# ISTH/SSC bleeding assessment tool ISTH BAT Status: LIVE Price: $0.005 USDC `GET /api/calc/isth_bat` HTML: https://magentlab.com/docs/isth-bat Markdown: https://magentlab.com/docs/isth-bat.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum fourteen caller-assigned Rodeghiero 2010 ISTH/SSC BAT symptom integers (Table S1, 0-4; cns_bleeding 0, 3, or 4) and return the published total (max 56). Does not apply later abnormal cutoffs. ## When to use When an agent has already assigned Rodeghiero 2010 Table S1 integers for all fourteen symptoms and needs the published sum. magent does not take a bleeding history, diagnose VWD, or apply Elbatarny 2014 / WFH abnormal cutoffs. ## When not to use - Not a medical device and not a diagnosis of VWD or any inherited bleeding disorder. - magent does not take the bleeding history. Each of the fourteen symptoms is a caller-assigned integer from Rodeghiero 2010 Table S1. - cns_bleeding is 0, 3, or 4 only (never; subdural, any intervention; intracerebral, any intervention). Grades 1 and 2 are not used in Table S1. - This 2010 proposal letter did not identify an abnormal bleeding score. magent returns score and max_score only and does not apply later Elbatarny 2014 or WFH ≥4 male / ≥6 female / ≥3 child cutoffs. - Negative scores for surgery, tooth extraction, and postpartum bleeding are not in this bleeding score. Only the most severe score ever recorded per symptom, and only symptoms before or at diagnosis, are caller-side. ## Formula ``` ISTH/SSC BAT = epistaxis + cutaneous + minor_wounds + oral_cavity + gi_bleeding + hematuria + tooth_extraction + surgery + menorrhagia + postpartum_hemorrhage + muscle_hematomas + hemarthrosis + cns_bleeding + other_bleeding; each caller-assigned 0-4 from Rodeghiero 2010 Table S1 (cns_bleeding 0, 3, or 4 only); max 56; no abnormal cutoff in this letter ``` ## Citation [ISTH/SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders](https://doi.org/10.1111/j.1538-7836.2010.03975.x) Rodeghiero F, Tosetto A, Abshire T, et al. J Thromb Haemost. 2010;8(9):2063-2065 DOI: [10.1111/j.1538-7836.2010.03975.x](https://doi.org/10.1111/j.1538-7836.2010.03975.x) ## Worked example ### All fourteen symptoms 0 Given: `cns_bleeding=0, cutaneous=0, epistaxis=0, gi_bleeding=0, hemarthrosis=0, hematuria=0, menorrhagia=0, minor_wounds=0, muscle_hematomas=0, oral_cavity=0, other_bleeding=0, postpartum_hemorrhage=0, surgery=0, tooth_extraction=0` 1. Each Table S1 symptom integer is 0 2. Score = 0 (max 56). This letter published no abnormal cutoff. ### Epistaxis 4, remaining symptoms 0 Given: `cns_bleeding=0, cutaneous=0, epistaxis=4, gi_bleeding=0, hemarthrosis=0, hematuria=0, menorrhagia=0, minor_wounds=0, muscle_hematomas=0, oral_cavity=0, other_bleeding=0, postpartum_hemorrhage=0, surgery=0, tooth_extraction=0` 1. epistaxis 4; remaining thirteen items 0 2. Score = 4 (max 56) ### CNS bleeding 4, remaining symptoms 0 Given: `cns_bleeding=4, cutaneous=0, epistaxis=0, gi_bleeding=0, hemarthrosis=0, hematuria=0, menorrhagia=0, minor_wounds=0, muscle_hematomas=0, oral_cavity=0, other_bleeding=0, postpartum_hemorrhage=0, surgery=0, tooth_extraction=0` 1. cns_bleeding 4 (intracerebral, any intervention); remaining thirteen items 0 2. Score = 4 (max 56). Table S1 does not use CNS grades 1 or 2. ## Also searched as - ISTH BAT - ISTH/SSC BAT - ISTH-BAT - bleeding assessment tool - Rodeghiero bleeding score - SSC bleeding questionnaire - inherited bleeding BAT - ISTH bleeding score ## Parameters - `epistaxis` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 epistaxis integer (0-4). 0 no/trivial; 1 >5/year or >10 minutes; 2 consultation only; 3 packing, cauterization, or antifibrinolytic; 4 blood transfusion, replacement therapy, or desmopressin. magent does not take the bleeding history. - `cutaneous` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 cutaneous integer (0-4). 0 no/trivial; 1 five or more bruises >1 cm in exposed areas; 2 consultation only; 3 extensive; 4 spontaneous hematoma requiring blood transfusion. magent does not take the bleeding history. - `minor_wounds` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 bleeding from minor wounds integer (0-4). 0 no/trivial; 1 >5/year or >10 minutes; 2 consultation only; 3 surgical hemostasis; 4 blood transfusion, replacement therapy, or desmopressin. magent does not take the bleeding history. - `oral_cavity` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 oral-cavity integer (0-4). 0 no/trivial; 1 present; 2 consultation only; 3 surgical hemostasis or antifibrinolytic; 4 blood transfusion, replacement therapy, or desmopressin. magent does not take the bleeding history. - `gi_bleeding` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 GI bleeding integer (0-4). 0 no/trivial; 1 present not associated with ulcer, portal hypertension, hemorrhoids, or angiodysplasia; 2 consultation only; 3 surgical hemostasis or antifibrinolytic; 4 blood transfusion, replacement therapy, or desmopressin. magent does not take the bleeding history. - `hematuria` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 hematuria integer (0-4). 0 no/trivial; 1 present (macroscopic); 2 consultation only; 3 surgical hemostasis or iron therapy; 4 blood transfusion, replacement therapy, or desmopressin. magent does not take the bleeding history. - `tooth_extraction` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 tooth-extraction integer (0-4). 0 no/trivial or none done; 1 referred in ≤25% of procedures, no intervention; 2 referred in >25% of procedures, no intervention; 3 resuturing or packing; 4 blood transfusion, replacement therapy, or desmopressin. magent does not take the bleeding history. - `surgery` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 surgery integer (0-4). 0 no/trivial or none done; 1 referred in ≤25% of procedures, no intervention; 2 referred in >25% of procedures, no intervention; 3 surgical hemostasis or antifibrinolytics; 4 blood transfusion, replacement therapy, or desmopressin. magent does not take the bleeding history. - `menorrhagia` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 menorrhagia integer (0-4). 0 no/trivial; 1 consultation only, pads more often than every 2 hours, clot and flooding, or PBAC >100; 2 time off work/school >2/year or antifibrinolytics, hormonal, or iron therapy; 3 combined antifibrinolytics and hormonal therapy, or present since menarche and >12 months; 4 acute menorrhagia requiring hospital admission and emergency treatment, transfusion/replacement/desmopressin, or dilatation and curettage, endometrial ablation, or hysterectomy. magent does not take the bleeding history. - `postpartum_hemorrhage` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 postpartum-hemorrhage integer (0-4). 0 no/trivial or no deliveries; 1 consultation only, use of syntocin, or lochia >6 weeks; 2 iron therapy or antifibrinolytics; 3 blood transfusion, replacement therapy, desmopressin, examination under anaesthesia, or uterine balloon/packing; 4 any procedure requiring critical care or surgical intervention. magent does not take the bleeding history. - `muscle_hematomas` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 muscle-hematomas integer (0-4). 0 never; 1 post trauma, no therapy; 2 spontaneous, no therapy; 3 spontaneous or traumatic, requiring desmopressin or replacement therapy; 4 spontaneous or traumatic, requiring surgical intervention or blood transfusion. magent does not take the bleeding history. - `hemarthrosis` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 hemarthrosis integer (0-4). 0 never; 1 post trauma, no therapy; 2 spontaneous, no therapy; 3 spontaneous or traumatic, requiring desmopressin or replacement therapy; 4 spontaneous or traumatic, requiring surgical intervention or blood transfusion. magent does not take the bleeding history. - `cns_bleeding` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 CNS bleeding integer (0, 3, or 4 only). 0 never; 3 subdural, any intervention; 4 intracerebral, any intervention. Grades 1 and 2 are not used in Table S1. magent does not take the bleeding history. - `other_bleeding` (integer, required): Caller-assigned Rodeghiero 2010 Table S1 other bleedings integer, including infancy-specific symptoms (0-4). 0 no/trivial; 1 present; 2 consultation only; 3 surgical hemostasis, antifibrinolytics, or iron therapy; 4 blood transfusion, replacement therapy, or desmopressin. magent does not take the bleeding history. ## 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/isth_bat` 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": [ { "cns_bleeding": "0", "cutaneous": "0", "epistaxis": "0", "gi_bleeding": "0", "hemarthrosis": "0", "hematuria": "0", "menorrhagia": "0", "minor_wounds": "0", "muscle_hematomas": "0", "oral_cavity": "0", "other_bleeding": "0", "postpartum_hemorrhage": "0", "surgery": "0", "tooth_extraction": "0" }, { "cns_bleeding": "0", "cutaneous": "0", "epistaxis": "0", "gi_bleeding": "0", "hemarthrosis": "0", "hematuria": "0", "menorrhagia": "0", "minor_wounds": "0", "muscle_hematomas": "0", "oral_cavity": "0", "other_bleeding": "0", "postpartum_hemorrhage": "0", "surgery": "0", "tooth_extraction": "0" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/isth-bat Example 200: ```json { "count": 2, "path": "/api/calc/isth_bat", "items": [ { "components": [ { "value": 0, "factor": "epistaxis", "points": 0, "present": false }, { "value": 0, "factor": "cutaneous", "points": 0, "present": false }, { "value": 0, "factor": "minor_wounds", "points": 0, "present": false }, { "value": 0, "factor": "oral_cavity", "points": 0, "present": false }, { "value": 0, "factor": "gi_bleeding", "points": 0, "present": false }, { "value": 0, "factor": "hematuria", "points": 0, "present": false }, { "value": 0, "factor": "tooth_extraction", "points": 0, "present": false }, { "value": 0, "factor": "surgery", "points": 0, "present": false }, { "value": 0, "factor": "menorrhagia", "points": 0, "present": false }, { "value": 0, "factor": "postpartum_hemorrhage", "points": 0, "present": false }, { "value": 0, "factor": "muscle_hematomas", "points": 0, "present": false }, { "value": 0, "factor": "hemarthrosis", "points": 0, "present": false }, { "value": 0, "factor": "cns_bleeding", "points": 0, "present": false }, { "value": 0, "factor": "other_bleeding", "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": "Rodeghiero F, Tosetto A, Abshire T, et al.", "doi": "10.1111/j.1538-7836.2010.03975.x", "id": "rodeghiero-2010", "source": "J Thromb Haemost. 2010;8(9):2063-2065", "title": "ISTH/SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders" }, "formula": "isth_bat", "formula_expression": "ISTH/SSC BAT = epistaxis + cutaneous + minor_wounds + oral_cavity + gi_bleeding + hematuria + tooth_extraction + surgery + menorrhagia + postpartum_hemorrhage + muscle_hematomas + hemarthrosis + cns_bleeding + other_bleeding; each caller-assigned 0-4 from Rodeghiero 2010 Table S1 (cns_bleeding 0, 3, or 4 only); max 56; no abnormal cutoff in this letter", "max_score": 56, "score": 0 }, { "components": [ { "value": 0, "factor": "epistaxis", "points": 0, "present": false }, { "value": 0, "factor": "cutaneous", "points": 0, "present": false }, { "value": 0, "factor": "minor_wounds", "points": 0, "present": false }, { "value": 0, "factor": "oral_cavity", "points": 0, "present": false }, { "value": 0, "factor": "gi_bleeding", "points": 0, "present": false }, { "value": 0, "factor": "hematuria", "points": 0, "present": false }, { "value": 0, "factor": "tooth_extraction", "points": 0, "present": false }, { "value": 0, "factor": "surgery", "points": 0, "present": false }, { "value": 0, "factor": "menorrhagia", "points": 0, "present": false }, { "value": 0, "factor": "postpartum_hemorrhage", "points": 0, "present": false }, { "value": 0, "factor": "muscle_hematomas", "points": 0, "present": false }, { "value": 0, "factor": "hemarthrosis", "points": 0, "present": false }, { "value": 0, "factor": "cns_bleeding", "points": 0, "present": false }, { "value": 0, "factor": "other_bleeding", "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": "Rodeghiero F, Tosetto A, Abshire T, et al.", "doi": "10.1111/j.1538-7836.2010.03975.x", "id": "rodeghiero-2010", "source": "J Thromb Haemost. 2010;8(9):2063-2065", "title": "ISTH/SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders" }, "formula": "isth_bat", "formula_expression": "ISTH/SSC BAT = epistaxis + cutaneous + minor_wounds + oral_cavity + gi_bleeding + hematuria + tooth_extraction + surgery + menorrhagia + postpartum_hemorrhage + muscle_hematomas + hemarthrosis + cns_bleeding + other_bleeding; each caller-assigned 0-4 from Rodeghiero 2010 Table S1 (cns_bleeding 0, 3, or 4 only); max 56; no abnormal cutoff in this letter", "max_score": 56, "score": 0 } ] } ``` ## Response fields - `formula` (string): isth_bat - `formula_expression` (string): Exact expression used - `score` (integer): Rodeghiero 2010 ISTH/SSC BAT sum of fourteen Table S1 symptom integers (0-56) - `max_score` (integer): Always 56 - `components` (array): Per-symptom caller-assigned Table S1 points - `citation` (object): Rodeghiero 2010 J Thromb Haemost citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 0, "factor": "epistaxis", "points": 0, "present": false }, { "value": 0, "factor": "cutaneous", "points": 0, "present": false }, { "value": 0, "factor": "minor_wounds", "points": 0, "present": false }, { "value": 0, "factor": "oral_cavity", "points": 0, "present": false }, { "value": 0, "factor": "gi_bleeding", "points": 0, "present": false }, { "value": 0, "factor": "hematuria", "points": 0, "present": false }, { "value": 0, "factor": "tooth_extraction", "points": 0, "present": false }, { "value": 0, "factor": "surgery", "points": 0, "present": false }, { "value": 0, "factor": "menorrhagia", "points": 0, "present": false }, { "value": 0, "factor": "postpartum_hemorrhage", "points": 0, "present": false }, { "value": 0, "factor": "muscle_hematomas", "points": 0, "present": false }, { "value": 0, "factor": "hemarthrosis", "points": 0, "present": false }, { "value": 0, "factor": "cns_bleeding", "points": 0, "present": false }, { "value": 0, "factor": "other_bleeding", "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": "Rodeghiero F, Tosetto A, Abshire T, et al.", "doi": "10.1111/j.1538-7836.2010.03975.x", "id": "rodeghiero-2010", "source": "J Thromb Haemost. 2010;8(9):2063-2065", "title": "ISTH/SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders" }, "formula": "isth_bat", "formula_expression": "ISTH/SSC BAT = epistaxis + cutaneous + minor_wounds + oral_cavity + gi_bleeding + hematuria + tooth_extraction + surgery + menorrhagia + postpartum_hemorrhage + muscle_hematomas + hemarthrosis + cns_bleeding + other_bleeding; each caller-assigned 0-4 from Rodeghiero 2010 Table S1 (cns_bleeding 0, 3, or 4 only); max 56; no abnormal cutoff in this letter", "max_score": 56, "score": 0 } ``` ## Errors - HTTP 400 `invalid_isth_bat_item`: each ISTH BAT symptom rating must be an integer from 0 to 4 (Rodeghiero 2010 Table S1; cns_bleeding is 0, 3, or 4 only). 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 - [ISTH overt DIC](https://magentlab.com/docs/isth-dic) — Sum the four Taylor 2001 ISTH SSC overt DIC laboratory items (platelets, fibrin-related marker, PT prolongation, fibrinogen) and return the published <5 / >=5 band. - [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). - [HEP score](https://magentlab.com/docs/hep) — Sum the Cuker 2010 HIT Expert Probability (HEP) eight clinical features with published signed integer weights and return the 2010 cutoff-2 and cutoff-5 operating points. ## 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.