# Hestia criteria Hestia criteria Status: LIVE Price: $0.005 USDC `GET /api/calc/hestia` HTML: https://magentlab.com/docs/hestia Markdown: https://magentlab.com/docs/hestia.md 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 [Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study](https://doi.org/10.1111/j.1538-7836.2011.04388.x) Zondag W, Mos ICM, Creemers-Schild D, et al. J Thromb Haemost. 2011;9(8):1500-1507 DOI: [10.1111/j.1538-7836.2011.04388.x](https://doi.org/10.1111/j.1538-7836.2011.04388.x) ## Worked example ### All 11 exclusions absent Given: `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` 1. All 11 caller-assigned exclusion flags are false 2. Outpatient eligible ### Hemodynamic instability excludes home treatment Given: `creatinine_clearance_lt_30=false, hemodynamically_unstable=true, 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` 1. hemodynamically_unstable is true (caller-assigned, including SBP <100 with HR >100 or ICU) 2. 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 ## Parameters - `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. Method: `POST /api/calc/hestia` 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": [ { "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" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/hestia Example 200: ```json { "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 fields - `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 Frozen fixture. Not a live lookup. ```json { "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 } ``` ## 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 - [PESI](https://magentlab.com/docs/pesi) — Compute the Aujesky 2005 Pulmonary Embolism Severity Index (PESI) from age, sex, comorbidities, vital signs, and altered mental status. - [sPESI](https://magentlab.com/docs/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. - 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 EIP-3009 (scheme exact, assetTransferMethod eip3009) with validBefore = now + accepts[0].maxTimeoutSeconds (600 seconds). That window starts when you sign and must cover wallet confirmation plus CDP verify and settle. Magent retries transient facilitator 429/5xx before answering. Do not send upto or batch-settlement payloads; magent does not offer those schemes. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON echoing accepted, payload, and extensions when present). - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. Settlement happens before the tool runs. HTTP 503 settlement_uncertain or settle_failed: retry the same PAYMENT-SIGNATURE. Mint a new 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. - 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. - not offered `batch-settlement`: Not offered. Payment-channel vouchers claimed later in batches. Not the same as POST {items} bulk (that is still exact). 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 - 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.