# IMPROVE VTE associative score IMPROVE VTE Status: LIVE Price: $0.005 USDC `GET /api/calc/improve_vte` HTML: https://magentlab.com/docs/improve-vte Markdown: https://magentlab.com/docs/improve-vte.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Spyropoulos 2011 7-factor associative IMPROVE VTE score during hospitalization from age and six caller-assigned flags. ## When to use When an agent needs the published 7-factor associative IMPROVE VTE score during hospitalization (not the 4-factor admission predictive model, not IMPROVEDD, not Padua, not Caprini). magent does not examine the patient and does not diagnose VTE or issue a prophylaxis order. ## When not to use - Not a medical device. - Not a VTE diagnosis. magent does not diagnose venous thromboembolism. - Not a prophylaxis order. This tool does not recommend a drug or start thromboprophylaxis. - 7-factor associative IMPROVE VTE score during hospitalization (Spyropoulos 2011). Observed VTE in the paper was 1.5% at score 2-3 and 5.7% at score >=4; score >=2 was associated with higher mortality. Those figures are published associations, not per-integer rates and not a treatment threshold. - Not the 4-factor admission-only predictive model. Not IMPROVEDD (no D-dimer). - Not Padua or Caprini. - magent does not examine the patient. Flags are caller-assigned. ## Formula ``` IMPROVE VTE (Spyropoulos 2011 7-factor associative during hospitalization) = previous_vte (3) + known_thrombophilia (2) + lower_limb_paralysis (2) + current_cancer (2) + immobilized_ge_7_days (1) + icu_ccu_stay (1) + age>60 (1); max 12; 0-1, 2-3 (observed VTE 1.5%), >=4 (observed VTE 5.7%); not the 4-factor admission predictive model; not IMPROVEDD ``` ## Citation [Predictive and associative models to identify hospitalized medical patients at risk for VTE](https://doi.org/10.1378/chest.10-1944) Spyropoulos AC, Anderson FA Jr, FitzGerald G, Decousus H, Pini M, Chong BH, Zotz RB, Bergmann JF, Tapson VF, Froehlich JB, Monreal M, Merli GJ, Pavanello R, Turpie AGG, Nakamura M, Piovella F, Kakkar AK, Spencer FA, IMPROVE Investigators Chest. 2011;140(3):706-714 DOI: [10.1378/chest.10-1944](https://doi.org/10.1378/chest.10-1944) ## Worked example ### Age 50, all flags false Given: `age=50, current_cancer=false, icu_ccu_stay=false, immobilized_ge_7_days=false, known_thrombophilia=false, lower_limb_paralysis=false, previous_vte=false` 1. Age 50 is not >60 → 0; all six flags false → 0 2. Score = 0 (max 12); vte_band 0-1 ### Previous VTE plus current cancer is >=4 Given: `age=50, current_cancer=true, icu_ccu_stay=false, immobilized_ge_7_days=false, known_thrombophilia=false, lower_limb_paralysis=false, previous_vte=true` 1. previous_vte → 3; current_cancer → 2; age 50 not >60 → 0 2. Score = 5 (max 12); vte_band >=4 ## Also searched as - IMPROVE VTE score - IMPROVE associative VTE - Spyropoulos IMPROVE - hospital VTE risk - IMPROVE medical VTE - 7-factor IMPROVE VTE - associative IMPROVE VTE ## Parameters - `age` (integer, required): Age in years (18-120). Scores 1 when age >60 (Spyropoulos 2011). Age 60 scores 0; age 61 scores 1. - `previous_vte` (boolean, required): Previous VTE as assigned by the caller (Spyropoulos 2011 7-factor associative model). true or false. 3 points if true. magent does not diagnose VTE. - `known_thrombophilia` (boolean, required): Known thrombophilia as assigned by the caller (Spyropoulos 2011). true or false. 2 points if true. magent does not interpret a thrombophilia panel. - `lower_limb_paralysis` (boolean, required): Lower-limb paralysis as assigned by the caller (Spyropoulos 2011). true or false. 2 points if true. magent does not examine the patient. - `current_cancer` (boolean, required): Current cancer as assigned by the caller (Spyropoulos 2011). true or false. 2 points if true. magent does not diagnose cancer. - `immobilized_ge_7_days` (boolean, required): Immobilized ≥7 days as assigned by the caller (Spyropoulos 2011, during hospitalization). true or false. 1 point if true. magent does not observe mobility. - `icu_ccu_stay` (boolean, required): ICU or CCU stay as assigned by the caller (Spyropoulos 2011, during hospitalization). true or false. 1 point if true. magent does not assign level of care. ## 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/improve_vte` 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": "50", "current_cancer": "false", "icu_ccu_stay": "false", "immobilized_ge_7_days": "false", "known_thrombophilia": "false", "lower_limb_paralysis": "false", "previous_vte": "false" }, { "age": "50", "current_cancer": "false", "icu_ccu_stay": "false", "immobilized_ge_7_days": "false", "known_thrombophilia": "false", "lower_limb_paralysis": "false", "previous_vte": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/improve-vte Example 200: ```json { "count": 2, "path": "/api/calc/improve_vte", "items": [ { "components": [ { "factor": "previous_vte", "points": 0, "present": false }, { "factor": "known_thrombophilia", "points": 0, "present": false }, { "factor": "lower_limb_paralysis", "points": 0, "present": false }, { "factor": "current_cancer", "points": 0, "present": false }, { "factor": "immobilized_ge_7_days", "points": 0, "present": false }, { "factor": "icu_ccu_stay", "points": 0, "present": false }, { "value": 50, "factor": "age_gt_60", "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": "Spyropoulos AC, Anderson FA Jr, FitzGerald G, Decousus H, Pini M, Chong BH, Zotz RB, Bergmann JF, Tapson VF, Froehlich JB, Monreal M, Merli GJ, Pavanello R, Turpie AGG, Nakamura M, Piovella F, Kakkar AK, Spencer FA, IMPROVE Investigators", "doi": "10.1378/chest.10-1944", "id": "spyropoulos-2011", "pmid": "21436241", "source": "Chest. 2011;140(3):706-714", "title": "Predictive and associative models to identify hospitalized medical patients at risk for VTE" }, "formula": "improve_vte", "formula_expression": "IMPROVE VTE (Spyropoulos 2011 7-factor associative during hospitalization) = previous_vte (3) + known_thrombophilia (2) + lower_limb_paralysis (2) + current_cancer (2) + immobilized_ge_7_days (1) + icu_ccu_stay (1) + age>60 (1); max 12; 0-1, 2-3 (observed VTE 1.5%), >=4 (observed VTE 5.7%); not the 4-factor admission predictive model; not IMPROVEDD", "age_years": 50, "max_score": 12, "score": 0, "vte_band": "0-1" }, { "components": [ { "factor": "previous_vte", "points": 0, "present": false }, { "factor": "known_thrombophilia", "points": 0, "present": false }, { "factor": "lower_limb_paralysis", "points": 0, "present": false }, { "factor": "current_cancer", "points": 0, "present": false }, { "factor": "immobilized_ge_7_days", "points": 0, "present": false }, { "factor": "icu_ccu_stay", "points": 0, "present": false }, { "value": 50, "factor": "age_gt_60", "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": "Spyropoulos AC, Anderson FA Jr, FitzGerald G, Decousus H, Pini M, Chong BH, Zotz RB, Bergmann JF, Tapson VF, Froehlich JB, Monreal M, Merli GJ, Pavanello R, Turpie AGG, Nakamura M, Piovella F, Kakkar AK, Spencer FA, IMPROVE Investigators", "doi": "10.1378/chest.10-1944", "id": "spyropoulos-2011", "pmid": "21436241", "source": "Chest. 2011;140(3):706-714", "title": "Predictive and associative models to identify hospitalized medical patients at risk for VTE" }, "formula": "improve_vte", "formula_expression": "IMPROVE VTE (Spyropoulos 2011 7-factor associative during hospitalization) = previous_vte (3) + known_thrombophilia (2) + lower_limb_paralysis (2) + current_cancer (2) + immobilized_ge_7_days (1) + icu_ccu_stay (1) + age>60 (1); max 12; 0-1, 2-3 (observed VTE 1.5%), >=4 (observed VTE 5.7%); not the 4-factor admission predictive model; not IMPROVEDD", "age_years": 50, "max_score": 12, "score": 0, "vte_band": "0-1" } ] } ``` ## Response fields - `formula` (string): improve_vte - `formula_expression` (string): Exact expression used - `score` (integer): Total points 0-12 - `max_score` (integer): Always 12 - `vte_band` (string): Spyropoulos 2011 observed-VTE band during hospitalization: 0-1, 2-3, or >=4. Not a diagnosis and not a prophylaxis order. - `age_years` (integer): Age used for the >60 criterion - `components` (array): Per-item points - `citation` (object): Spyropoulos 2011 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "previous_vte", "points": 0, "present": false }, { "factor": "known_thrombophilia", "points": 0, "present": false }, { "factor": "lower_limb_paralysis", "points": 0, "present": false }, { "factor": "current_cancer", "points": 0, "present": false }, { "factor": "immobilized_ge_7_days", "points": 0, "present": false }, { "factor": "icu_ccu_stay", "points": 0, "present": false }, { "value": 50, "factor": "age_gt_60", "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": "Spyropoulos AC, Anderson FA Jr, FitzGerald G, Decousus H, Pini M, Chong BH, Zotz RB, Bergmann JF, Tapson VF, Froehlich JB, Monreal M, Merli GJ, Pavanello R, Turpie AGG, Nakamura M, Piovella F, Kakkar AK, Spencer FA, IMPROVE Investigators", "doi": "10.1378/chest.10-1944", "id": "spyropoulos-2011", "pmid": "21436241", "source": "Chest. 2011;140(3):706-714", "title": "Predictive and associative models to identify hospitalized medical patients at risk for VTE" }, "formula": "improve_vte", "formula_expression": "IMPROVE VTE (Spyropoulos 2011 7-factor associative during hospitalization) = previous_vte (3) + known_thrombophilia (2) + lower_limb_paralysis (2) + current_cancer (2) + immobilized_ge_7_days (1) + icu_ccu_stay (1) + age>60 (1); max 12; 0-1, 2-3 (observed VTE 1.5%), >=4 (observed VTE 5.7%); not the 4-factor admission predictive model; not IMPROVEDD", "age_years": 50, "max_score": 12, "score": 0, "vte_band": "0-1" } ``` ## Errors - HTTP 400 `invalid_age`: age must be an integer from 18 to 120 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 - [Padua score](https://magentlab.com/docs/padua) — Compute the Barbar 2010 Padua Prediction Score for VTE risk in hospitalized medical patients from age and ten caller-assigned findings. - [Caprini score](https://magentlab.com/docs/caprini) — Sum Caprini 2005 Table 3 thrombosis risk factors with exclusive age and surgery weights and return the Table 2 band (low / moderate / high / highest). - [Wells DVT](https://magentlab.com/docs/wells-dvt) — Compute the Wells deep-vein thrombosis probability score and return three-tier and two-tier bands. ## 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.