# HAS-BLED

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/has_bled`
HTML: https://magentlab.com/docs/has-bled
Markdown: https://magentlab.com/docs/has-bled.md

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

## What it computes

Compute the HAS-BLED bleeding-risk score from discrete clinical flags.

## When to use

When an agent needs AF bleeding-risk arithmetic and must not invent the point total from prose.

## When not to use

- Not a diagnosis and not a treatment or anticoagulation recommendation.
- Labile INR and other flags are caller-supplied. magent does not read an INR time-in-range.

## Formula

```
HAS-BLED = hypertension + abnormal_renal + abnormal_liver + stroke + bleeding + labile_inr + elderly(age>65) + drugs + alcohol; max 9
```

## Citation

A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey
Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GYH
Chest. 2010;138(5):1093-1100
DOI: [10.1378/chest.10-0134](https://doi.org/10.1378/chest.10-0134)

## Worked example

### Age 78, hypertension only

Given: `abnormal_liver=false, abnormal_renal=false, age=78, alcohol=false, bleeding=false, drugs=false, hypertension=true, labile_inr=false, stroke=false`

1. Hypertension → 1; age >65 → 1
2. Score = 2


## Parameters

- `age` (integer, required): Age in years (18-120). Age >65 scores 1 (E).
- `hypertension` (boolean, required): Uncontrolled hypertension (H). true or false.
- `abnormal_renal` (boolean, required): Abnormal renal function (A). true or false.
- `abnormal_liver` (boolean, required): Abnormal liver function (A). true or false. Renal and liver each score 1.
- `stroke` (boolean, required): Prior stroke (S). true or false.
- `bleeding` (boolean, required): Bleeding history or predisposition (B). true or false.
- `labile_inr` (boolean, required): Labile INR (L). true or false.
- `drugs` (boolean, required): Concomitant antiplatelet or NSAID (D). true or false.
- `alcohol` (boolean, required): Alcohol excess (D). true or false. Drugs and alcohol each score 1.

## Bulk (POST)

POST the same path with a JSON items array. Price is n times the GET unit. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/has_bled`
Max items: 25
Price: unit_amount * n (unit 5000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- 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": [
    {
      "abnormal_liver": "false",
      "abnormal_renal": "false",
      "age": "78",
      "alcohol": "false",
      "bleeding": "false",
      "drugs": "false",
      "hypertension": "true",
      "labile_inr": "false",
      "stroke": "false"
    },
    {
      "abnormal_liver": "false",
      "abnormal_renal": "false",
      "age": "78",
      "alcohol": "false",
      "bleeding": "false",
      "drugs": "false",
      "hypertension": "true",
      "labile_inr": "false",
      "stroke": "false"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/has-bled

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/has_bled",
  "items": [
    {
      "components": [
        {
          "factor": "hypertension",
          "points": 1,
          "present": true
        },
        {
          "factor": "abnormal_renal",
          "points": 0,
          "present": false
        },
        {
          "factor": "abnormal_liver",
          "points": 0,
          "present": false
        },
        {
          "factor": "stroke",
          "points": 0,
          "present": false
        },
        {
          "factor": "bleeding",
          "points": 0,
          "present": false
        },
        {
          "factor": "labile_inr",
          "points": 0,
          "present": false
        },
        {
          "value": 78,
          "factor": "elderly_age_gt_65",
          "points": 1,
          "present": true
        },
        {
          "factor": "drugs",
          "points": 0,
          "present": false
        },
        {
          "factor": "alcohol",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or coded-ontology output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "age_years": 78,
      "citation": {
        "authors": "Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GYH",
        "doi": "10.1378/chest.10-0134",
        "id": "pisters-2010",
        "source": "Chest. 2010;138(5):1093-1100",
        "title": "A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey"
      },
      "formula": "has_bled",
      "formula_expression": "HAS-BLED = hypertension + abnormal_renal + abnormal_liver + stroke + bleeding + labile_inr + elderly(age>65) + drugs + alcohol; max 9",
      "max_score": 9,
      "score": 2
    },
    {
      "components": [
        {
          "factor": "hypertension",
          "points": 1,
          "present": true
        },
        {
          "factor": "abnormal_renal",
          "points": 0,
          "present": false
        },
        {
          "factor": "abnormal_liver",
          "points": 0,
          "present": false
        },
        {
          "factor": "stroke",
          "points": 0,
          "present": false
        },
        {
          "factor": "bleeding",
          "points": 0,
          "present": false
        },
        {
          "factor": "labile_inr",
          "points": 0,
          "present": false
        },
        {
          "value": 78,
          "factor": "elderly_age_gt_65",
          "points": 1,
          "present": true
        },
        {
          "factor": "drugs",
          "points": 0,
          "present": false
        },
        {
          "factor": "alcohol",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or coded-ontology output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "age_years": 78,
      "citation": {
        "authors": "Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GYH",
        "doi": "10.1378/chest.10-0134",
        "id": "pisters-2010",
        "source": "Chest. 2010;138(5):1093-1100",
        "title": "A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey"
      },
      "formula": "has_bled",
      "formula_expression": "HAS-BLED = hypertension + abnormal_renal + abnormal_liver + stroke + bleeding + labile_inr + elderly(age>65) + drugs + alcohol; max 9",
      "max_score": 9,
      "score": 2
    }
  ]
}
```

## Response fields

- `formula` (string): has_bled
- `formula_expression` (string): Exact expression used
- `score` (integer): Total points 0-9
- `max_score` (integer): Always 9
- `age_years` (integer): Age used for the E criterion
- `components` (array): Per-factor points
- `citation` (object): Chest 2010 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "factor": "hypertension",
      "points": 1,
      "present": true
    },
    {
      "factor": "abnormal_renal",
      "points": 0,
      "present": false
    },
    {
      "factor": "abnormal_liver",
      "points": 0,
      "present": false
    },
    {
      "factor": "stroke",
      "points": 0,
      "present": false
    },
    {
      "factor": "bleeding",
      "points": 0,
      "present": false
    },
    {
      "factor": "labile_inr",
      "points": 0,
      "present": false
    },
    {
      "value": 78,
      "factor": "elderly_age_gt_65",
      "points": 1,
      "present": true
    },
    {
      "factor": "drugs",
      "points": 0,
      "present": false
    },
    {
      "factor": "alcohol",
      "points": 0,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or coded-ontology output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "age_years": 78,
  "citation": {
    "authors": "Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GYH",
    "doi": "10.1378/chest.10-0134",
    "id": "pisters-2010",
    "source": "Chest. 2010;138(5):1093-1100",
    "title": "A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey"
  },
  "formula": "has_bled",
  "formula_expression": "HAS-BLED = hypertension + abnormal_renal + abnormal_liver + stroke + bleeding + labile_inr + elderly(age>65) + drugs + alcohol; max 9",
  "max_score": 9,
  "score": 2
}
```

## Errors

- 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_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.
- HTTP 402 `payment_required`: Missing or invalid PAYMENT-SIGNATURE; decode the PAYMENT-REQUIRED header
- HTTP 409 `payment_in_progress`: The same authorization nonce is already being settled; retry shortly
- HTTP 429 `rate_limited`: Too many requests from this client
- HTTP 503 `settlement_uncertain`: Settlement is unconfirmed; retry with the same PAYMENT-SIGNATURE
- HTTP 503 `facilitator_unavailable`: Payment facilitator unavailable
- HTTP 503 `facilitator_misconfigured`: Payment facilitator is not configured
- HTTP 503 `facilitator_unauthorized`: Payment facilitator rejected credentials
- HTTP 503 `ledger_unavailable`: Payment ledger unavailable
- HTTP 503 `payment_unavailable`: Payment processing unavailable

## Related tools

- [CHA2DS2-VASc](https://magentlab.com/docs/cha2ds2-vasc) — Compute the CHA2DS2-VASc stroke-risk score from discrete clinical flags.

## Also searched as

- HASBLED
- HAS BLED score
- Pisters bleeding score
- AF bleed risk

## Payment

Required query parameters must be present and valid. 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.

## Guarantees

- Invalid query parameters return HTTP 400 before settlement. You are not charged.
- Settlement finishes before the tool executes. Uncertain settlement fails closed (HTTP 503).
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are not persisted. Request logs store path without query.