# Karnofsky Performance Status (KPS)

Karnofsky

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

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

## What it computes

Return the Karnofsky 1949 Performance Status 10-100 from a caller-assigned integer, with a stable label.

## When to use

When an agent already has a Karnofsky Performance Status 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 as in Karnofsky 1949 and needs the published score and label. magent does not observe the patient or assign performance status. Not ECOG.

## When not to use

- Not a medical device and not a performance-status assignment. magent does not observe the patient.
- Karnofsky 1949 decades 10-100 only. Grade 0 (dead) is not scored.
- The caller assigns kps 10-100. magent does not examine the patient or convert ECOG grades.

## Formula

```
Karnofsky Performance Status = caller-assigned integer 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 (Karnofsky 1949); max 100; grade 0 (dead) is not scored
```

## Citation

[The clinical evaluation of chemotherapeutic agents in cancer](https://www.worldcat.org/oclc/1455041)
Karnofsky DA, Burchenal JH
In: MacLeod CM, ed. Evaluation of Chemotherapeutic Agents. New York: Columbia University Press; 1949:191-205
DOI: none

## Worked example

### KPS 100 normal

Given: `kps=100`

1. kps 100 → score 100; max 100; kps 100; normal


### KPS 10 moribund

Given: `kps=10`

1. kps 10 → score 10; max 100; kps 10; moribund


## Also searched as

- Karnofsky Performance Status
- KPS
- Karnofsky score
- Karnofsky 1949
- Karnofsky scale
- performance status 10-100
- KPS 10-100

## Parameters

- `kps` (integer, required): Karnofsky 1949 Performance Status 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 as assigned by the caller (100 normal, no complaints; 90 minor signs or symptoms, normal activity; 80 normal activity with effort; 70 cares for self; 60 occasional assistance; 50 considerable assistance and frequent medical care; 40 disabled; 30 severely disabled; 20 very sick, hospital admission necessary; 10 moribund). Grade 0 (dead) is not scored. magent does not observe the patient.

## 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/karnofsky`
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": [
    {
      "kps": "100"
    },
    {
      "kps": "100"
    }
  ]
}
```

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

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/karnofsky",
  "items": [
    {
      "components": [
        {
          "factor": "kps",
          "points": 100,
          "present": true
        }
      ],
      "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": "Karnofsky DA, Burchenal JH",
        "id": "karnofsky-1949",
        "source": "In: MacLeod CM, ed. Evaluation of Chemotherapeutic Agents. New York: Columbia University Press; 1949:191-205",
        "title": "The clinical evaluation of chemotherapeutic agents in cancer"
      },
      "formula": "karnofsky",
      "formula_expression": "Karnofsky Performance Status = caller-assigned integer 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 (Karnofsky 1949); max 100; grade 0 (dead) is not scored",
      "max_score": 100,
      "score": 100,
      "kps": 100,
      "kps_label": "normal"
    },
    {
      "components": [
        {
          "factor": "kps",
          "points": 100,
          "present": true
        }
      ],
      "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": "Karnofsky DA, Burchenal JH",
        "id": "karnofsky-1949",
        "source": "In: MacLeod CM, ed. Evaluation of Chemotherapeutic Agents. New York: Columbia University Press; 1949:191-205",
        "title": "The clinical evaluation of chemotherapeutic agents in cancer"
      },
      "formula": "karnofsky",
      "formula_expression": "Karnofsky Performance Status = caller-assigned integer 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 (Karnofsky 1949); max 100; grade 0 (dead) is not scored",
      "max_score": 100,
      "score": 100,
      "kps": 100,
      "kps_label": "normal"
    }
  ]
}
```

## Response fields

- `formula` (string): karnofsky
- `formula_expression` (string): Published Karnofsky decade rule
- `score` (integer): Same as kps (10-100 by tens)
- `max_score` (integer): 100
- `kps` (integer): Caller-assigned Karnofsky 1949 Performance Status 10-100 by tens
- `kps_label` (string): Stable token for that decade: normal, minor_symptoms, effort, selfcare, occasional_assistance, considerable_assistance, disabled, severely_disabled, very_sick, or moribund
- `components` (array): kps component
- `citation` (object): Karnofsky 1949
- `disclaimer` (string): Not a medical device

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "factor": "kps",
      "points": 100,
      "present": true
    }
  ],
  "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": "Karnofsky DA, Burchenal JH",
    "id": "karnofsky-1949",
    "source": "In: MacLeod CM, ed. Evaluation of Chemotherapeutic Agents. New York: Columbia University Press; 1949:191-205",
    "title": "The clinical evaluation of chemotherapeutic agents in cancer"
  },
  "formula": "karnofsky",
  "formula_expression": "Karnofsky Performance Status = caller-assigned integer 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 (Karnofsky 1949); max 100; grade 0 (dead) is not scored",
  "max_score": 100,
  "score": 100,
  "kps": 100,
  "kps_label": "normal"
}
```

## Errors

- HTTP 400 `invalid_karnofsky`: kps must be 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 (Karnofsky 1949). Grade 0 (dead) is not scored. 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

- [ECOG](https://magentlab.com/docs/ecog) — Return the Oken 1982 ECOG performance status grade 0-4 from a caller-assigned integer, with a stable label.
- [IPI](https://magentlab.com/docs/ipi) — Sum the Shipp 1993 five-factor International Prognostic Index (all ages) and return low (0–1), low_intermediate (2), high_intermediate (3), or high (4–5).

## 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.