# HScore HScore Status: LIVE Price: $0.005 USDC `GET /api/calc/hscore` HTML: https://magentlab.com/docs/hscore Markdown: https://magentlab.com/docs/hscore.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the nine Fardet 2014 Table 4 HScore items from caller-assigned bands and return whether the total is ≥169 (published best cutoff). ## When to use When an agent has already assigned Fardet 2014 Table 4 bands (not raw labs) and needs the published HScore total and ≥169 cutoff, not an HLH-2004 diagnosis and not a Table 5 probability for every integer. ## When not to use - Not a medical device. Not a diagnosis of reactive hemophagocytic syndrome, HLH, or macrophage activation syndrome. - This is Fardet 2014 Table 4 HScore only. Not HLH-2004. magent does not interpolate Table 5 probabilities for every integer. - All nine Table 4 items are required. magent does not take raw labs; the caller assigns published bands. - Bone marrow hemophagocytosis is one scored item (35 points if present). It is not required for a diagnosis; this tool is not a diagnosis. ## Formula ``` HScore = immunosuppression (true 18) + temperature_band (lt_38_4 0, 38_4_to_39_4 33, gt_39_4 49) + organomegaly (none 0, hepato_or_spleno 23, hepato_and_spleno 38) + cytopenia_lineages (1 → 0, 2 → 24, 3 → 34) + ferritin_band (lt_2000 0, 2000_to_6000 35, gt_6000 50) + triglyceride_band (lt_1_5 0, 1_5_to_4 44, gt_4 64) + fibrinogen_band (gt_2_5 0, le_2_5 30) + sgot_band (lt_30 0, ge_30 19) + marrow_hemophagocytosis (true 35); Fardet 2014 Table 4; max 337; score_ge_169 iff total >= 169 (Table 5 best cutoff) ``` ## Citation [Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome](https://doi.org/10.1002/art.38690) Fardet L, Galicier L, Lambotte O, Marzac C, Aumont C, Chahwan D, Coppo P, Hejblum G Arthritis Rheumatol. 2014;66(9):2613-2620 DOI: [10.1002/art.38690](https://doi.org/10.1002/art.38690) ## Worked example ### All lowest bands and false flags Given: `cytopenia_lineages=1, ferritin_band=lt_2000, fibrinogen_band=gt_2_5, immunosuppression=false, marrow_hemophagocytosis=false, organomegaly=none, sgot_band=lt_30, temperature_band=lt_38_4, triglyceride_band=lt_1_5` 1. Each Table 4 item at the 0-point band or false 2. Score = 0 (max 337); score_ge_169 false (below the ≥169 cutoff) ### Published best cutoff 169 Given: `cytopenia_lineages=1, ferritin_band=lt_2000, fibrinogen_band=gt_2_5, immunosuppression=true, marrow_hemophagocytosis=false, organomegaly=hepato_and_spleno, sgot_band=lt_30, temperature_band=gt_39_4, triglyceride_band=gt_4` 1. trig_high 64 + temp_high 49 + organo_and 38 + immunosuppression 18 2. Score = 169 (max 337); score_ge_169 true (Fardet 2014 Table 5 best cutoff) ## Also searched as - HScore - Fardet HScore - reactive hemophagocytic syndrome score - HScore Fardet 2014 - hemophagocytic syndrome HScore - HScore 169 cutoff - Fardet 2014 hemophagocytosis ## Parameters - `immunosuppression` (boolean, required): Known underlying immunosuppression as assigned by the caller (Fardet 2014 Table 4 footnote: HIV positive or long-term glucocorticoids, cyclosporine, or azathioprine). true scores 18; false scores 0. - `temperature_band` (string, required): Caller-assigned Fardet 2014 Table 4 temperature band (°C). lt_38_4 (<38.4) scores 0; 38_4_to_39_4 (38.4–39.4) scores 33; gt_39_4 (>39.4) scores 49. magent does not take a raw temperature. - `organomegaly` (string, required): Caller-assigned Fardet 2014 Table 4 organomegaly. none scores 0; hepato_or_spleno (hepatomegaly or splenomegaly) scores 23; hepato_and_spleno (hepatomegaly and splenomegaly) scores 38. magent does not examine the patient. - `cytopenia_lineages` (integer, required): Caller-assigned number of cytopenia lineages (integer 1, 2, or 3). 1 scores 0; 2 scores 24; 3 scores 34. Zero cytopenias were not assessed in Fardet 2014 and are rejected. Cytopenia definition (paper footnote, caller already applied): Hb ≤9.2 g/dL and/or WBC ≤5000/mm³ and/or platelets ≤110000/mm³. magent does not take those labs. - `ferritin_band` (string, required): Caller-assigned Fardet 2014 Table 4 ferritin band (ng/ml). lt_2000 (<2000) scores 0; 2000_to_6000 (2000–6000) scores 35; gt_6000 (>6000) scores 50. magent does not take a raw ferritin. - `triglyceride_band` (string, required): Caller-assigned Fardet 2014 Table 4 triglyceride band (mmol/L). lt_1_5 (<1.5) scores 0; 1_5_to_4 (1.5–4.0) scores 44; gt_4 (>4.0) scores 64. magent does not take a raw triglyceride. - `fibrinogen_band` (string, required): Caller-assigned Fardet 2014 Table 4 fibrinogen band (g/L). gt_2_5 (>2.5) scores 0; le_2_5 (≤2.5) scores 30. magent does not take a raw fibrinogen. - `sgot_band` (string, required): Caller-assigned Fardet 2014 Table 4 SGOT/AST band (IU/L). lt_30 (<30) scores 0; ge_30 (≥30) scores 19. magent does not take a raw SGOT. - `marrow_hemophagocytosis` (boolean, required): Hemophagocytosis features on bone marrow aspirate as assigned by the caller (Fardet 2014 Table 4). true scores 35; false scores 0. Not required for a diagnosis; this tool is not a diagnosis. ## 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/hscore` 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": [ { "cytopenia_lineages": "1", "ferritin_band": "lt_2000", "fibrinogen_band": "gt_2_5", "immunosuppression": "false", "marrow_hemophagocytosis": "false", "organomegaly": "none", "sgot_band": "lt_30", "temperature_band": "lt_38_4", "triglyceride_band": "lt_1_5" }, { "cytopenia_lineages": "1", "ferritin_band": "lt_2000", "fibrinogen_band": "gt_2_5", "immunosuppression": "false", "marrow_hemophagocytosis": "false", "organomegaly": "none", "sgot_band": "lt_30", "temperature_band": "lt_38_4", "triglyceride_band": "lt_1_5" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/hscore Example 200: ```json { "count": 2, "path": "/api/calc/hscore", "items": [ { "components": [ { "factor": "immunosuppression", "points": 0, "present": false }, { "value": "lt_38_4", "factor": "temperature_band", "points": 0, "present": false }, { "value": "none", "factor": "organomegaly", "points": 0, "present": false }, { "value": 1, "factor": "cytopenia_lineages", "points": 0, "present": false }, { "value": "lt_2000", "factor": "ferritin_band", "points": 0, "present": false }, { "value": "lt_1_5", "factor": "triglyceride_band", "points": 0, "present": false }, { "value": "gt_2_5", "factor": "fibrinogen_band", "points": 0, "present": false }, { "value": "lt_30", "factor": "sgot_band", "points": 0, "present": false }, { "factor": "marrow_hemophagocytosis", "points": 0, "present": false } ], "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": "Fardet L, Galicier L, Lambotte O, Marzac C, Aumont C, Chahwan D, Coppo P, Hejblum G", "doi": "10.1002/art.38690", "id": "fardet-2014", "pmid": "24782338", "source": "Arthritis Rheumatol. 2014;66(9):2613-2620", "title": "Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome" }, "formula": "hscore", "formula_expression": "HScore = immunosuppression (true 18) + temperature_band (lt_38_4 0, 38_4_to_39_4 33, gt_39_4 49) + organomegaly (none 0, hepato_or_spleno 23, hepato_and_spleno 38) + cytopenia_lineages (1 → 0, 2 → 24, 3 → 34) + ferritin_band (lt_2000 0, 2000_to_6000 35, gt_6000 50) + triglyceride_band (lt_1_5 0, 1_5_to_4 44, gt_4 64) + fibrinogen_band (gt_2_5 0, le_2_5 30) + sgot_band (lt_30 0, ge_30 19) + marrow_hemophagocytosis (true 35); Fardet 2014 Table 4; max 337; score_ge_169 iff total >= 169 (Table 5 best cutoff)", "max_score": 337, "score": 0, "score_ge_169": false }, { "components": [ { "factor": "immunosuppression", "points": 0, "present": false }, { "value": "lt_38_4", "factor": "temperature_band", "points": 0, "present": false }, { "value": "none", "factor": "organomegaly", "points": 0, "present": false }, { "value": 1, "factor": "cytopenia_lineages", "points": 0, "present": false }, { "value": "lt_2000", "factor": "ferritin_band", "points": 0, "present": false }, { "value": "lt_1_5", "factor": "triglyceride_band", "points": 0, "present": false }, { "value": "gt_2_5", "factor": "fibrinogen_band", "points": 0, "present": false }, { "value": "lt_30", "factor": "sgot_band", "points": 0, "present": false }, { "factor": "marrow_hemophagocytosis", "points": 0, "present": false } ], "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": "Fardet L, Galicier L, Lambotte O, Marzac C, Aumont C, Chahwan D, Coppo P, Hejblum G", "doi": "10.1002/art.38690", "id": "fardet-2014", "pmid": "24782338", "source": "Arthritis Rheumatol. 2014;66(9):2613-2620", "title": "Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome" }, "formula": "hscore", "formula_expression": "HScore = immunosuppression (true 18) + temperature_band (lt_38_4 0, 38_4_to_39_4 33, gt_39_4 49) + organomegaly (none 0, hepato_or_spleno 23, hepato_and_spleno 38) + cytopenia_lineages (1 → 0, 2 → 24, 3 → 34) + ferritin_band (lt_2000 0, 2000_to_6000 35, gt_6000 50) + triglyceride_band (lt_1_5 0, 1_5_to_4 44, gt_4 64) + fibrinogen_band (gt_2_5 0, le_2_5 30) + sgot_band (lt_30 0, ge_30 19) + marrow_hemophagocytosis (true 35); Fardet 2014 Table 4; max 337; score_ge_169 iff total >= 169 (Table 5 best cutoff)", "max_score": 337, "score": 0, "score_ge_169": false } ] } ``` ## Response fields - `formula` (string): hscore - `formula_expression` (string): Exact expression used - `score` (integer): HScore points 0-337 - `max_score` (integer): 337 - `score_ge_169` (boolean): true iff score ≥ 169 (Fardet 2014 Table 5 best cutoff; sensitivity 93%, specificity 86%, accurate classification 90%). Not a diagnosis. - `components` (array): Per-item Table 4 points - `citation` (object): Fardet et al. Arthritis Rheumatol 2014 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "immunosuppression", "points": 0, "present": false }, { "value": "lt_38_4", "factor": "temperature_band", "points": 0, "present": false }, { "value": "none", "factor": "organomegaly", "points": 0, "present": false }, { "value": 1, "factor": "cytopenia_lineages", "points": 0, "present": false }, { "value": "lt_2000", "factor": "ferritin_band", "points": 0, "present": false }, { "value": "lt_1_5", "factor": "triglyceride_band", "points": 0, "present": false }, { "value": "gt_2_5", "factor": "fibrinogen_band", "points": 0, "present": false }, { "value": "lt_30", "factor": "sgot_band", "points": 0, "present": false }, { "factor": "marrow_hemophagocytosis", "points": 0, "present": false } ], "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": "Fardet L, Galicier L, Lambotte O, Marzac C, Aumont C, Chahwan D, Coppo P, Hejblum G", "doi": "10.1002/art.38690", "id": "fardet-2014", "pmid": "24782338", "source": "Arthritis Rheumatol. 2014;66(9):2613-2620", "title": "Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome" }, "formula": "hscore", "formula_expression": "HScore = immunosuppression (true 18) + temperature_band (lt_38_4 0, 38_4_to_39_4 33, gt_39_4 49) + organomegaly (none 0, hepato_or_spleno 23, hepato_and_spleno 38) + cytopenia_lineages (1 → 0, 2 → 24, 3 → 34) + ferritin_band (lt_2000 0, 2000_to_6000 35, gt_6000 50) + triglyceride_band (lt_1_5 0, 1_5_to_4 44, gt_4 64) + fibrinogen_band (gt_2_5 0, le_2_5 30) + sgot_band (lt_30 0, ge_30 19) + marrow_hemophagocytosis (true 35); Fardet 2014 Table 4; max 337; score_ge_169 iff total >= 169 (Table 5 best cutoff)", "max_score": 337, "score": 0, "score_ge_169": false } ``` ## Errors - HTTP 400 `invalid_hscore_band`: temperature_band, organomegaly, cytopenia_lineages, ferritin_band, triglyceride_band, fibrinogen_band, and sgot_band must be Fardet 2014 Table 4 values. 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. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [4Ts score](https://magentlab.com/docs/four-ts) — Compute the Lo 2006 4Ts score as the sum of four caller-assigned integers 0-2 (thrombocytopenia, timing, thrombosis, other causes). - [SIC score](https://magentlab.com/docs/sic) — Sum Iba 2017 Table 3 SIC items (platelets, INR, and four-item SOFA capped at 2) and return the point total and whether published SIC criteria are met. - [SIRS](https://magentlab.com/docs/sirs) — Compute the Bone 1992 ACCP/SCCM SIRS criteria from temperature, heart rate, respiratory rate, and WBC, with optional PaCO2 and band percent. ## 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.