 2.5 (max 4.0); gpa_group 2.5-3.0; median survival 11 months (abstract/KM) ### KPS 80, age 70, extracranial mets, one brain met Given: `age=70, brain_metastasis_count=1, extracranial_metastases=true, kps=80` 1. KPS 80 → 1.0; age 70 is >=60 → 0; extracranial mets present → 0; one brain met → 1.0 2. Score = 2.0 (max 4.0); gpa_group 1.5-2.0; median survival 7 months (abstract/KM) ## Also searched as - GI-GPA - gastrointestinal GPA - Sperduto GI-GPA - graded prognostic assessment GI - GI cancer brain metastases GPA - updated GI-GPA - Sperduto 2019 GI-GPA - GI GPA median survival ## Parameters - `kps` (integer, required): Caller-assigned Karnofsky Performance Status decade 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100. Sperduto 2019 Table 4: <80 (10-70) scores 0; 80 scores 1.0; 90-100 scores 2.0. Grade 0 (dead) is not scored. magent does not assign KPS. - `age` (integer, required): Age in years (18-120). Sperduto 2019 Table 4: >=60 scores 0; <60 scores 0.5. - `extracranial_metastases` (boolean, required): Extracranial metastases (ECM). true (present) scores 0; false (absent) scores 0.5 (Sperduto 2019 Table 4). magent does not stage extracranial disease. - `brain_metastasis_count` (integer, required): Number of brain metastases (integer 1-50). Sperduto 2019 Table 4: >3 scores 0; 2-3 scores 0.5; 1 scores 1.0. magent does not count metastases on imaging. ## 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/gi_gpa` 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": "50", "brain_metastasis_count": "1", "extracranial_metastases": "false", "kps": "100" }, { "age": "50", "brain_metastasis_count": "1", "extracranial_metastases": "false", "kps": "100" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/gi-gpa Example 200: ```json { "count": 2, "path": "/api/calc/gi_gpa", "items": [ { "components": [ { "value": 100, "factor": "kps", "points": 2.0, "present": true }, { "value": 50, "factor": "age", "points": 0.5, "present": true }, { "value": false, "factor": "extracranial_metastases", "points": 0.5, "present": true }, { "value": 1, "factor": "brain_metastasis_count", "points": 1.0, "present": true } ], "age": 50, "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": "Sperduto PW, Fang P, Li J, et al.", "doi": "10.1016/j.ctro.2019.06.007", "id": "sperduto-2019-gi-gpa", "pmid": "31341974", "source": "Clin Transl Radiat Oncol. 2019;18:39-45", "title": "Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA)" }, "formula": "gi_gpa", "formula_expression": "GI-GPA = kps_pts + age_pts + extracranial_pts + brain_met_pts; KPS <80 (10-70) 0, 80 1.0, 90-100 2.0; age >=60 0, <60 0.5; extracranial mets present 0, absent 0.5; brain mets >3 0, 2-3 0.5, 1 1.0; groups 0-1.0 / 1.5-2.0 / 2.5-3.0 / 3.5-4.0; max 4.0 (Sperduto 2019 Table 4; median survival from abstract/KM 3, 7, 11, 17 months)", "max_score": 4.0, "score": 4.0, "brain_metastasis_count": 1, "extracranial_metastases": false, "gpa_group": "3.5-4.0", "kps": 100, "median_survival_months": 17 }, { "components": [ { "value": 100, "factor": "kps", "points": 2.0, "present": true }, { "value": 50, "factor": "age", "points": 0.5, "present": true }, { "value": false, "factor": "extracranial_metastases", "points": 0.5, "present": true }, { "value": 1, "factor": "brain_metastasis_count", "points": 1.0, "present": true } ], "age": 50, "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": "Sperduto PW, Fang P, Li J, et al.", "doi": "10.1016/j.ctro.2019.06.007", "id": "sperduto-2019-gi-gpa", "pmid": "31341974", "source": "Clin Transl Radiat Oncol. 2019;18:39-45", "title": "Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA)" }, "formula": "gi_gpa", "formula_expression": "GI-GPA = kps_pts + age_pts + extracranial_pts + brain_met_pts; KPS <80 (10-70) 0, 80 1.0, 90-100 2.0; age >=60 0, <60 0.5; extracranial mets present 0, absent 0.5; brain mets >3 0, 2-3 0.5, 1 1.0; groups 0-1.0 / 1.5-2.0 / 2.5-3.0 / 3.5-4.0; max 4.0 (Sperduto 2019 Table 4; median survival from abstract/KM 3, 7, 11, 17 months)", "max_score": 4.0, "score": 4.0, "brain_metastasis_count": 1, "extracranial_metastases": false, "gpa_group": "3.5-4.0", "kps": 100, "median_survival_months": 17 } ] } ``` ## Response fields - `formula` (string): gi_gpa - `formula_expression` (string): Exact expression used - `score` (number): Total GI-GPA points 0-4.0 in 0.5 steps - `max_score` (number): Always 4.0 - `gpa_group` (string): 0-1.0, 1.5-2.0, 2.5-3.0, or 3.5-4.0 from Sperduto 2019 - `median_survival_months` (integer): Published median survival in months for that GPA group from the Sperduto 2019 abstract/Kaplan-Meier figures (3, 7, 11, 17), not the Table 4 footnote - `kps` (integer): Caller-assigned Karnofsky decade used for points - `age` (integer): Age in years used for points - `extracranial_metastases` (boolean): true if extracranial metastases are present - `brain_metastasis_count` (integer): Number of brain metastases used for points - `components` (array): Per-factor points - `citation` (object): Sperduto 2019 Clin Transl Radiat Oncol citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 100, "factor": "kps", "points": 2.0, "present": true }, { "value": 50, "factor": "age", "points": 0.5, "present": true }, { "value": false, "factor": "extracranial_metastases", "points": 0.5, "present": true }, { "value": 1, "factor": "brain_metastasis_count", "points": 1.0, "present": true } ], "age": 50, "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": "Sperduto PW, Fang P, Li J, et al.", "doi": "10.1016/j.ctro.2019.06.007", "id": "sperduto-2019-gi-gpa", "pmid": "31341974", "source": "Clin Transl Radiat Oncol. 2019;18:39-45", "title": "Estimating survival in patients with gastrointestinal cancers and brain metastases: An update of the graded prognostic assessment for gastrointestinal cancers (GI-GPA)" }, "formula": "gi_gpa", "formula_expression": "GI-GPA = kps_pts + age_pts + extracranial_pts + brain_met_pts; KPS <80 (10-70) 0, 80 1.0, 90-100 2.0; age >=60 0, <60 0.5; extracranial mets present 0, absent 0.5; brain mets >3 0, 2-3 0.5, 1 1.0; groups 0-1.0 / 1.5-2.0 / 2.5-3.0 / 3.5-4.0; max 4.0 (Sperduto 2019 Table 4; median survival from abstract/KM 3, 7, 11, 17 months)", "max_score": 4.0, "score": 4.0, "brain_metastasis_count": 1, "extracranial_metastases": false, "gpa_group": "3.5-4.0", "kps": 100, "median_survival_months": 17 } ``` ## Errors - HTTP 400 `invalid_karnofsky`: kps must be 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 (Karnofsky 1949). Grade 0 (dead) is not scored. Returned before settlement; you are not charged. - HTTP 400 `invalid_age`: age must be an integer from 18 to 120 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_brain_metastasis_count`: brain_metastasis_count must be an integer from 1 to 50 (Sperduto 2019 number of brain metastases). 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 - [Brain metastasis velocity](https://magentlab.com/docs/bmv) — Compute Farris 2017 brain metastasis velocity as new_brain_metastases / years_since_first_srs and report the published low, intermediate, or high group plus that group's median overall survival after initial distant brain failure. - [THRIVE](https://magentlab.com/docs/thrive) — Compute the Flint 2010 THRIVE (Totaled Health Risks in Vascular Events) score from trichotomized age, trichotomized NIHSS, and the chronic disease scale (hypertension, diabetes mellitus, atrial fibrillation). - [Karnofsky](https://magentlab.com/docs/karnofsky) — Return the Karnofsky 1949 Performance Status 10-100 from a caller-assigned integer, with a stable label. ## 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.