Manchester score for SCLC (Cerny 1987)

Manchester

Sum the Cerny 1987 Manchester pretreatment factors for small-cell lung cancer and return good (0–1), intermediate (2–3), or poor (≥4).

LIVE $0.005 USDC GET /api/calc/manchester

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

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

What it computes

Sum the Cerny 1987 Manchester pretreatment factors for small-cell lung cancer and return good (0–1), intermediate (2–3), or poor (≥4).

When to use

When an agent needs the published Cerny 1987 Manchester score and prognostic group and must not invent an SCLC diagnosis or stage, must not use the BRCA Manchester score, and must not assay labs or assign Karnofsky performance status.

When not to use

Not a medical device and not a diagnosis. magent does not examine the patient.
Not the BRCA Manchester scoring system used in hereditary breast and ovarian cancer risk.
magent does not stage small-cell lung cancer. extensive_stage is caller-assigned (limited versus extensive).
magent does not assay LDH, sodium, ALP, or bicarbonate, or apply laboratory ULN. ldh_gt_uln and alp_gt_1_5_uln are caller-assigned flags.
magent does not assign Karnofsky performance status. kps is a caller-assigned Karnofsky 1949 decade 10-100; grade 0 (dead) is not scored.
Cerny 1987 three groups only: good (0-1), intermediate (2-3), poor (≥4). This tool does not return 2-year survival percentages.

Formula

Manchester = ldh_gt_uln 1 + sodium_lt_132 1 + alp_gt_1_5_uln 1 + bicarbonate_lt_24 1 + kps_lt_60 1 + extensive_stage 1; Cerny 1987; max 6; good 0-1, intermediate 2-3, poor ≥4

Citation

Title: Pretreatment prognostic factors and scoring system in 407 small-cell lung cancer patients
Authors: Cerny T, Blair V, Anderson H, Bramwell V, Thatcher N
Source: Int J Cancer. 1987;39(2):146-149
DOI: 10.1002/ijc.2910390204

Worked example

No factors (limited stage, KPS 80)

Given: alp_gt_1_5_uln=falsebicarbonate_mmol_l=24extensive_stage=falsekps=80ldh_gt_uln=falsesodium_mmol_l=140

All six Cerny 1987 factors absent → 0
Score = 0 (max 6); prognostic_group = good

LDH, ALP, KPS 50, and extensive stage

Given: alp_gt_1_5_uln=truebicarbonate_mmol_l=24extensive_stage=truekps=50ldh_gt_uln=truesodium_mmol_l=140

ldh_gt_uln → 1; alp_gt_1_5_uln → 1; kps 50 < 60 → 1; extensive_stage → 1
Score = 4 (max 6); prognostic_group = poor (≥4)

Also searched as

Manchester score
Cerny Manchester score
SCLC Manchester
Manchester prognostic score
Cerny 1987
small-cell lung cancer Manchester
SCLC prognostic index
Manchester score SCLC

Try

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

/api/calc/manchester?ldh_gt_uln=false&sodium_mmol_l=140&alp_gt_1_5_uln=false&bicarbonate_mmol_l=24&kps=80&extensive_stage=false

Full URL: https://api.magentlab.com/api/calc/manchester?ldh_gt_uln=false&sodium_mmol_l=140&alp_gt_1_5_uln=false&bicarbonate_mmol_l=24&kps=80&extensive_stage=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/manchester?ldh_gt_uln=false&sodium_mmol_l=140&alp_gt_1_5_uln=false&bicarbonate_mmol_l=24&kps=80&extensive_stage=false"

Parameters

Name	Type	Required	Description
`ldh_gt_uln`	boolean	required	LDH exceeds the laboratory upper limit of normal as assigned by the caller (Cerny 1987). true scores 1. magent does not assay LDH or apply ULN.
`sodium_mmol_l`	number	required	Serum sodium in mmol/L (110-160). Cerny 1987 scores 1 when sodium is <132 mmol/L; 132 scores 0.
`alp_gt_1_5_uln`	boolean	required	ALP >1.5 × laboratory ULN as assigned by the caller (Cerny 1987). true scores 1. magent does not assay ALP or apply ULN.
`bicarbonate_mmol_l`	number	required	Serum bicarbonate in mmol/L (2-45). Cerny 1987 scores 1 when bicarbonate is <24 mmol/L; 24 scores 0.
`kps`	integer	required	Karnofsky 1949 Performance Status 10, 20, 30, 40, 50, 60, 70, 80, 90, or 100 as assigned by the caller. Cerny 1987 scores 1 when kps is <60; 60 scores 0. Grade 0 (dead) is not scored. magent does not observe the patient.
`extensive_stage`	boolean	required	Extensive-stage small-cell lung cancer as assigned by the caller (Cerny 1987). true scores 1. magent does not stage the cancer.

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/manchester 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": [
    {
      "alp_gt_1_5_uln": "false",
      "bicarbonate_mmol_l": "24",
      "extensive_stage": "false",
      "kps": "80",
      "ldh_gt_uln": "false",
      "sodium_mmol_l": "140"
    },
    {
      "alp_gt_1_5_uln": "false",
      "bicarbonate_mmol_l": "24",
      "extensive_stage": "false",
      "kps": "80",
      "ldh_gt_uln": "false",
      "sodium_mmol_l": "140"
    }
  ]
}

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/manchester",
  "items": [
    {
      "components": [
        {
          "factor": "ldh_gt_uln",
          "points": 0,
          "present": false
        },
        {
          "value": 140.0,
          "factor": "sodium_lt_132",
          "points": 0,
          "present": false
        },
        {
          "factor": "alp_gt_1_5_uln",
          "points": 0,
          "present": false
        },
        {
          "value": 24.0,
          "factor": "bicarbonate_lt_24",
          "points": 0,
          "present": false
        },
        {
          "value": 80,
          "factor": "kps_lt_60",
          "points": 0,
          "present": false
        },
        {
          "factor": "extensive_stage",
          "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": "Cerny T, Blair V, Anderson H, Bramwell V, Thatcher N",
        "doi": "10.1002/ijc.2910390204",
        "id": "cerny-1987",
        "pmid": "3026969",
        "source": "Int J Cancer. 1987;39(2):146-149",
        "title": "Pretreatment prognostic factors and scoring system in 407 small-cell lung cancer patients"
      },
      "formula": "manchester",
      "formula_expression": "Manchester = ldh_gt_uln 1 + sodium_lt_132 1 + alp_gt_1_5_uln 1 + bicarbonate_lt_24 1 + kps_lt_60 1 + extensive_stage 1; Cerny 1987; max 6; good 0-1, intermediate 2-3, poor ≥4",
      "max_score": 6,
      "score": 0,
      "sodium_mmol_l": 140.0,
      "bicarbonate_mmol_l": 24.0,
      "kps": 80,
      "prognostic_group": "good"
    },
    {
      "components": [
        {
          "factor": "ldh_gt_uln",
          "points": 0,
          "present": false
        },
        {
          "value": 140.0,
          "factor": "sodium_lt_132",
          "points": 0,
          "present": false
        },
        {
          "factor": "alp_gt_1_5_uln",
          "points": 0,
          "present": false
        },
        {
          "value": 24.0,
          "factor": "bicarbonate_lt_24",
          "points": 0,
          "present": false
        },
        {
          "value": 80,
          "factor": "kps_lt_60",
          "points": 0,
          "present": false
        },
        {
          "factor": "extensive_stage",
          "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": "Cerny T, Blair V, Anderson H, Bramwell V, Thatcher N",
        "doi": "10.1002/ijc.2910390204",
        "id": "cerny-1987",
        "pmid": "3026969",
        "source": "Int J Cancer. 1987;39(2):146-149",
        "title": "Pretreatment prognostic factors and scoring system in 407 small-cell lung cancer patients"
      },
      "formula": "manchester",
      "formula_expression": "Manchester = ldh_gt_uln 1 + sodium_lt_132 1 + alp_gt_1_5_uln 1 + bicarbonate_lt_24 1 + kps_lt_60 1 + extensive_stage 1; Cerny 1987; max 6; good 0-1, intermediate 2-3, poor ≥4",
      "max_score": 6,
      "score": 0,
      "sodium_mmol_l": 140.0,
      "bicarbonate_mmol_l": 24.0,
      "kps": 80,
      "prognostic_group": "good"
    }
  ]
}

Response

Field	Type	Description
`formula`	string	manchester
`formula_expression`	string	Exact expression used
`score`	integer	Cerny 1987 Manchester points 0-6
`max_score`	integer	Always 6
`prognostic_group`	string	good when score is 0–1, intermediate when 2–3, poor when 4–6 (Cerny 1987). Not a diagnosis. Not the BRCA Manchester score. magent does not stage the cancer.
`sodium_mmol_l`	number	Parsed sodium_mmol_l (110-160)
`bicarbonate_mmol_l`	number	Parsed bicarbonate_mmol_l (2-45)
`kps`	integer	Caller-assigned Karnofsky 1949 Performance Status 10-100 by tens
`components`	array	Per-factor points
`citation`	object	Cerny 1987 Int J Cancer citation
`disclaimer`	string	Not-a-device notice

Example JSON

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

{
  "components": [
    {
      "factor": "ldh_gt_uln",
      "points": 0,
      "present": false
    },
    {
      "value": 140.0,
      "factor": "sodium_lt_132",
      "points": 0,
      "present": false
    },
    {
      "factor": "alp_gt_1_5_uln",
      "points": 0,
      "present": false
    },
    {
      "value": 24.0,
      "factor": "bicarbonate_lt_24",
      "points": 0,
      "present": false
    },
    {
      "value": 80,
      "factor": "kps_lt_60",
      "points": 0,
      "present": false
    },
    {
      "factor": "extensive_stage",
      "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": "Cerny T, Blair V, Anderson H, Bramwell V, Thatcher N",
    "doi": "10.1002/ijc.2910390204",
    "id": "cerny-1987",
    "pmid": "3026969",
    "source": "Int J Cancer. 1987;39(2):146-149",
    "title": "Pretreatment prognostic factors and scoring system in 407 small-cell lung cancer patients"
  },
  "formula": "manchester",
  "formula_expression": "Manchester = ldh_gt_uln 1 + sodium_lt_132 1 + alp_gt_1_5_uln 1 + bicarbonate_lt_24 1 + kps_lt_60 1 + extensive_stage 1; Cerny 1987; max 6; good 0-1, intermediate 2-3, poor ≥4",
  "max_score": 6,
  "score": 0,
  "sodium_mmol_l": 140.0,
  "bicarbonate_mmol_l": 24.0,
  "kps": 80,
  "prognostic_group": "good"
}

Client errors (HTTP 400)

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

HTTP	Code	When
400	`invalid_sodium`	sodium_mmol_l must be a number from 110 to 160 Returned before settlement; you are not charged.
400	`invalid_bicarbonate`	bicarbonate_mmol_l must be a number from 2 to 45. Returned before settlement; you are not charged.
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.
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

Karnofsky — Return the Karnofsky 1949 Performance Status 10-100 from a caller-assigned integer, with a stable label.
ECOG — Return the Oken 1982 ECOG performance status grade 0-4 from a caller-assigned integer, with a stable label.

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.