MACOCHA score

MACOCHA

Sum the seven De Jong 2013 Table 1 MACOCHA factors from caller-assigned flags and return the 0-12 total plus high_risk at that paper's score >= 3 cutoff.

LIVE $0.005 USDC GET /api/calc/macocha

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

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

What it computes

Sum the seven De Jong 2013 Table 1 MACOCHA factors from caller-assigned flags and return the 0-12 total plus high_risk at that paper's score >= 3 cutoff.

When to use

When an agent already has the seven De Jong 2013 MACOCHA flags (Mallampati III or IV, obstructive sleep apnea, reduced cervical mobility, limited mouth opening, coma, severe hypoxemia, non-anesthesiologist operator) and needs the published 0-12 total. magent does not examine the airway, compute GCS, or measure SpO2.

When not to use

Not a medical device.
Not an intubation order.
magent does not examine the airway, compute GCS, or measure SpO2. The caller assigns each Table 1 flag.
Mallampati is a yes/no III-or-IV flag, not a 1-4 scale. Coma is the paper's pathology item (typically GCS <8 in that derivation); magent does not take raw GCS.
high_risk is score >= 3 from De Jong 2013 (NPV ~98% at that cut in the validation cohort). 0 = easy, 12 = very difficult. Not a later review cut.

Formula

MACOCHA = mallampati_iii_iv (5) + obstructive_sleep_apnea (2) + reduced_cervical_mobility (1) + limited_mouth_opening (1) + coma (1) + severe_hypoxemia (1) + non_anesthesiologist (1); De Jong 2013 Table 1; max 12; 0 easy, 12 very difficult; high_risk iff score >= 3

Citation

Title: Early identification of patients at risk for difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study
Authors: De Jong A, Molinari N, Terzi N, Mongardon N, Arnal JM, Guitton C, et al.
Source: Am J Respir Crit Care Med. 2013;187(8):832-839
DOI: 10.1164/rccm.201210-1851OC

Worked example

All flags false

Given: coma=falselimited_mouth_opening=falsemallampati_iii_iv=falsenon_anesthesiologist=falseobstructive_sleep_apnea=falsereduced_cervical_mobility=falsesevere_hypoxemia=false

All seven caller-assigned flags false
score = 0; max 12; high_risk is false

Mallampati III or IV only

Given: coma=falselimited_mouth_opening=falsemallampati_iii_iv=truenon_anesthesiologist=falseobstructive_sleep_apnea=falsereduced_cervical_mobility=falsesevere_hypoxemia=false

mallampati_iii_iv true scores 5
The other six flags are false
score = 5; max 12; high_risk is true (score >= 3)

Also searched as

MACOCHA score
De Jong 2013 MACOCHA
ICU difficult intubation score
Mallampati apnea cervical
difficult airway ICU
MACOCHA
ICU intubation prediction
MACOCHA airway

Try

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

/api/calc/macocha?mallampati_iii_iv=false&obstructive_sleep_apnea=false&reduced_cervical_mobility=false&limited_mouth_opening=false&coma=false&severe_hypoxemia=false&non_anesthesiologist=false

Full URL: https://api.magentlab.com/api/calc/macocha?mallampati_iii_iv=false&obstructive_sleep_apnea=false&reduced_cervical_mobility=false&limited_mouth_opening=false&coma=false&severe_hypoxemia=false&non_anesthesiologist=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/macocha?mallampati_iii_iv=false&obstructive_sleep_apnea=false&reduced_cervical_mobility=false&limited_mouth_opening=false&coma=false&severe_hypoxemia=false&non_anesthesiologist=false"

Parameters

Name	Type	Required	Description
`mallampati_iii_iv`	boolean	required	Mallampati class III or IV as assigned by the caller (De Jong 2013 Table 1). true or false. Not a 1-4 Mallampati integer. magent does not examine the airway.
`obstructive_sleep_apnea`	boolean	required	Obstructive sleep apnea syndrome as assigned by the caller (De Jong 2013 Table 1). true or false. magent does not diagnose sleep apnea.
`reduced_cervical_mobility`	boolean	required	Reduced mobility of the cervical spine as assigned by the caller (De Jong 2013 Table 1). true or false. magent does not examine the neck.
`limited_mouth_opening`	boolean	required	Limited mouth opening <3 cm as assigned by the caller (De Jong 2013 Table 1). true or false. magent does not measure mouth opening.
`coma`	boolean	required	Coma as assigned by the caller (De Jong 2013 Table 1 pathology item; typically GCS <8 in that derivation). true or false. magent does not take raw GCS or compute GCS.
`severe_hypoxemia`	boolean	required	Severe hypoxemia (SpO2 <80%) as assigned by the caller (De Jong 2013 Table 1). true or false. magent does not measure SpO2.
`non_anesthesiologist`	boolean	required	Non-anesthesiologist operator as assigned by the caller (De Jong 2013 Table 1). true or false. magent does not identify the operator.

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/macocha 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": [
    {
      "coma": "false",
      "limited_mouth_opening": "false",
      "mallampati_iii_iv": "false",
      "non_anesthesiologist": "false",
      "obstructive_sleep_apnea": "false",
      "reduced_cervical_mobility": "false",
      "severe_hypoxemia": "false"
    },
    {
      "coma": "false",
      "limited_mouth_opening": "false",
      "mallampati_iii_iv": "false",
      "non_anesthesiologist": "false",
      "obstructive_sleep_apnea": "false",
      "reduced_cervical_mobility": "false",
      "severe_hypoxemia": "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/macocha",
  "items": [
    {
      "components": [
        {
          "factor": "mallampati_iii_iv",
          "points": 0,
          "present": false
        },
        {
          "factor": "obstructive_sleep_apnea",
          "points": 0,
          "present": false
        },
        {
          "factor": "reduced_cervical_mobility",
          "points": 0,
          "present": false
        },
        {
          "factor": "limited_mouth_opening",
          "points": 0,
          "present": false
        },
        {
          "factor": "coma",
          "points": 0,
          "present": false
        },
        {
          "factor": "severe_hypoxemia",
          "points": 0,
          "present": false
        },
        {
          "factor": "non_anesthesiologist",
          "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": "De Jong A, Molinari N, Terzi N, Mongardon N, Arnal JM, Guitton C, et al.",
        "doi": "10.1164/rccm.201210-1851OC",
        "id": "de-jong-2013",
        "pmid": "23348979",
        "source": "Am J Respir Crit Care Med. 2013;187(8):832-839",
        "title": "Early identification of patients at risk for difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study"
      },
      "formula": "macocha",
      "formula_expression": "MACOCHA = mallampati_iii_iv (5) + obstructive_sleep_apnea (2) + reduced_cervical_mobility (1) + limited_mouth_opening (1) + coma (1) + severe_hypoxemia (1) + non_anesthesiologist (1); De Jong 2013 Table 1; max 12; 0 easy, 12 very difficult; high_risk iff score >= 3",
      "max_score": 12,
      "score": 0,
      "high_risk": false
    },
    {
      "components": [
        {
          "factor": "mallampati_iii_iv",
          "points": 0,
          "present": false
        },
        {
          "factor": "obstructive_sleep_apnea",
          "points": 0,
          "present": false
        },
        {
          "factor": "reduced_cervical_mobility",
          "points": 0,
          "present": false
        },
        {
          "factor": "limited_mouth_opening",
          "points": 0,
          "present": false
        },
        {
          "factor": "coma",
          "points": 0,
          "present": false
        },
        {
          "factor": "severe_hypoxemia",
          "points": 0,
          "present": false
        },
        {
          "factor": "non_anesthesiologist",
          "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": "De Jong A, Molinari N, Terzi N, Mongardon N, Arnal JM, Guitton C, et al.",
        "doi": "10.1164/rccm.201210-1851OC",
        "id": "de-jong-2013",
        "pmid": "23348979",
        "source": "Am J Respir Crit Care Med. 2013;187(8):832-839",
        "title": "Early identification of patients at risk for difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study"
      },
      "formula": "macocha",
      "formula_expression": "MACOCHA = mallampati_iii_iv (5) + obstructive_sleep_apnea (2) + reduced_cervical_mobility (1) + limited_mouth_opening (1) + coma (1) + severe_hypoxemia (1) + non_anesthesiologist (1); De Jong 2013 Table 1; max 12; 0 easy, 12 very difficult; high_risk iff score >= 3",
      "max_score": 12,
      "score": 0,
      "high_risk": false
    }
  ]
}

Response

Field	Type	Description
`formula`	string	macocha
`formula_expression`	string	Exact expression used
`score`	integer	MACOCHA points 0-12
`max_score`	integer	Always 12
`high_risk`	boolean	true iff score >= 3 (De Jong 2013 operating point for ruling out difficult intubation; NPV ~98% in that validation cohort). Not an intubation order.
`components`	array	Per-factor points
`citation`	object	De Jong 2013 Am J Respir Crit Care Med citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "components": [
    {
      "factor": "mallampati_iii_iv",
      "points": 0,
      "present": false
    },
    {
      "factor": "obstructive_sleep_apnea",
      "points": 0,
      "present": false
    },
    {
      "factor": "reduced_cervical_mobility",
      "points": 0,
      "present": false
    },
    {
      "factor": "limited_mouth_opening",
      "points": 0,
      "present": false
    },
    {
      "factor": "coma",
      "points": 0,
      "present": false
    },
    {
      "factor": "severe_hypoxemia",
      "points": 0,
      "present": false
    },
    {
      "factor": "non_anesthesiologist",
      "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": "De Jong A, Molinari N, Terzi N, Mongardon N, Arnal JM, Guitton C, et al.",
    "doi": "10.1164/rccm.201210-1851OC",
    "id": "de-jong-2013",
    "pmid": "23348979",
    "source": "Am J Respir Crit Care Med. 2013;187(8):832-839",
    "title": "Early identification of patients at risk for difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study"
  },
  "formula": "macocha",
  "formula_expression": "MACOCHA = mallampati_iii_iv (5) + obstructive_sleep_apnea (2) + reduced_cervical_mobility (1) + limited_mouth_opening (1) + coma (1) + severe_hypoxemia (1) + non_anesthesiologist (1); De Jong 2013 Table 1; max 12; 0 easy, 12 very difficult; high_risk iff score >= 3",
  "max_score": 12,
  "score": 0,
  "high_risk": false
}

Client errors (HTTP 400)

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

HTTP	Code	When
400	`invalid_macocha`	MACOCHA inputs must match De Jong 2013 Mallampati, sleep apnea, cervical mobility, mouth opening, coma, hypoxia, and operator factors from that paper. 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

Mallampati — Return the Samsoon 1987 modified Mallampati class 1-4 from a caller-assigned integer, with a stable label.
HEAVEN — Apply the Davis 2017 HEAVEN criteria from six caller-assigned flags and return high_risk iff any is true, plus the count of criteria met (0-6).
Pediatric ETT size — Compute Cole 1957 uncuffed pediatric endotracheal tube internal diameter from age in years.

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.