IMDC (Heng 2009)

IMDC

Sum the Heng 2009 IMDC adverse factors for metastatic RCC treated with VEGF-targeted agents and return favorable (0), intermediate (1–2), or poor (3–6). Heng 2009 reported 2-year OS 75% (median not reached), 53% (median 27 months), and 7% (median 8.8 months) in those groups.

LIVE $0.005 USDC GET /api/calc/imdc

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

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

What it computes

When to use

When an agent needs the published Heng 2009 IMDC point total and risk group and must not invent an RCC diagnosis or treatment recommendation, and must not assign KPS or compare labs to institutional LLN/ULN.

When not to use

Not a medical device and not an RCC diagnosis or treatment recommendation. magent does not examine the patient.
Heng 2009 overall-survival figures are published cohort results, not a treatment choice.
magent does not assign Karnofsky performance status or compare hemoglobin, corrected calcium, neutrophils, or platelets to institutional LLN/ULN. All six inputs are caller-assigned flags.

Formula

IMDC = kps_lt_80 1 + diagnosis_to_treatment_lt_1_year 1 + hemoglobin_lt_lln 1 + corrected_calcium_gt_uln 1 + neutrophils_gt_uln 1 + platelets_gt_uln 1; Heng 2009; max 6; favorable 0, intermediate 1-2, poor ≥3

Citation

Title: Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study
Authors: Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, Eigl BJ, Ruether JD, Cheng T, North S, Venner P, Knox JJ, Chi KN, Kollmannsberger C, McDermott DF, Rini BI, Bukowski RM, Rha SY, Choueiri TK
Source: J Clin Oncol. 2009;27(34):5794-5799
DOI: 10.1200/JCO.2008.21.4809

Worked example

All flags false

Given: corrected_calcium_gt_uln=falsediagnosis_to_treatment_lt_1_year=falsehemoglobin_lt_lln=falsekps_lt_80=falseneutrophils_gt_uln=falseplatelets_gt_uln=false

All six caller-assigned flags false → 0
Score = 0 (max 6); imdc_band = favorable

KPS <80, diagnosis-to-treatment <1 year, and hemoglobin <LLN

Given: corrected_calcium_gt_uln=falsediagnosis_to_treatment_lt_1_year=truehemoglobin_lt_lln=truekps_lt_80=trueneutrophils_gt_uln=falseplatelets_gt_uln=false

kps_lt_80 → 1; diagnosis_to_treatment_lt_1_year → 1; hemoglobin_lt_lln → 1; remaining flags 0
Score = 3 (max 6); imdc_band = poor (≥3)

Also searched as

IMDC
Heng score
metastatic RCC risk
International Metastatic RCC Database Consortium
Heng 2009
IMDC risk
VEGF-targeted RCC prognosis
Karnofsky IMDC

Try

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

/api/calc/imdc?kps_lt_80=false&diagnosis_to_treatment_lt_1_year=false&hemoglobin_lt_lln=false&corrected_calcium_gt_uln=false&neutrophils_gt_uln=false&platelets_gt_uln=false

Full URL: https://api.magentlab.com/api/calc/imdc?kps_lt_80=false&diagnosis_to_treatment_lt_1_year=false&hemoglobin_lt_lln=false&corrected_calcium_gt_uln=false&neutrophils_gt_uln=false&platelets_gt_uln=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/imdc?kps_lt_80=false&diagnosis_to_treatment_lt_1_year=false&hemoglobin_lt_lln=false&corrected_calcium_gt_uln=false&neutrophils_gt_uln=false&platelets_gt_uln=false"

Parameters

Name	Type	Required	Description
`kps_lt_80`	boolean	required	Karnofsky performance status <80 as assigned by the caller (Heng 2009). true scores 1. magent does not assign KPS.
`diagnosis_to_treatment_lt_1_year`	boolean	required	Time from diagnosis to systemic treatment <1 year as assigned by the caller (Heng 2009). true scores 1. magent does not date the interval.
`hemoglobin_lt_lln`	boolean	required	Hemoglobin below the institutional lower limit of normal as assigned by the caller (Heng 2009). true scores 1. magent does not assay hemoglobin or apply LLN.
`corrected_calcium_gt_uln`	boolean	required	Corrected calcium above the institutional upper limit of normal as assigned by the caller (Heng 2009). true scores 1. magent does not assay calcium or apply ULN.
`neutrophils_gt_uln`	boolean	required	Neutrophils above the institutional upper limit of normal as assigned by the caller (Heng 2009). true scores 1. magent does not assay ANC or apply ULN.
`platelets_gt_uln`	boolean	required	Platelets above the institutional upper limit of normal as assigned by the caller (Heng 2009). true scores 1. magent does not assay platelets or apply ULN.

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/imdc 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": [
    {
      "corrected_calcium_gt_uln": "false",
      "diagnosis_to_treatment_lt_1_year": "false",
      "hemoglobin_lt_lln": "false",
      "kps_lt_80": "false",
      "neutrophils_gt_uln": "false",
      "platelets_gt_uln": "false"
    },
    {
      "corrected_calcium_gt_uln": "false",
      "diagnosis_to_treatment_lt_1_year": "false",
      "hemoglobin_lt_lln": "false",
      "kps_lt_80": "false",
      "neutrophils_gt_uln": "false",
      "platelets_gt_uln": "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/imdc",
  "items": [
    {
      "components": [
        {
          "factor": "kps_lt_80",
          "points": 0,
          "present": false
        },
        {
          "factor": "diagnosis_to_treatment_lt_1_year",
          "points": 0,
          "present": false
        },
        {
          "factor": "hemoglobin_lt_lln",
          "points": 0,
          "present": false
        },
        {
          "factor": "corrected_calcium_gt_uln",
          "points": 0,
          "present": false
        },
        {
          "factor": "neutrophils_gt_uln",
          "points": 0,
          "present": false
        },
        {
          "factor": "platelets_gt_uln",
          "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": "Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, Eigl BJ, Ruether JD, Cheng T, North S, Venner P, Knox JJ, Chi KN, Kollmannsberger C, McDermott DF, Rini BI, Bukowski RM, Rha SY, Choueiri TK",
        "doi": "10.1200/JCO.2008.21.4809",
        "id": "heng-2009",
        "pmid": "19826129",
        "source": "J Clin Oncol. 2009;27(34):5794-5799",
        "title": "Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study"
      },
      "formula": "imdc",
      "formula_expression": "IMDC = kps_lt_80 1 + diagnosis_to_treatment_lt_1_year 1 + hemoglobin_lt_lln 1 + corrected_calcium_gt_uln 1 + neutrophils_gt_uln 1 + platelets_gt_uln 1; Heng 2009; max 6; favorable 0, intermediate 1-2, poor ≥3",
      "max_score": 6,
      "score": 0,
      "imdc_band": "favorable"
    },
    {
      "components": [
        {
          "factor": "kps_lt_80",
          "points": 0,
          "present": false
        },
        {
          "factor": "diagnosis_to_treatment_lt_1_year",
          "points": 0,
          "present": false
        },
        {
          "factor": "hemoglobin_lt_lln",
          "points": 0,
          "present": false
        },
        {
          "factor": "corrected_calcium_gt_uln",
          "points": 0,
          "present": false
        },
        {
          "factor": "neutrophils_gt_uln",
          "points": 0,
          "present": false
        },
        {
          "factor": "platelets_gt_uln",
          "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": "Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, Eigl BJ, Ruether JD, Cheng T, North S, Venner P, Knox JJ, Chi KN, Kollmannsberger C, McDermott DF, Rini BI, Bukowski RM, Rha SY, Choueiri TK",
        "doi": "10.1200/JCO.2008.21.4809",
        "id": "heng-2009",
        "pmid": "19826129",
        "source": "J Clin Oncol. 2009;27(34):5794-5799",
        "title": "Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study"
      },
      "formula": "imdc",
      "formula_expression": "IMDC = kps_lt_80 1 + diagnosis_to_treatment_lt_1_year 1 + hemoglobin_lt_lln 1 + corrected_calcium_gt_uln 1 + neutrophils_gt_uln 1 + platelets_gt_uln 1; Heng 2009; max 6; favorable 0, intermediate 1-2, poor ≥3",
      "max_score": 6,
      "score": 0,
      "imdc_band": "favorable"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	imdc
`formula_expression`	string	Exact expression used
`score`	integer	IMDC points 0-6
`max_score`	integer	Always 6
`imdc_band`	string	favorable when score is 0 (Heng 2009: 2-year OS 75%; median OS not reached), intermediate when 1–2 (median OS 27 months; 2-year OS 53%), poor when 3–6 (median OS 8.8 months; 2-year OS 7%). Not an RCC diagnosis or treatment recommendation. Caller assigns KPS and lab flags versus institutional LLN/ULN.
`components`	array	Per-factor points
`citation`	object	Heng 2009 J Clin Oncol citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "components": [
    {
      "factor": "kps_lt_80",
      "points": 0,
      "present": false
    },
    {
      "factor": "diagnosis_to_treatment_lt_1_year",
      "points": 0,
      "present": false
    },
    {
      "factor": "hemoglobin_lt_lln",
      "points": 0,
      "present": false
    },
    {
      "factor": "corrected_calcium_gt_uln",
      "points": 0,
      "present": false
    },
    {
      "factor": "neutrophils_gt_uln",
      "points": 0,
      "present": false
    },
    {
      "factor": "platelets_gt_uln",
      "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": "Heng DY, Xie W, Regan MM, Warren MA, Golshayan AR, Sahi C, Eigl BJ, Ruether JD, Cheng T, North S, Venner P, Knox JJ, Chi KN, Kollmannsberger C, McDermott DF, Rini BI, Bukowski RM, Rha SY, Choueiri TK",
    "doi": "10.1200/JCO.2008.21.4809",
    "id": "heng-2009",
    "pmid": "19826129",
    "source": "J Clin Oncol. 2009;27(34):5794-5799",
    "title": "Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study"
  },
  "formula": "imdc",
  "formula_expression": "IMDC = kps_lt_80 1 + diagnosis_to_treatment_lt_1_year 1 + hemoglobin_lt_lln 1 + corrected_calcium_gt_uln 1 + neutrophils_gt_uln 1 + platelets_gt_uln 1; Heng 2009; max 6; favorable 0, intermediate 1-2, poor ≥3",
  "max_score": 6,
  "score": 0,
  "imdc_band": "favorable"
}

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

NLR — Compute the Zahorec 2001 neutrophil-to-lymphocyte ratio from relative neutrophil and lymphocyte percents.
ANC — Compute absolute neutrophil count from WBC and neutrophil plus band percents, plus a Bodey 1966 granulocyte band.

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. 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

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged.
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.