# HFA-ICOS VEGF-inhibitor baseline CV risk HFA-ICOS VEGF-inhibitor baseline CV risk Status: LIVE Price: $0.005 USDC `GET /api/calc/hfa_icos_vegf` HTML: https://magentlab.com/docs/hfa-icos-vegf Markdown: https://magentlab.com/docs/hfa-icos-vegf.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Classify Lyon 2020 HFA-ICOS baseline cardiovascular risk for someone scheduled to receive VEGF inhibitors or VEGF TKIs, using that table's very-high, High, Medium 2, and Medium 1 rows. ## When to use When an agent already has caller-assigned age, sex, LVEF, QTc, and the VEGF-inhibitor table's yes/no factors and needs the published low/medium/high/very-high class plus cardiotoxicity guide. magent does not measure QTc or decide whether to start a VEGF inhibitor. ## When not to use - Not a medical device. Not a treatment, hold, or monitoring order for VEGF inhibitors or VEGF TKIs. - Cardiotoxicity percentages are a published guide (low <2%, medium 2-9%, high 10-19%, very high >=20%). The paper states evidence for defining absolute risk is limited. - magent does not measure QTc, LVEF, troponin, BNP, lipids, eGFR, or BMI, and does not assign vascular disease, arrhythmia, or smoking history. - Hypertension, diabetes, hyperlipidemia, CKD, proteinuria, smoking, and obesity are caller-assigned flags matching Lyon 2020 footnotes, not computed from labs. - One Medium 1 factor remains low risk. Age >=75 is High only. QTc >=480 ms is High only. LVEF <50% is High only. ## Formula ``` HFA-ICOS VEGF-inhibitor class (Lyon 2020): very_high if any very-high factor; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low. medium_points = Medium 2 + Medium 1 only. Very high: heart_failure_or_cardiomyopathy, arterial_vascular_disease (IHD, PCI, CABG, stable angina, TIA, stroke, or PVD). High: venous_thrombosis, lvef_percent<50, qtc_ms>=480, age_years>=75, hypertension, prior_anthracycline. Medium 2: lvef 50-54, male 450<=qtc<480, female 460<=qtc<480, arrhythmia (AF/flutter/VT/VF). Medium 1: elevated_troponin, elevated_bnp, age 65-74, diabetes, hyperlipidemia, ckd, proteinuria, prior_left_chest_or_mediastinal_rt, current_or_significant_smoker, obesity. Age exclusive (>=75 High; 65-74 Medium 1; <65 none). LVEF exclusive (<50 High; 50-54 Medium 2; >=55 none). QTc exclusive (>=480 High; else sex-specific Medium 2). cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20% ``` ## Citation [Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society](https://doi.org/10.1002/ejhf.1920) Lyon AR, Dent S, Stanway S, et al. Eur J Heart Fail. 2020;22(11):1945-1960 DOI: [10.1002/ejhf.1920](https://doi.org/10.1002/ejhf.1920) ## Worked example ### Age 50, no factors Given: `age_years=50, arrhythmia=false, arterial_vascular_disease=false, ckd=false, current_or_significant_smoker=false, diabetes=false, elevated_bnp=false, elevated_troponin=false, heart_failure_or_cardiomyopathy=false, hyperlipidemia=false, hypertension=false, lvef_percent=60, obesity=false, prior_anthracycline=false, prior_left_chest_or_mediastinal_rt=false, proteinuria=false, qtc_ms=400, sex=female, venous_thrombosis=false` 1. No very-high or High factors 2. medium_points = 0 3. risk_level low; cardiotoxicity_guide <2% ### Arterial vascular disease Given: `age_years=50, arrhythmia=false, arterial_vascular_disease=true, ckd=false, current_or_significant_smoker=false, diabetes=false, elevated_bnp=false, elevated_troponin=false, heart_failure_or_cardiomyopathy=false, hyperlipidemia=false, hypertension=false, lvef_percent=60, obesity=false, prior_anthracycline=false, prior_left_chest_or_mediastinal_rt=false, proteinuria=false, qtc_ms=400, sex=female, venous_thrombosis=false` 1. arterial_vascular_disease is a very-high factor 2. risk_level very_high; cardiotoxicity_guide >=20% ### Hypertension only Given: `age_years=50, arrhythmia=false, arterial_vascular_disease=false, ckd=false, current_or_significant_smoker=false, diabetes=false, elevated_bnp=false, elevated_troponin=false, heart_failure_or_cardiomyopathy=false, hyperlipidemia=false, hypertension=true, lvef_percent=60, obesity=false, prior_anthracycline=false, prior_left_chest_or_mediastinal_rt=false, proteinuria=false, qtc_ms=400, sex=female, venous_thrombosis=false` 1. hypertension is a High factor on the VEGF-inhibitor table 2. risk_level high; cardiotoxicity_guide 10-19% ## Also searched as - HFA-ICOS VEGF - VEGF inhibitor cardiovascular risk - VEGF TKI baseline risk - Lyon 2020 VEGF - cardio-oncology VEGF inhibitors - HFA ICOS VEGF inhibitors ## Parameters - `age_years` (integer, required): Integer age in years (18-100) as assigned by the caller. Lyon 2020 VEGF-inhibitor table: >=75 High; 65-74 Medium 1; <65 no age points. Bands are exclusive. magent does not read an identity document. - `sex` (string, required): male or female as assigned by the caller. Used only for the sex-specific borderline QTc Medium 2 band (men 450-479 ms; women 460-479 ms). - `lvef_percent` (integer, required): Baseline left-ventricular ejection fraction, integer percent 10-80, as assigned by the caller. <50 High; 50-54 Medium 2; >=55 no LVEF points. magent does not read an echocardiogram. - `qtc_ms` (integer, required): Baseline QTc in milliseconds, integer 300-700, as assigned by the caller. >=480 High; men 450-479 Medium 2; women 460-479 Medium 2. magent does not measure QTc. - `heart_failure_or_cardiomyopathy` (boolean, required): Heart failure or cardiomyopathy (Lyon 2020 VEGF-inhibitor table, very high). Caller-assigned. true or false. - `arterial_vascular_disease` (boolean, required): Arterial vascular disease: IHD, PCI, CABG, stable angina, TIA, stroke, or PVD as one caller bool (Lyon 2020 VEGF-inhibitor table, very high). true or false. magent does not diagnose vascular disease. - `venous_thrombosis` (boolean, required): Venous thrombosis (DVT or PE) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, High). true or false. - `hypertension` (boolean, required): Hypertension (SBP >140 mmHg or DBP >90 mmHg, or on treatment) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, High). true or false. magent does not read a blood-pressure cuff. - `prior_anthracycline` (boolean, required): Prior anthracycline exposure as assigned by the caller (Lyon 2020 VEGF-inhibitor table, High). true or false. - `arrhythmia` (boolean, required): Arrhythmia (atrial fibrillation, atrial flutter, ventricular tachycardia, or ventricular fibrillation) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 2). true or false. - `elevated_troponin` (boolean, required): Elevated baseline troponin above the local laboratory upper limit of normal as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. magent does not assay troponin. - `elevated_bnp` (boolean, required): Elevated baseline BNP or NT-proBNP above the local laboratory upper limit of normal as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. magent does not assay BNP. - `diabetes` (boolean, required): Diabetes mellitus (glycated haemoglobin >7.0% or >53 mmol/mol, or on treatment) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. - `hyperlipidemia` (boolean, required): Hyperlipidemia (non-HDL cholesterol >3.8 mmol/L or >145 mg/dL) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. magent does not convert lipid units. - `ckd` (boolean, required): Chronic kidney disease (eGFR <60 mL/min/1.73 m2) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. magent does not compute eGFR. - `proteinuria` (boolean, required): Proteinuria as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. - `prior_left_chest_or_mediastinal_rt` (boolean, required): Prior radiotherapy to the left chest or mediastinum as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. - `current_or_significant_smoker` (boolean, required): Current smoker or significant smoking history as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. - `obesity` (boolean, required): Obesity (BMI >30 kg/m2) as assigned by the caller (Lyon 2020 VEGF-inhibitor table, Medium 1). true or false. magent does not compute BMI. ## 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/hfa_icos_vegf` 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_years": "50", "arrhythmia": "false", "arterial_vascular_disease": "false", "ckd": "false", "current_or_significant_smoker": "false", "diabetes": "false", "elevated_bnp": "false", "elevated_troponin": "false", "heart_failure_or_cardiomyopathy": "false", "hyperlipidemia": "false", "hypertension": "false", "lvef_percent": "60", "obesity": "false", "prior_anthracycline": "false", "prior_left_chest_or_mediastinal_rt": "false", "proteinuria": "false", "qtc_ms": "400", "sex": "female", "venous_thrombosis": "false" }, { "age_years": "50", "arrhythmia": "false", "arterial_vascular_disease": "false", "ckd": "false", "current_or_significant_smoker": "false", "diabetes": "false", "elevated_bnp": "false", "elevated_troponin": "false", "heart_failure_or_cardiomyopathy": "false", "hyperlipidemia": "false", "hypertension": "false", "lvef_percent": "60", "obesity": "false", "prior_anthracycline": "false", "prior_left_chest_or_mediastinal_rt": "false", "proteinuria": "false", "qtc_ms": "400", "sex": "female", "venous_thrombosis": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/hfa-icos-vegf Example 200: ```json { "count": 2, "path": "/api/calc/hfa_icos_vegf", "items": [ { "components": [ { "factor": "heart_failure_or_cardiomyopathy", "points": 0, "present": false, "tier": "very_high" }, { "factor": "arterial_vascular_disease", "points": 0, "present": false, "tier": "very_high" }, { "factor": "venous_thrombosis", "points": 0, "present": false, "tier": "high" }, { "factor": "lvef_lt_50", "points": 0, "present": false, "tier": "high" }, { "factor": "qtc_ge_480", "points": 0, "present": false, "tier": "high" }, { "factor": "age_ge_75", "points": 0, "present": false, "tier": "high" }, { "factor": "hypertension", "points": 0, "present": false, "tier": "high" }, { "factor": "prior_anthracycline", "points": 0, "present": false, "tier": "high" }, { "factor": "lvef_50_to_54", "points": 0, "present": false, "tier": "medium_2" }, { "factor": "borderline_qtc", "points": 0, "present": false, "tier": "medium_2" }, { "factor": "arrhythmia", "points": 0, "present": false, "tier": "medium_2" }, { "factor": "elevated_troponin", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "elevated_bnp", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "age_65_to_74", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "diabetes", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "hyperlipidemia", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "ckd", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "proteinuria", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "prior_left_chest_or_mediastinal_rt", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "current_or_significant_smoker", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "obesity", "points": 0, "present": false, "tier": "medium_1" } ], "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": "Lyon AR, Dent S, Stanway S, et al.", "doi": "10.1002/ejhf.1920", "id": "lyon-2020", "pmid": "32458582", "source": "Eur J Heart Fail. 2020;22(11):1945-1960", "title": "Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society" }, "formula": "hfa_icos_vegf", "formula_expression": "HFA-ICOS VEGF-inhibitor class (Lyon 2020): very_high if any very-high factor; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low. medium_points = Medium 2 + Medium 1 only. Very high: heart_failure_or_cardiomyopathy, arterial_vascular_disease (IHD, PCI, CABG, stable angina, TIA, stroke, or PVD). High: venous_thrombosis, lvef_percent<50, qtc_ms>=480, age_years>=75, hypertension, prior_anthracycline. Medium 2: lvef 50-54, male 450<=qtc<480, female 460<=qtc<480, arrhythmia (AF/flutter/VT/VF). Medium 1: elevated_troponin, elevated_bnp, age 65-74, diabetes, hyperlipidemia, ckd, proteinuria, prior_left_chest_or_mediastinal_rt, current_or_significant_smoker, obesity. Age exclusive (>=75 High; 65-74 Medium 1; <65 none). LVEF exclusive (<50 High; 50-54 Medium 2; >=55 none). QTc exclusive (>=480 High; else sex-specific Medium 2). cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%", "age_years": 50, "sex": "female", "qtc_ms": 400, "cardiotoxicity_guide": "<2%", "lvef_percent": 60, "medium_points": 0, "risk_level": "low", "high_factor": false, "very_high_factor": false }, { "components": [ { "factor": "heart_failure_or_cardiomyopathy", "points": 0, "present": false, "tier": "very_high" }, { "factor": "arterial_vascular_disease", "points": 0, "present": false, "tier": "very_high" }, { "factor": "venous_thrombosis", "points": 0, "present": false, "tier": "high" }, { "factor": "lvef_lt_50", "points": 0, "present": false, "tier": "high" }, { "factor": "qtc_ge_480", "points": 0, "present": false, "tier": "high" }, { "factor": "age_ge_75", "points": 0, "present": false, "tier": "high" }, { "factor": "hypertension", "points": 0, "present": false, "tier": "high" }, { "factor": "prior_anthracycline", "points": 0, "present": false, "tier": "high" }, { "factor": "lvef_50_to_54", "points": 0, "present": false, "tier": "medium_2" }, { "factor": "borderline_qtc", "points": 0, "present": false, "tier": "medium_2" }, { "factor": "arrhythmia", "points": 0, "present": false, "tier": "medium_2" }, { "factor": "elevated_troponin", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "elevated_bnp", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "age_65_to_74", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "diabetes", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "hyperlipidemia", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "ckd", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "proteinuria", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "prior_left_chest_or_mediastinal_rt", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "current_or_significant_smoker", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "obesity", "points": 0, "present": false, "tier": "medium_1" } ], "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": "Lyon AR, Dent S, Stanway S, et al.", "doi": "10.1002/ejhf.1920", "id": "lyon-2020", "pmid": "32458582", "source": "Eur J Heart Fail. 2020;22(11):1945-1960", "title": "Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society" }, "formula": "hfa_icos_vegf", "formula_expression": "HFA-ICOS VEGF-inhibitor class (Lyon 2020): very_high if any very-high factor; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low. medium_points = Medium 2 + Medium 1 only. Very high: heart_failure_or_cardiomyopathy, arterial_vascular_disease (IHD, PCI, CABG, stable angina, TIA, stroke, or PVD). High: venous_thrombosis, lvef_percent<50, qtc_ms>=480, age_years>=75, hypertension, prior_anthracycline. Medium 2: lvef 50-54, male 450<=qtc<480, female 460<=qtc<480, arrhythmia (AF/flutter/VT/VF). Medium 1: elevated_troponin, elevated_bnp, age 65-74, diabetes, hyperlipidemia, ckd, proteinuria, prior_left_chest_or_mediastinal_rt, current_or_significant_smoker, obesity. Age exclusive (>=75 High; 65-74 Medium 1; <65 none). LVEF exclusive (<50 High; 50-54 Medium 2; >=55 none). QTc exclusive (>=480 High; else sex-specific Medium 2). cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%", "age_years": 50, "sex": "female", "qtc_ms": 400, "cardiotoxicity_guide": "<2%", "lvef_percent": 60, "medium_points": 0, "risk_level": "low", "high_factor": false, "very_high_factor": false } ] } ``` ## Response fields - `formula` (string): hfa_icos_vegf - `formula_expression` (string): Lyon 2020 VEGF-inhibitor HFA-ICOS classification expression - `age_years` (integer): Integer age 18-100 used - `sex` (string): male or female used for borderline QTc - `lvef_percent` (integer): Integer LVEF percent 10-80 used - `qtc_ms` (integer): Integer QTc in milliseconds 300-700 used - `very_high_factor` (boolean): true if any Lyon 2020 VEGF-inhibitor very-high factor is present - `high_factor` (boolean): true if any Lyon 2020 VEGF-inhibitor High factor is present - `medium_points` (integer): Sum of Medium 1 and Medium 2 points only - `risk_level` (string): low, medium, high, or very_high from the published classification - `cardiotoxicity_guide` (string): Published guide: <2%, 2-9%, 10-19%, or >=20% - `components` (array): Per-factor present flag, points, and tier - `citation` (object): Lyon et al. Eur J Heart Fail 2020 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "heart_failure_or_cardiomyopathy", "points": 0, "present": false, "tier": "very_high" }, { "factor": "arterial_vascular_disease", "points": 0, "present": false, "tier": "very_high" }, { "factor": "venous_thrombosis", "points": 0, "present": false, "tier": "high" }, { "factor": "lvef_lt_50", "points": 0, "present": false, "tier": "high" }, { "factor": "qtc_ge_480", "points": 0, "present": false, "tier": "high" }, { "factor": "age_ge_75", "points": 0, "present": false, "tier": "high" }, { "factor": "hypertension", "points": 0, "present": false, "tier": "high" }, { "factor": "prior_anthracycline", "points": 0, "present": false, "tier": "high" }, { "factor": "lvef_50_to_54", "points": 0, "present": false, "tier": "medium_2" }, { "factor": "borderline_qtc", "points": 0, "present": false, "tier": "medium_2" }, { "factor": "arrhythmia", "points": 0, "present": false, "tier": "medium_2" }, { "factor": "elevated_troponin", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "elevated_bnp", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "age_65_to_74", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "diabetes", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "hyperlipidemia", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "ckd", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "proteinuria", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "prior_left_chest_or_mediastinal_rt", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "current_or_significant_smoker", "points": 0, "present": false, "tier": "medium_1" }, { "factor": "obesity", "points": 0, "present": false, "tier": "medium_1" } ], "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": "Lyon AR, Dent S, Stanway S, et al.", "doi": "10.1002/ejhf.1920", "id": "lyon-2020", "pmid": "32458582", "source": "Eur J Heart Fail. 2020;22(11):1945-1960", "title": "Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society" }, "formula": "hfa_icos_vegf", "formula_expression": "HFA-ICOS VEGF-inhibitor class (Lyon 2020): very_high if any very-high factor; else high if any high factor or medium_points>=5; else medium if medium_points 2-4; else low. medium_points = Medium 2 + Medium 1 only. Very high: heart_failure_or_cardiomyopathy, arterial_vascular_disease (IHD, PCI, CABG, stable angina, TIA, stroke, or PVD). High: venous_thrombosis, lvef_percent<50, qtc_ms>=480, age_years>=75, hypertension, prior_anthracycline. Medium 2: lvef 50-54, male 450<=qtc<480, female 460<=qtc<480, arrhythmia (AF/flutter/VT/VF). Medium 1: elevated_troponin, elevated_bnp, age 65-74, diabetes, hyperlipidemia, ckd, proteinuria, prior_left_chest_or_mediastinal_rt, current_or_significant_smoker, obesity. Age exclusive (>=75 High; 65-74 Medium 1; <65 none). LVEF exclusive (<50 High; 50-54 Medium 2; >=55 none). QTc exclusive (>=480 High; else sex-specific Medium 2). cardiotoxicity_guide low <2%, medium 2-9%, high 10-19%, very_high >=20%", "age_years": 50, "sex": "female", "qtc_ms": 400, "cardiotoxicity_guide": "<2%", "lvef_percent": 60, "medium_points": 0, "risk_level": "low", "high_factor": false, "very_high_factor": false } ``` ## Errors - HTTP 400 `invalid_hfa_icos_vegf`: Lyon 2020 HFA-ICOS VEGF-inhibitor inputs must match that table's age, LVEF, QTc, sex, and yes/no factors. 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 - [HFA-ICOS anthracycline baseline CV risk](https://magentlab.com/docs/hfa-icos-anthracycline) — Apply the Lyon 2020 HFA-ICOS anthracycline baseline cardiovascular risk proforma from caller-assigned age, LVEF, and published Very high, High, Medium 2, and Medium 1 factors. Returns risk_level, medium_points, and the paper's expert-opinion cardiotoxicity_guide. - [NYHA](https://magentlab.com/docs/nyha) — Return the 1994 NYHA functional capacity class 1-4 from a caller-assigned integer, with the published class description. - [MAGGIC](https://magentlab.com/docs/maggic) — Sum the Pocock 2013 MAGGIC integer chart from thirteen caller-supplied heart-failure predictors and return the published Table 4 1-year and 3-year death probabilities for scores 0-50. - [HCM Risk-SCD](https://magentlab.com/docs/hcm-risk-scd) — Compute the O'Mahony 2014 HCM Risk-SCD 5-year sudden cardiac death probability from maximal wall thickness, left-atrial diameter, maximal LVOT gradient, family history of SCD, NSVT, unexplained syncope, and age. ## 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.