# ISTH overt DIC score

ISTH overt DIC

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/isth_dic`
HTML: https://magentlab.com/docs/isth-dic
Markdown: https://magentlab.com/docs/isth-dic.md

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

## What it computes

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.

## When to use

When an agent needs the published ISTH overt DIC point total and band from laboratory items and must not invent a DIC diagnosis, a D-dimer grade, or the non-overt serial score.

## When not to use

- Not a medical device.
- Not a diagnosis of DIC without an underlying disorder associated with DIC. The ISTH prerequisite (an underlying disorder known to be associated with DIC) is caller-side; magent scores the four laboratory items only.
- Not the ISTH non-overt serial DIC algorithm.
- magent does not grade D-dimer assays. fibrin_related_marker is a caller-assigned none, moderate, or strong value.
- Does not return mortality percents. Band >=5 is compatible with overt DIC; band <5 is not compatible with overt DIC.

## Formula

```
ISTH overt DIC = platelets_10e9_l (>=100 → 0; 50 to <100 → 1; <50 → 2) + fibrin_related_marker (none 0, moderate 2, strong 3) + pt_prolongation_sec (<3 → 0; >=3 and <6 → 1; >=6 → 2) + fibrinogen_g_l (>=1.0 → 0; <1.0 → 1); max 8; bands <5 / >=5
```

## Citation

[Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation](https://doi.org/10.1055/s-0037-1616068)
Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M
Thromb Haemost. 2001;86(5):1327-1330
DOI: [10.1055/s-0037-1616068](https://doi.org/10.1055/s-0037-1616068)

## Worked example

### All laboratory items non-scoring

Given: `fibrin_related_marker=none, fibrinogen_g_l=2.5, platelets_10e9_l=180, pt_prolongation_sec=1.0`

1. Platelets 180 >= 100 → 0; fibrin_related_marker none → 0; PT prolongation 1.0 < 3 → 0; fibrinogen 2.5 g/L >= 1.0 → 0
2. Score = 0 (max 8); band <5 (not compatible with overt DIC)


## Also searched as

- ISTH DIC score
- ISTH overt DIC
- Taylor DIC score
- disseminated intravascular coagulation ISTH
- ISTH SSC DIC
- overt DIC criteria
- fibrin related marker DIC
- ISTH DIC algorithm

## Parameters

- `platelets_10e9_l` (number, required): Platelet count ×10^9/L (1-2000). >=100 scores 0; 50 to <100 scores 1; <50 scores 2. 100 scores 0; 50 scores 1; 49 scores 2 (Taylor 2001).
- `fibrin_related_marker` (string, required): Caller-assigned ISTH fibrin-related marker (Taylor 2001). none scores 0; moderate scores 2; strong scores 3. magent does not grade D-dimer assays.
- `pt_prolongation_sec` (number, required): Prothrombin time prolongation in seconds above the laboratory ULN (0-30). <3 scores 0; >=3 and <6 scores 1; >=6 scores 2. 3.0 and 5.9 score 1; 6.0 scores 2; 2.9 scores 0 (Taylor 2001 table gaps filled at 3 and 6).
- `fibrinogen_g_l` (number, optional): Fibrinogen in g/L (0.1-10). Provide this or fibrinogen_mg_dl, not both. >=1.0 scores 0; <1.0 scores 1. 1.0 scores 0 (Taylor 2001).
- `fibrinogen_mg_dl` (number, optional): Fibrinogen in mg/dL (10-1000). Converted as g/L = mg/dL / 100. Provide this or fibrinogen_g_l, not both.

## 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_dic`
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": [
    {
      "fibrin_related_marker": "none",
      "fibrinogen_g_l": "2.5",
      "platelets_10e9_l": "180",
      "pt_prolongation_sec": "1.0"
    },
    {
      "fibrin_related_marker": "none",
      "fibrinogen_g_l": "2.5",
      "platelets_10e9_l": "180",
      "pt_prolongation_sec": "1.0"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/isth-dic

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/isth_dic",
  "items": [
    {
      "components": [
        {
          "value": 180.0,
          "factor": "platelets",
          "points": 0,
          "present": false
        },
        {
          "value": "none",
          "factor": "fibrin_related_marker",
          "points": 0,
          "present": false
        },
        {
          "value": 1.0,
          "factor": "pt_prolongation",
          "points": 0,
          "present": false
        },
        {
          "value": 2.5,
          "factor": "fibrinogen",
          "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": "Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M",
        "doi": "10.1055/s-0037-1616068",
        "id": "taylor-2001",
        "pmid": "11816725",
        "source": "Thromb Haemost. 2001;86(5):1327-1330",
        "title": "Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation"
      },
      "formula": "isth_dic",
      "formula_expression": "ISTH overt DIC = platelets_10e9_l (>=100 → 0; 50 to <100 → 1; <50 → 2) + fibrin_related_marker (none 0, moderate 2, strong 3) + pt_prolongation_sec (<3 → 0; >=3 and <6 → 1; >=6 → 2) + fibrinogen_g_l (>=1.0 → 0; <1.0 → 1); max 8; bands <5 / >=5",
      "max_score": 8,
      "score": 0,
      "platelets_10e9_l": 180.0,
      "fibrin_related_marker": "none",
      "fibrinogen_g_l": 2.5,
      "isth_dic_band": "<5",
      "pt_prolongation_sec": 1.0
    },
    {
      "components": [
        {
          "value": 180.0,
          "factor": "platelets",
          "points": 0,
          "present": false
        },
        {
          "value": "none",
          "factor": "fibrin_related_marker",
          "points": 0,
          "present": false
        },
        {
          "value": 1.0,
          "factor": "pt_prolongation",
          "points": 0,
          "present": false
        },
        {
          "value": 2.5,
          "factor": "fibrinogen",
          "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": "Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M",
        "doi": "10.1055/s-0037-1616068",
        "id": "taylor-2001",
        "pmid": "11816725",
        "source": "Thromb Haemost. 2001;86(5):1327-1330",
        "title": "Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation"
      },
      "formula": "isth_dic",
      "formula_expression": "ISTH overt DIC = platelets_10e9_l (>=100 → 0; 50 to <100 → 1; <50 → 2) + fibrin_related_marker (none 0, moderate 2, strong 3) + pt_prolongation_sec (<3 → 0; >=3 and <6 → 1; >=6 → 2) + fibrinogen_g_l (>=1.0 → 0; <1.0 → 1); max 8; bands <5 / >=5",
      "max_score": 8,
      "score": 0,
      "platelets_10e9_l": 180.0,
      "fibrin_related_marker": "none",
      "fibrinogen_g_l": 2.5,
      "isth_dic_band": "<5",
      "pt_prolongation_sec": 1.0
    }
  ]
}
```

## Response fields

- `formula` (string): isth_dic
- `formula_expression` (string): Exact expression used
- `score` (integer): Total points 0-8
- `max_score` (integer): Always 8
- `isth_dic_band` (string): <5 (not compatible with overt DIC; suggestive of non-overt) or >=5 (compatible with overt DIC). Score 5 is overt. Not a mortality percent.
- `platelets_10e9_l` (number): Platelet count used (×10^9/L)
- `fibrin_related_marker` (string): Caller-assigned none, moderate, or strong marker used
- `pt_prolongation_sec` (number): PT prolongation used, seconds above ULN
- `fibrinogen_g_l` (number): Fibrinogen used in g/L (after mg/dL conversion when that unit is supplied)
- `components` (array): Per-item points
- `citation` (object): Taylor 2001 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": 180.0,
      "factor": "platelets",
      "points": 0,
      "present": false
    },
    {
      "value": "none",
      "factor": "fibrin_related_marker",
      "points": 0,
      "present": false
    },
    {
      "value": 1.0,
      "factor": "pt_prolongation",
      "points": 0,
      "present": false
    },
    {
      "value": 2.5,
      "factor": "fibrinogen",
      "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": "Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M",
    "doi": "10.1055/s-0037-1616068",
    "id": "taylor-2001",
    "pmid": "11816725",
    "source": "Thromb Haemost. 2001;86(5):1327-1330",
    "title": "Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation"
  },
  "formula": "isth_dic",
  "formula_expression": "ISTH overt DIC = platelets_10e9_l (>=100 → 0; 50 to <100 → 1; <50 → 2) + fibrin_related_marker (none 0, moderate 2, strong 3) + pt_prolongation_sec (<3 → 0; >=3 and <6 → 1; >=6 → 2) + fibrinogen_g_l (>=1.0 → 0; <1.0 → 1); max 8; bands <5 / >=5",
  "max_score": 8,
  "score": 0,
  "platelets_10e9_l": 180.0,
  "fibrin_related_marker": "none",
  "fibrinogen_g_l": 2.5,
  "isth_dic_band": "<5",
  "pt_prolongation_sec": 1.0
}
```

## Errors

- HTTP 400 `invalid_platelets`: platelets_10e9_l must be a number from 1 to 2000 Returned before settlement; you are not charged.
- HTTP 400 `invalid_fibrin_marker`: fibrin_related_marker must be none, moderate, or strong (Taylor 2001 ISTH DIC). Returned before settlement; you are not charged.
- HTTP 400 `invalid_pt_prolongation`: pt_prolongation_sec must be a number from 0 to 30 (seconds above ULN; Taylor 2001). Returned before settlement; you are not charged.
- HTTP 400 `invalid_fibrinogen`: fibrinogen_g_l (0.1-10) or fibrinogen_mg_dl (10-1000) is required, not both. 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

- [PLASMIC score](https://magentlab.com/docs/plasmic) — Sum the seven Bendapudi 2017 PLASMIC items and return the published 0-4 / 5 / 6-7 pretest band for severe ADAMTS13 deficiency.
- [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).

## 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 echoing accepted, payload, and extensions when present).
- 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.
- 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.