Infection / VTE · LIVE

Hestia criteria

Apply the Zondag 2011 Hestia exclusion checklist and return whether outpatient treatment of acute PE is eligible from 11 caller-assigned items.

LIVE $0.005 USDC GET /api/calc/hestia

Markdown: /docs/hestia.md · Canonical: https://magentlab.com/docs/hestia

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

What it computes

Apply the Zondag 2011 Hestia exclusion checklist and return whether outpatient treatment of acute PE is eligible from 11 caller-assigned items.

When to use

When an agent already has proven acute PE in an adult, as in the Hestia Study, and needs the published outpatient-eligibility checklist from caller-assigned findings.

When not to use

Not a diagnosis of pulmonary embolism or of outpatient safety.
This tool is the Zondag 2011 Hestia exclusion checklist only. It is not PESI and not sPESI.
The caller assigns all 11 items. magent does not examine the patient or assign the 11 items.
Outpatient eligibility is the published checklist only: any yes excludes home treatment.

Formula

outpatient eligible iff none of the 11 exclusion criteria

Citation

Title: Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study
Authors: Zondag W, Mos ICM, Creemers-Schild D, et al.
Source: J Thromb Haemost. 2011;9(8):1500-1507
DOI: 10.1111/j.1538-7836.2011.04388.x

Worked example

All 11 exclusions absent

Given: creatinine_clearance_lt_30=falsehemodynamically_unstable=falsehigh_bleeding_risk=falsehistory_of_hit=falseiv_pain_meds_gt_24h=falsemedical_or_social_admission=falseoxygen_gt_24h=falsepe_on_anticoagulation=falsepregnant=falsesevere_liver_impairment=falsethrombolysis_or_embolectomy=false

All 11 caller-assigned exclusion flags are false
Outpatient eligible

Hemodynamic instability excludes home treatment

Given: creatinine_clearance_lt_30=falsehemodynamically_unstable=truehigh_bleeding_risk=falsehistory_of_hit=falseiv_pain_meds_gt_24h=falsemedical_or_social_admission=falseoxygen_gt_24h=falsepe_on_anticoagulation=falsepregnant=falsesevere_liver_impairment=falsethrombolysis_or_embolectomy=false

hemodynamically_unstable is true (caller-assigned, including SBP <100 with HR >100 or ICU)
Any yes excludes home treatment

Also searched as

Hestia criteria
Hestia Study
Zondag Hestia
Hestia PE rule
outpatient PE Hestia
Hestia exclusion criteria
home treatment pulmonary embolism

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/hestia?hemodynamically_unstable=false&thrombolysis_or_embolectomy=false&high_bleeding_risk=false&oxygen_gt_24h=false&pe_on_anticoagulation=false&iv_pain_meds_gt_24h=false&medical_or_social_admission=false&creatinine_clearance_lt_30=false&severe_liver_impairment=false&pregnant=false&history_of_hit=false

Full URL: https://api.magentlab.com/api/calc/hestia?hemodynamically_unstable=false&thrombolysis_or_embolectomy=false&high_bleeding_risk=false&oxygen_gt_24h=false&pe_on_anticoagulation=false&iv_pain_meds_gt_24h=false&medical_or_social_admission=false&creatinine_clearance_lt_30=false&severe_liver_impairment=false&pregnant=false&history_of_hit=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/hestia?hemodynamically_unstable=false&thrombolysis_or_embolectomy=false&high_bleeding_risk=false&oxygen_gt_24h=false&pe_on_anticoagulation=false&iv_pain_meds_gt_24h=false&medical_or_social_admission=false&creatinine_clearance_lt_30=false&severe_liver_impairment=false&pregnant=false&history_of_hit=false"

Parameters

Name	Type	Required	Description
`hemodynamically_unstable`	boolean	required	Hemodynamic instability left to the clinician, including SBP <100 mmHg with heart rate >100 or ICU admission, as assigned by the caller. true or false. magent does not measure blood pressure or heart rate.
`thrombolysis_or_embolectomy`	boolean	required	Thrombolysis or embolectomy necessary. true or false as assigned by the caller. magent does not decide reperfusion.
`high_bleeding_risk`	boolean	required	Active bleeding or high risk of bleeding as assigned by the caller (paper: GI bleeding in the preceding 14 days, stroke <4 weeks, operation <2 weeks, bleeding disorder or platelets <75×10^9/L, or uncontrolled hypertension SBP >180 or DBP >110). true or false. magent does not compute bleeding risk.
`oxygen_gt_24h`	boolean	required	More than 24 h of oxygen supply to keep SaO2 >90%, as assigned by the caller. true or false. magent does not compute oxygen duration or saturation.
`pe_on_anticoagulation`	boolean	required	Pulmonary embolism diagnosed during anticoagulant treatment. true or false as assigned by the caller.
`iv_pain_meds_gt_24h`	boolean	required	Severe pain needing intravenous pain medication for more than 24 h. true or false as assigned by the caller.
`medical_or_social_admission`	boolean	required	Medical or social reason for hospital treatment >24 h (paper: infection, malignancy, no support system). true or false as assigned by the caller.
`creatinine_clearance_lt_30`	boolean	required	Creatinine clearance <30 mL/min by Cockcroft-Gault, as assigned by the caller. true or false. magent does not compute Cockcroft-Gault.
`severe_liver_impairment`	boolean	required	Severe liver impairment as judged by the caller (paper: physician judgement). true or false. magent does not grade liver impairment.
`pregnant`	boolean	required	Pregnancy. true or false as assigned by the caller.
`history_of_hit`	boolean	required	Documented history of heparin-induced thrombocytopenia (HIT). true or false as assigned by the caller. magent does not diagnose HIT.

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.

POST /api/calc/hestia Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 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 (fixture)

{
  "items": [
    {
      "creatinine_clearance_lt_30": "false",
      "hemodynamically_unstable": "false",
      "high_bleeding_risk": "false",
      "history_of_hit": "false",
      "iv_pain_meds_gt_24h": "false",
      "medical_or_social_admission": "false",
      "oxygen_gt_24h": "false",
      "pe_on_anticoagulation": "false",
      "pregnant": "false",
      "severe_liver_impairment": "false",
      "thrombolysis_or_embolectomy": "false"
    },
    {
      "creatinine_clearance_lt_30": "false",
      "hemodynamically_unstable": "false",
      "high_bleeding_risk": "false",
      "history_of_hit": "false",
      "iv_pain_meds_gt_24h": "false",
      "medical_or_social_admission": "false",
      "oxygen_gt_24h": "false",
      "pe_on_anticoagulation": "false",
      "pregnant": "false",
      "severe_liver_impairment": "false",
      "thrombolysis_or_embolectomy": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/hestia",
  "items": [
    {
      "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": "Zondag W, Mos ICM, Creemers-Schild D, et al.",
        "doi": "10.1111/j.1538-7836.2011.04388.x",
        "id": "zondag-2011",
        "source": "J Thromb Haemost. 2011;9(8):1500-1507",
        "title": "Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study"
      },
      "formula": "hestia",
      "formula_expression": "outpatient eligible iff none of the 11 exclusion criteria",
      "criteria": [
        {
          "factor": "hemodynamically_unstable",
          "met": false
        },
        {
          "factor": "thrombolysis_or_embolectomy",
          "met": false
        },
        {
          "factor": "high_bleeding_risk",
          "met": false
        },
        {
          "factor": "oxygen_gt_24h",
          "met": false
        },
        {
          "factor": "pe_on_anticoagulation",
          "met": false
        },
        {
          "factor": "iv_pain_meds_gt_24h",
          "met": false
        },
        {
          "factor": "medical_or_social_admission",
          "met": false
        },
        {
          "factor": "creatinine_clearance_lt_30",
          "met": false
        },
        {
          "factor": "severe_liver_impairment",
          "met": false
        },
        {
          "factor": "pregnant",
          "met": false
        },
        {
          "factor": "history_of_hit",
          "met": false
        }
      ],
      "outpatient_eligible": true
    },
    {
      "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": "Zondag W, Mos ICM, Creemers-Schild D, et al.",
        "doi": "10.1111/j.1538-7836.2011.04388.x",
        "id": "zondag-2011",
        "source": "J Thromb Haemost. 2011;9(8):1500-1507",
        "title": "Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study"
      },
      "formula": "hestia",
      "formula_expression": "outpatient eligible iff none of the 11 exclusion criteria",
      "criteria": [
        {
          "factor": "hemodynamically_unstable",
          "met": false
        },
        {
          "factor": "thrombolysis_or_embolectomy",
          "met": false
        },
        {
          "factor": "high_bleeding_risk",
          "met": false
        },
        {
          "factor": "oxygen_gt_24h",
          "met": false
        },
        {
          "factor": "pe_on_anticoagulation",
          "met": false
        },
        {
          "factor": "iv_pain_meds_gt_24h",
          "met": false
        },
        {
          "factor": "medical_or_social_admission",
          "met": false
        },
        {
          "factor": "creatinine_clearance_lt_30",
          "met": false
        },
        {
          "factor": "severe_liver_impairment",
          "met": false
        },
        {
          "factor": "pregnant",
          "met": false
        },
        {
          "factor": "history_of_hit",
          "met": false
        }
      ],
      "outpatient_eligible": true
    }
  ]
}

Response

Field	Type	Description
`formula`	string	hestia
`formula_expression`	string	Outpatient eligible iff none of the 11 Zondag 2011 exclusion criteria
`outpatient_eligible`	boolean	true only when all 11 exclusion criteria are absent. Any yes excludes home treatment. Not a diagnosis.
`criteria`	array	Per-factor rows with factor and met; met is true when that exclusion is present
`citation`	object	Zondag 2011 J Thromb Haemost citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "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": "Zondag W, Mos ICM, Creemers-Schild D, et al.",
    "doi": "10.1111/j.1538-7836.2011.04388.x",
    "id": "zondag-2011",
    "source": "J Thromb Haemost. 2011;9(8):1500-1507",
    "title": "Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study"
  },
  "formula": "hestia",
  "formula_expression": "outpatient eligible iff none of the 11 exclusion criteria",
  "criteria": [
    {
      "factor": "hemodynamically_unstable",
      "met": false
    },
    {
      "factor": "thrombolysis_or_embolectomy",
      "met": false
    },
    {
      "factor": "high_bleeding_risk",
      "met": false
    },
    {
      "factor": "oxygen_gt_24h",
      "met": false
    },
    {
      "factor": "pe_on_anticoagulation",
      "met": false
    },
    {
      "factor": "iv_pain_meds_gt_24h",
      "met": false
    },
    {
      "factor": "medical_or_social_admission",
      "met": false
    },
    {
      "factor": "creatinine_clearance_lt_30",
      "met": false
    },
    {
      "factor": "severe_liver_impairment",
      "met": false
    },
    {
      "factor": "pregnant",
      "met": false
    },
    {
      "factor": "history_of_hit",
      "met": false
    }
  ],
  "outpatient_eligible": true
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_flag`	boolean clinical flags must be true or false Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

PESI — Compute the Aujesky 2005 Pulmonary Embolism Severity Index (PESI) from age, sex, comorbidities, vital signs, and altered mental status.
sPESI — Compute the Jiménez 2010 simplified Pulmonary Embolism Severity Index (sPESI) from age and five caller-assigned findings.

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. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

Invalid query parameters return HTTP 400 before settlement. You are not charged.
Settlement finishes before the tool executes (paymentFlow upfront). 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.