IMPROVEDD VTE risk score

IMPROVEDD

Compute the Gibson 2017 IMPROVEDD VTE score from age, six caller-assigned IMPROVE flags, and caller-assigned D-dimer >=2x ULN.

LIVE $0.005 USDC GET /api/calc/improvedd

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

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

What it computes

Compute the Gibson 2017 IMPROVEDD VTE score from age, six caller-assigned IMPROVE flags, and caller-assigned D-dimer >=2x ULN.

When to use

When an agent needs the published IMPROVEDD VTE score (Spyropoulos 2011 7-factor associative IMPROVE items plus D-dimer >=2x ULN). Not the 4-factor admission predictive model, not Padua, not Caprini. magent does not assay D-dimer, 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.
Gibson 2017 IMPROVEDD: Spyropoulos 2011 7-factor associative IMPROVE items plus 2 points if caller-assigned D-dimer is >=2x ULN. Max 14. Cutoff 0-1 (low) vs >=2 (high; heightened VTE risk through 77 days). Does not copy Spyropoulos 2011 observed hospitalization percents.
Not the 4-factor admission-only predictive IMPROVE model.
Not Padua or Caprini.
magent does not assay D-dimer. d_dimer_ge_2x_uln is caller-assigned.
magent does not examine the patient. Flags are caller-assigned.

Formula

IMPROVEDD VTE (Gibson 2017; Spyropoulos 2011 7-factor associative items plus D-dimer >=2x ULN) = 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) + d_dimer_ge_2x_uln (2); max 14; 0-1 low vs >=2 high (heightened VTE risk through 77 days when >=2); not the 4-factor admission predictive model; not Padua; not Caprini

Citation

Title: The IMPROVEDD VTE Risk Score: Incorporation of D-Dimer into the IMPROVE Score to Improve Venous Thromboembolism Risk Stratification
Authors: Gibson CM, Spyropoulos AC, Cohen AT, Hull RD, Goldhaber SZ, Yusen RD, Hernandez AF, Korjian S, Daaboul Y, Gold A, Harrington RA, Chi G
Source: TH Open. 2017;1(1):e56-e65
DOI: 10.1055/s-0037-1603929

Worked example

Age 50, all flags false including D-dimer

Given: age=50current_cancer=falsed_dimer_ge_2x_uln=falseicu_ccu_stay=falseimmobilized_ge_7_days=falseknown_thrombophilia=falselower_limb_paralysis=falseprevious_vte=false

Age 50 is not >60 → 0; all seven flags false → 0
Score = 0 (max 14); vte_band low (0-1)

D-dimer >=2x ULN alone is high

Given: age=50current_cancer=falsed_dimer_ge_2x_uln=trueicu_ccu_stay=falseimmobilized_ge_7_days=falseknown_thrombophilia=falselower_limb_paralysis=falseprevious_vte=false

d_dimer_ge_2x_uln → 2; age 50 not >60 → 0
Score = 2 (max 14); vte_band high (>=2)

Also searched as

IMPROVEDD VTE score
IMPROVEDD
Gibson IMPROVEDD
IMPROVE D-dimer VTE
D-dimer IMPROVE score
hospital VTE D-dimer
IMPROVEDD risk score

Try

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

/api/calc/improvedd?age=50&previous_vte=false&known_thrombophilia=false&lower_limb_paralysis=false&current_cancer=false&immobilized_ge_7_days=false&icu_ccu_stay=false&d_dimer_ge_2x_uln=false

Full URL: https://api.magentlab.com/api/calc/improvedd?age=50&previous_vte=false&known_thrombophilia=false&lower_limb_paralysis=false&current_cancer=false&immobilized_ge_7_days=false&icu_ccu_stay=false&d_dimer_ge_2x_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/improvedd?age=50&previous_vte=false&known_thrombophilia=false&lower_limb_paralysis=false&current_cancer=false&immobilized_ge_7_days=false&icu_ccu_stay=false&d_dimer_ge_2x_uln=false"

Parameters

Name	Type	Required	Description
`age`	integer	required	Age in years (18-120). Scores 1 when age >60 (Spyropoulos 2011 / Gibson 2017). Age 60 scores 0; age 61 scores 1.
`previous_vte`	boolean	required	Previous VTE as assigned by the caller (Spyropoulos 2011 7-factor associative items in Gibson 2017 IMPROVEDD). 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 / Gibson 2017). 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 / Gibson 2017). 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 / Gibson 2017). 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 / Gibson 2017, 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 / Gibson 2017, during hospitalization). true or false. 1 point if true. magent does not assign level of care.
`d_dimer_ge_2x_uln`	boolean	required	D-dimer >=2x the local upper limit of normal as assigned by the caller (Gibson 2017). true or false. 2 points if true. magent does not assay D-dimer.

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/improvedd 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": [
    {
      "age": "50",
      "current_cancer": "false",
      "d_dimer_ge_2x_uln": "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",
      "d_dimer_ge_2x_uln": "false",
      "icu_ccu_stay": "false",
      "immobilized_ge_7_days": "false",
      "known_thrombophilia": "false",
      "lower_limb_paralysis": "false",
      "previous_vte": "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/improvedd",
  "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
        },
        {
          "factor": "d_dimer_ge_2x_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": "Gibson CM, Spyropoulos AC, Cohen AT, Hull RD, Goldhaber SZ, Yusen RD, Hernandez AF, Korjian S, Daaboul Y, Gold A, Harrington RA, Chi G",
        "doi": "10.1055/s-0037-1603929",
        "id": "gibson-2017",
        "pmid": "31249911",
        "source": "TH Open. 2017;1(1):e56-e65",
        "title": "The IMPROVEDD VTE Risk Score: Incorporation of D-Dimer into the IMPROVE Score to Improve Venous Thromboembolism Risk Stratification"
      },
      "formula": "improvedd",
      "formula_expression": "IMPROVEDD VTE (Gibson 2017; Spyropoulos 2011 7-factor associative items plus D-dimer >=2x ULN) = 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) + d_dimer_ge_2x_uln (2); max 14; 0-1 low vs >=2 high (heightened VTE risk through 77 days when >=2); not the 4-factor admission predictive model; not Padua; not Caprini",
      "max_score": 14,
      "score": 0,
      "age_years": 50,
      "vte_band": "low"
    },
    {
      "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
        },
        {
          "factor": "d_dimer_ge_2x_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": "Gibson CM, Spyropoulos AC, Cohen AT, Hull RD, Goldhaber SZ, Yusen RD, Hernandez AF, Korjian S, Daaboul Y, Gold A, Harrington RA, Chi G",
        "doi": "10.1055/s-0037-1603929",
        "id": "gibson-2017",
        "pmid": "31249911",
        "source": "TH Open. 2017;1(1):e56-e65",
        "title": "The IMPROVEDD VTE Risk Score: Incorporation of D-Dimer into the IMPROVE Score to Improve Venous Thromboembolism Risk Stratification"
      },
      "formula": "improvedd",
      "formula_expression": "IMPROVEDD VTE (Gibson 2017; Spyropoulos 2011 7-factor associative items plus D-dimer >=2x ULN) = 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) + d_dimer_ge_2x_uln (2); max 14; 0-1 low vs >=2 high (heightened VTE risk through 77 days when >=2); not the 4-factor admission predictive model; not Padua; not Caprini",
      "max_score": 14,
      "score": 0,
      "age_years": 50,
      "vte_band": "low"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	improvedd
`formula_expression`	string	Exact expression used
`score`	integer	Total points 0-14
`max_score`	integer	Always 14
`vte_band`	string	Gibson 2017 cutoff: low (score 0-1) vs high (score >=2, heightened VTE risk through 77 days). Not a diagnosis and not a prophylaxis order.
`age_years`	integer	Age used for the >60 criterion
`components`	array	Per-item points
`citation`	object	Gibson 2017 citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "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
    },
    {
      "factor": "d_dimer_ge_2x_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": "Gibson CM, Spyropoulos AC, Cohen AT, Hull RD, Goldhaber SZ, Yusen RD, Hernandez AF, Korjian S, Daaboul Y, Gold A, Harrington RA, Chi G",
    "doi": "10.1055/s-0037-1603929",
    "id": "gibson-2017",
    "pmid": "31249911",
    "source": "TH Open. 2017;1(1):e56-e65",
    "title": "The IMPROVEDD VTE Risk Score: Incorporation of D-Dimer into the IMPROVE Score to Improve Venous Thromboembolism Risk Stratification"
  },
  "formula": "improvedd",
  "formula_expression": "IMPROVEDD VTE (Gibson 2017; Spyropoulos 2011 7-factor associative items plus D-dimer >=2x ULN) = 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) + d_dimer_ge_2x_uln (2); max 14; 0-1 low vs >=2 high (heightened VTE risk through 77 days when >=2); not the 4-factor admission predictive model; not Padua; not Caprini",
  "max_score": 14,
  "score": 0,
  "age_years": 50,
  "vte_band": "low"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_age`	age must be an integer from 18 to 120 Returned before settlement; you are not charged.
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

IMPROVE VTE — Compute the Spyropoulos 2011 7-factor associative IMPROVE VTE score during hospitalization from age and six caller-assigned flags.

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. 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.