# ICE score (Lee 2019) ICE Status: LIVE Price: $0.005 USDC `GET /api/calc/ice` HTML: https://magentlab.com/docs/ice Markdown: https://magentlab.com/docs/ice.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum Lee 2019 Immune Effector Cell-Associated Encephalopathy (ICE) item points and return the 0-10 total. Not ASTCT ICANS grading. ## When to use When an agent has caller-assigned ICE exam item scores and needs the published 0-10 point total. Not for ICANS grading (related astct-icans takes a caller-assigned ice_score). ## When not to use - Not a medical device and not a diagnosis of ICANS or encephalopathy. - ICE points only (Lee 2019). Not ASTCT ICANS consensus grading (that is related astct-icans, which takes a caller-assigned ice_score). magent does not map ICE totals to an ICANS grade. - orientation, naming, following_commands, writing, and attention are caller-assigned. magent does not perform the ICE exam or examine the patient. - Not ASTCT CRS (related astct-crs). ## Formula ``` ICE = orientation (0-4; year, month, city, hospital) + naming (0-3; three objects) + following_commands (1) + writing (1) + attention (1; count backward from 100 by tens); max 10. ICE points only; not ASTCT ICANS grade. magent does not perform the exam ``` ## Citation [ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells](https://doi.org/10.1016/j.bbmt.2018.12.758) Lee DW, Santomasso BD, Locke FL, et al. Biol Blood Marrow Transplant. 2019;25(4):625-638 DOI: [10.1016/j.bbmt.2018.12.758](https://doi.org/10.1016/j.bbmt.2018.12.758) ## Worked example ### All items intact is ICE 10 Given: `attention=true, following_commands=true, naming=3, orientation=4, writing=true` 1. orientation 4 + naming 3 + following_commands 1 + writing 1 + attention 1 2. Score = 10 (max 10) ## Also searched as - ICE score - Immune Effector Cell-Associated Encephalopathy - ICE encephalopathy score - CAR-T encephalopathy ICE - Lee 2019 ICE - immune effector cell encephalopathy ## Parameters - `orientation` (integer, required): Caller-assigned orientation points 0-4 (year, month, city, hospital; Lee 2019 ICE). magent does not perform the exam. - `naming` (integer, required): Caller-assigned naming points 0-3 (three objects; Lee 2019 ICE). magent does not perform the exam. - `following_commands` (boolean, required): Ability to follow commands (Lee 2019 ICE, 1 point). true, false, 1, or 0. magent does not perform the exam. - `writing` (boolean, required): Ability to write a standard sentence (Lee 2019 ICE, 1 point). true, false, 1, or 0. magent does not perform the exam. - `attention` (boolean, required): Ability to count backward from 100 by tens (Lee 2019 ICE, 1 point). true, false, 1, or 0. magent does not perform the exam. ## 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/ice` 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": [ { "attention": "true", "following_commands": "true", "naming": "3", "orientation": "4", "writing": "true" }, { "attention": "true", "following_commands": "true", "naming": "3", "orientation": "4", "writing": "true" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/ice Example 200: ```json { "count": 2, "path": "/api/calc/ice", "items": [ { "components": [ { "value": 4, "factor": "orientation", "points": 4, "present": true }, { "value": 3, "factor": "naming", "points": 3, "present": true }, { "factor": "following_commands", "points": 1, "present": true }, { "factor": "writing", "points": 1, "present": true }, { "factor": "attention", "points": 1, "present": true } ], "writing": 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": "Lee DW, Santomasso BD, Locke FL, et al.", "doi": "10.1016/j.bbmt.2018.12.758", "id": "lee-2019", "source": "Biol Blood Marrow Transplant. 2019;25(4):625-638", "title": "ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells" }, "formula": "ice", "formula_expression": "ICE = orientation (0-4; year, month, city, hospital) + naming (0-3; three objects) + following_commands (1) + writing (1) + attention (1; count backward from 100 by tens); max 10. ICE points only; not ASTCT ICANS grade. magent does not perform the exam", "max_score": 10, "score": 10, "attention": true, "following_commands": true, "naming": 3, "orientation": 4 }, { "components": [ { "value": 4, "factor": "orientation", "points": 4, "present": true }, { "value": 3, "factor": "naming", "points": 3, "present": true }, { "factor": "following_commands", "points": 1, "present": true }, { "factor": "writing", "points": 1, "present": true }, { "factor": "attention", "points": 1, "present": true } ], "writing": 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": "Lee DW, Santomasso BD, Locke FL, et al.", "doi": "10.1016/j.bbmt.2018.12.758", "id": "lee-2019", "source": "Biol Blood Marrow Transplant. 2019;25(4):625-638", "title": "ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells" }, "formula": "ice", "formula_expression": "ICE = orientation (0-4; year, month, city, hospital) + naming (0-3; three objects) + following_commands (1) + writing (1) + attention (1; count backward from 100 by tens); max 10. ICE points only; not ASTCT ICANS grade. magent does not perform the exam", "max_score": 10, "score": 10, "attention": true, "following_commands": true, "naming": 3, "orientation": 4 } ] } ``` ## Response fields - `formula` (string): ice - `formula_expression` (string): Exact expression used - `score` (integer): ICE points 0-10 - `max_score` (integer): 10 - `orientation` (integer): Echo of caller-assigned orientation 0-4 - `naming` (integer): Echo of caller-assigned naming 0-3 - `following_commands` (boolean): Echo of the following-commands flag - `writing` (boolean): Echo of the writing flag - `attention` (boolean): Echo of the attention flag - `components` (array): Per-item points - `citation` (object): Lee 2019 Biol Blood Marrow Transplant citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 4, "factor": "orientation", "points": 4, "present": true }, { "value": 3, "factor": "naming", "points": 3, "present": true }, { "factor": "following_commands", "points": 1, "present": true }, { "factor": "writing", "points": 1, "present": true }, { "factor": "attention", "points": 1, "present": true } ], "writing": 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": "Lee DW, Santomasso BD, Locke FL, et al.", "doi": "10.1016/j.bbmt.2018.12.758", "id": "lee-2019", "source": "Biol Blood Marrow Transplant. 2019;25(4):625-638", "title": "ASTCT Consensus Grading for Cytokine Release Syndrome and Neurologic Toxicity Associated with Immune Effector Cells" }, "formula": "ice", "formula_expression": "ICE = orientation (0-4; year, month, city, hospital) + naming (0-3; three objects) + following_commands (1) + writing (1) + attention (1; count backward from 100 by tens); max 10. ICE points only; not ASTCT ICANS grade. magent does not perform the exam", "max_score": 10, "score": 10, "attention": true, "following_commands": true, "naming": 3, "orientation": 4 } ``` ## Errors - HTTP 400 `invalid_ice_orientation`: orientation must be an integer from 0 to 4 (Lee 2019 ICE year/month/city/hospital). Returned before settlement; you are not charged. - HTTP 400 `invalid_ice_naming`: naming must be an integer from 0 to 3 (Lee 2019 ICE three objects). 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 - [ASTCT ICANS](https://magentlab.com/docs/astct-icans) — Apply Lee 2019 Table 6 adult ASTCT ICANS consensus grading and return the overall grade (0-4) as the most severe of the ICE, depressed LOC, seizure, motor, and ICP/edema domains, with icans true when grade is 1 or greater. - [ASTCT CRS](https://magentlab.com/docs/astct-crs) — Apply Lee 2019 ASTCT Table 1 cytokine release syndrome grading and return grade 0–4 from caller-assigned fever, fever waiver, hypotension, and hypoxia. Grade is the more severe of hypotension versus hypoxia. Organ toxicities do not influence grade. Not ICANS. ## 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.