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Modified Sgarbossa criteria

Modified Sgarbossa

Apply the Smith 2012 unweighted modified Sgarbossa rule from three caller-assigned ECG flags and return whether any criterion is met.

LIVE $0.005 USDC GET /api/calc/modified_sgarbossa

Markdown: /docs/modified-sgarbossa.md · Canonical: https://magentlab.com/docs/modified-sgarbossa

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

What it computes

Apply the Smith 2012 unweighted modified Sgarbossa rule from three caller-assigned ECG flags and return whether any criterion is met.

When to use

When an agent already has the three Smith 2012 modified Sgarbossa flags for a tracing with left bundle-branch block and needs whether the unweighted any-of rule is positive. magent does not measure the ECG. Use the original Sgarbossa 1996 5/3/2 points score when that published weighting is required.

When not to use

• Not a medical device.
• Not a diagnosis of myocardial infarction, STEMI equivalent, or reperfusion decision.
• magent does not measure the ECG. Each flag is caller-assigned.
• This is Smith 2012 unweighted modified Sgarbossa (any of three flags). Not the original Sgarbossa 1996 5/3/2 points score.
• Not a 5 mm discordant ST-elevation rule. The third flag is excessive discordant STE with ST/S ratio ≤ −0.25 as assigned by the caller.

Formula

modified_sgarbossa iff concordant_st_elevation_1mm or concordant_st_depression_v1_v3 or excessive_discordant_ste_st_s_ge_0_25 (Smith 2012 unweighted modified Sgarbossa; not Sgarbossa 1996 5/3/2 points; not a 5 mm discordant rule)

Citation

Title

Diagnosis of ST-elevation myocardial infarction in the presence of left bundle branch block with the ST-elevation to S-wave ratio in a modified Sgarbossa rule

Authors

Smith SW, Dodd KW, Henry TD, Dvorak DM, Pearce LA

Source

Ann Emerg Med. 2012;60(6):766-776

DOI

10.1016/j.annemergmed.2012.07.119

Worked example

Also searched as

• Smith modified Sgarbossa
• modified Sgarbossa criteria
• Smith 2012 ST/S ratio
• excessive discordant ST elevation
• concordant ST elevation LBBB
• unweighted modified Sgarbossa
• STEMI equivalent LBBB
• Sgarbossa ST/S 0.25

Try

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

/api/calc/modified_sgarbossa?concordant_st_elevation_1mm=false&concordant_st_depression_v1_v3=false&excessive_discordant_ste_st_s_ge_0_25=false

Full URL: https://api.magentlab.com/api/calc/modified_sgarbossa?concordant_st_elevation_1mm=false&concordant_st_depression_v1_v3=false&excessive_discordant_ste_st_s_ge_0_25=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/modified_sgarbossa?concordant_st_elevation_1mm=false&concordant_st_depression_v1_v3=false&excessive_discordant_ste_st_s_ge_0_25=false"

Parameters

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/modified_sgarbossa 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": [
    {
      "concordant_st_depression_v1_v3": "false",
      "concordant_st_elevation_1mm": "false",
      "excessive_discordant_ste_st_s_ge_0_25": "false"
    },
    {
      "concordant_st_depression_v1_v3": "false",
      "concordant_st_elevation_1mm": "false",
      "excessive_discordant_ste_st_s_ge_0_25": "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/modified_sgarbossa",
  "items": [
    {
      "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": "Smith SW, Dodd KW, Henry TD, Dvorak DM, Pearce LA",
        "doi": "10.1016/j.annemergmed.2012.07.119",
        "id": "smith-2012",
        "pmid": "22939607",
        "source": "Ann Emerg Med. 2012;60(6):766-776",
        "title": "Diagnosis of ST-elevation myocardial infarction in the presence of left bundle branch block with the ST-elevation to S-wave ratio in a modified Sgarbossa rule"
      },
      "formula": "modified_sgarbossa",
      "formula_expression": "modified_sgarbossa iff concordant_st_elevation_1mm or concordant_st_depression_v1_v3 or excessive_discordant_ste_st_s_ge_0_25 (Smith 2012 unweighted modified Sgarbossa; not Sgarbossa 1996 5/3/2 points; not a 5 mm discordant rule)",
      "criteria": [
        {
          "factor": "concordant_st_elevation_1mm",
          "met": false
        },
        {
          "factor": "concordant_st_depression_v1_v3",
          "met": false
        },
        {
          "factor": "excessive_discordant_ste_st_s_ge_0_25",
          "met": false
        },
        {
          "factor": "modified_sgarbossa_any",
          "met": false
        }
      ],
      "modified_sgarbossa": 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": "Smith SW, Dodd KW, Henry TD, Dvorak DM, Pearce LA",
        "doi": "10.1016/j.annemergmed.2012.07.119",
        "id": "smith-2012",
        "pmid": "22939607",
        "source": "Ann Emerg Med. 2012;60(6):766-776",
        "title": "Diagnosis of ST-elevation myocardial infarction in the presence of left bundle branch block with the ST-elevation to S-wave ratio in a modified Sgarbossa rule"
      },
      "formula": "modified_sgarbossa",
      "formula_expression": "modified_sgarbossa iff concordant_st_elevation_1mm or concordant_st_depression_v1_v3 or excessive_discordant_ste_st_s_ge_0_25 (Smith 2012 unweighted modified Sgarbossa; not Sgarbossa 1996 5/3/2 points; not a 5 mm discordant rule)",
      "criteria": [
        {
          "factor": "concordant_st_elevation_1mm",
          "met": false
        },
        {
          "factor": "concordant_st_depression_v1_v3",
          "met": false
        },
        {
          "factor": "excessive_discordant_ste_st_s_ge_0_25",
          "met": false
        },
        {
          "factor": "modified_sgarbossa_any",
          "met": false
        }
      ],
      "modified_sgarbossa": false
    }
  ]
}

Response

Example JSON

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

{
  "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": "Smith SW, Dodd KW, Henry TD, Dvorak DM, Pearce LA",
    "doi": "10.1016/j.annemergmed.2012.07.119",
    "id": "smith-2012",
    "pmid": "22939607",
    "source": "Ann Emerg Med. 2012;60(6):766-776",
    "title": "Diagnosis of ST-elevation myocardial infarction in the presence of left bundle branch block with the ST-elevation to S-wave ratio in a modified Sgarbossa rule"
  },
  "formula": "modified_sgarbossa",
  "formula_expression": "modified_sgarbossa iff concordant_st_elevation_1mm or concordant_st_depression_v1_v3 or excessive_discordant_ste_st_s_ge_0_25 (Smith 2012 unweighted modified Sgarbossa; not Sgarbossa 1996 5/3/2 points; not a 5 mm discordant rule)",
  "criteria": [
    {
      "factor": "concordant_st_elevation_1mm",
      "met": false
    },
    {
      "factor": "concordant_st_depression_v1_v3",
      "met": false
    },
    {
      "factor": "excessive_discordant_ste_st_s_ge_0_25",
      "met": false
    },
    {
      "factor": "modified_sgarbossa_any",
      "met": false
    }
  ],
  "modified_sgarbossa": false
}

Client errors (HTTP 400)

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

Related tools

• Sgarbossa — Sum the three Sgarbossa 1996 GUSTO-1 ECG criteria in left bundle-branch block and return whether the total is ≥3.
• HEART score — Compute the HEART score as age points plus caller-assigned history, ECG, risk factors, and troponin (each 0-2).
• HEART Pathway — Apply the Mahler 2015 HEART Pathway and return whether a caller-assigned HEART score plus 0-hour and 3-hour troponin flags meet the published early-discharge rule.

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.