MAGENT

Medications · LIVE

MRC-ICU medication-regimen complexity

Sum the Gwynn 2019 MRC-ICU printed item weights from caller-assigned medication-class counts and device flags.

LIVE $0.005 USDC GET /api/calc/mrc_icu

Markdown: /docs/mrc-icu.md · Canonical: https://magentlab.com/docs/mrc-icu

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

What it computes

Sum the Gwynn 2019 MRC-ICU printed item weights from caller-assigned medication-class counts and device flags.

When to use

When an agent needs the published MRC-ICU point total and must not invent a pharmacist-staffing ratio or read a medication administration record.

When not to use

  • Not a medical device. Not a pharmacist-staffing order, census target, or monitoring protocol.
  • Counts and flags are caller-assigned. magent does not read the MAR, identify a medication, or decide whether two products are the same class.
  • A printed × means points times the count of qualifying medications in that class (integer 0-20). Non-multiplier items add the printed weight when the flag is true.
  • Parenteral-nutrition rows are two printed items (non-pharmacist service 1 point; clinical specialist pharmacist 3 points). Both may be sent; magent does not enforce exclusivity.
  • This is the Gwynn 2019 39-item table. Later MRC-ICU revisions are not applied.

Formula

MRC-ICU (Gwynn 2019) = sum of 39 printed item weights. Multiplier classes (printed ×) are weight × caller-assigned count of qualifying medications (0-20): aminoglycosides 3, antiarrhythmics 1, anticoagulants 1, anticonvulsants 3, azole_antifungals 2, blood_products 2, chemotherapy 3, ganciclovir_valganciclovir 1, hyperosmolar_fluids 1, immunosuppressants 3, prostacyclins 2, therapeutic_heparins 2, continuous_infusions 1, opioids_sedatives 1, continuous_opioids_sedatives 2, antimicrobials 1, restricted_antimicrobials 2. Flags add the printed weight when present: amphotericin_b 1, argatroban 2, clozapine 3, digoxin 3, lidocaine_infusion 2, lithium 3, theophylline 3, vancomycin_iv 3, warfarin 3, neuromuscular_blockade 2, tpn_non_pharmacist 1, tpn_clinical_pharmacist 3, thromboembolic_prophylaxis 1, stress_ulcer_prophylaxis 1, glycemic_control 1, bowel_regimen 1, chlorhexidine 1, dialysis 2, ecmo 2, iabp 1, lvad 1, mechanical_ventilation 2

Citation

Title
Development and validation of a medication regimen complexity scoring tool for critically ill patients
Authors
Gwynn ME, Poisson MO, Waller JL, Newsome AS
Source
Am J Health Syst Pharm. 2019;76(Supplement_2):S34-S40
DOI
10.1093/ajhp/zxy054

Worked example

No qualifying medications or devices

Given: lithium=falsetherapeutic_heparins=0digoxin=falsechlorhexidine=falsemechanical_ventilation=falseopioids_sedatives=0tpn_non_pharmacist=falselidocaine_infusion=falseclozapine=falsecontinuous_infusions=0dialysis=falsewarfarin=falseargatroban=falsetheophylline=falseneuromuscular_blockade=falsethromboembolic_prophylaxis=falserestricted_antimicrobials=0anticonvulsants=0anticoagulants=0antimicrobials=0continuous_opioids_sedatives=0ecmo=falseglycemic_control=falseganciclovir_valganciclovir=0hyperosmolar_fluids=0azole_antifungals=0bowel_regimen=falseaminoglycosides=0immunosuppressants=0antiarrhythmics=0vancomycin_iv=falsestress_ulcer_prophylaxis=falseprostacyclins=0iabp=falsechemotherapy=0lvad=falseamphotericin_b=falseblood_products=0tpn_clinical_pharmacist=false

  1. all counts 0 and all flags false
  2. score = 0

Intravenous vancomycin only

Given: lithium=falsetherapeutic_heparins=0digoxin=falsechlorhexidine=falsemechanical_ventilation=falseopioids_sedatives=0tpn_non_pharmacist=falselidocaine_infusion=falseclozapine=falsecontinuous_infusions=0dialysis=falsewarfarin=falseargatroban=falsetheophylline=falseneuromuscular_blockade=falsethromboembolic_prophylaxis=falserestricted_antimicrobials=0anticonvulsants=0anticoagulants=0antimicrobials=0continuous_opioids_sedatives=0ecmo=falseglycemic_control=falseganciclovir_valganciclovir=0hyperosmolar_fluids=0azole_antifungals=0bowel_regimen=falseaminoglycosides=0immunosuppressants=0antiarrhythmics=0vancomycin_iv=truestress_ulcer_prophylaxis=falseprostacyclins=0iabp=falsechemotherapy=0lvad=falseamphotericin_b=falseblood_products=0tpn_clinical_pharmacist=false

  1. vancomycin_iv is a 3-point flag
  2. score = 3

Two aminoglycosides

Given: lithium=falsetherapeutic_heparins=0digoxin=falsechlorhexidine=falsemechanical_ventilation=falseopioids_sedatives=0tpn_non_pharmacist=falselidocaine_infusion=falseclozapine=falsecontinuous_infusions=0dialysis=falsewarfarin=falseargatroban=falsetheophylline=falseneuromuscular_blockade=falsethromboembolic_prophylaxis=falserestricted_antimicrobials=0anticonvulsants=0anticoagulants=0antimicrobials=0continuous_opioids_sedatives=0ecmo=falseglycemic_control=falseganciclovir_valganciclovir=0hyperosmolar_fluids=0azole_antifungals=0bowel_regimen=falseaminoglycosides=2immunosuppressants=0antiarrhythmics=0vancomycin_iv=falsestress_ulcer_prophylaxis=falseprostacyclins=0iabp=falsechemotherapy=0lvad=falseamphotericin_b=falseblood_products=0tpn_clinical_pharmacist=false

  1. aminoglycosides printed 3×
  2. score = 3 × 2 = 6

Also searched as

  • MRC-ICU
  • medication regimen complexity ICU
  • Gwynn 2019 MRC-ICU
  • ICU medication complexity score
  • vancomycin aminoglycoside ICU score

Try

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

/api/calc/mrc_icu?aminoglycosides=0&amphotericin_b=false&antiarrhythmics=0&anticoagulants=0&anticonvulsants=0&argatroban=false&azole_antifungals=0&blood_products=0&chemotherapy=0&clozapine=false&digoxin=false&ganciclovir_valganciclovir=0&hyperosmolar_fluids=0&immunosuppressants=0&lidocaine_infusion=false&lithium=false&prostacyclins=0&theophylline=false&therapeutic_heparins=0&vancomycin_iv=false&warfarin=false&neuromuscular_blockade=false&continuous_infusions=0&tpn_non_pharmacist=false&tpn_clinical_pharmacist=false&thromboembolic_prophylaxis=false&stress_ulcer_prophylaxis=false&glycemic_control=false&bowel_regimen=false&chlorhexidine=false&opioids_sedatives=0&continuous_opioids_sedatives=0&antimicrobials=0&restricted_antimicrobials=0&dialysis=false&ecmo=false&iabp=false&lvad=false&mechanical_ventilation=false

Full URL: https://api.magentlab.com/api/calc/mrc_icu?aminoglycosides=0&amphotericin_b=false&antiarrhythmics=0&anticoagulants=0&anticonvulsants=0&argatroban=false&azole_antifungals=0&blood_products=0&chemotherapy=0&clozapine=false&digoxin=false&ganciclovir_valganciclovir=0&hyperosmolar_fluids=0&immunosuppressants=0&lidocaine_infusion=false&lithium=false&prostacyclins=0&theophylline=false&therapeutic_heparins=0&vancomycin_iv=false&warfarin=false&neuromuscular_blockade=false&continuous_infusions=0&tpn_non_pharmacist=false&tpn_clinical_pharmacist=false&thromboembolic_prophylaxis=false&stress_ulcer_prophylaxis=false&glycemic_control=false&bowel_regimen=false&chlorhexidine=false&opioids_sedatives=0&continuous_opioids_sedatives=0&antimicrobials=0&restricted_antimicrobials=0&dialysis=false&ecmo=false&iabp=false&lvad=false&mechanical_ventilation=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/mrc_icu?aminoglycosides=0&amphotericin_b=false&antiarrhythmics=0&anticoagulants=0&anticonvulsants=0&argatroban=false&azole_antifungals=0&blood_products=0&chemotherapy=0&clozapine=false&digoxin=false&ganciclovir_valganciclovir=0&hyperosmolar_fluids=0&immunosuppressants=0&lidocaine_infusion=false&lithium=false&prostacyclins=0&theophylline=false&therapeutic_heparins=0&vancomycin_iv=false&warfarin=false&neuromuscular_blockade=false&continuous_infusions=0&tpn_non_pharmacist=false&tpn_clinical_pharmacist=false&thromboembolic_prophylaxis=false&stress_ulcer_prophylaxis=false&glycemic_control=false&bowel_regimen=false&chlorhexidine=false&opioids_sedatives=0&continuous_opioids_sedatives=0&antimicrobials=0&restricted_antimicrobials=0&dialysis=false&ecmo=false&iabp=false&lvad=false&mechanical_ventilation=false"

Parameters

Name Type Required Description
aminoglycosides integer required Count of aminoglycosides (amikacin, gentamicin, tobramycin) as assigned by the caller (integer 0-20). Gwynn 2019 printed 3×. magent does not read the MAR.
amphotericin_b boolean required Amphotericin B or liposomal amphotericin B present as assigned by the caller (Gwynn 2019). true adds 1 point.
antiarrhythmics integer required Count of antiarrhythmics (amiodarone, dofetilide, sotalol) as assigned by the caller (integer 0-20). Gwynn 2019 printed 1×.
anticoagulants integer required Count of anticoagulants (NOACs/DOACs, fondaparinux) as assigned by the caller (integer 0-20). Gwynn 2019 printed 1×.
anticonvulsants integer required Count of anticonvulsants (carbamazepine, phenobarbital, phenytoin, valproic acid) as assigned by the caller (integer 0-20). Gwynn 2019 printed 3×.
argatroban boolean required Argatroban present as assigned by the caller (Gwynn 2019). true adds 2 points.
azole_antifungals integer required Count of azole antifungals (posaconazole, voriconazole) as assigned by the caller (integer 0-20). Gwynn 2019 printed 2×.
blood_products integer required Count of blood products (factor products, antithrombin III) as assigned by the caller (integer 0-20). Gwynn 2019 printed 2×.
chemotherapy integer required Count of active inpatient chemotherapy agents as assigned by the caller (integer 0-20). Gwynn 2019 printed 3×.
clozapine boolean required Clozapine present as assigned by the caller (Gwynn 2019). true adds 3 points.
digoxin boolean required Digoxin present as assigned by the caller (Gwynn 2019). true adds 3 points.
ganciclovir_valganciclovir integer required Count of ganciclovir or valganciclovir products as assigned by the caller (integer 0-20). Gwynn 2019 printed 1×.
hyperosmolar_fluids integer required Count of hyperosmolar fluids (hypertonic saline 1.5%, 3%, 23.4%; mannitol) as assigned by the caller (integer 0-20). Gwynn 2019 printed 1×.
immunosuppressants integer required Count of immunosuppressants (cyclosporine, sirolimus, tacrolimus) as assigned by the caller (integer 0-20). Gwynn 2019 printed 3×.
lidocaine_infusion boolean required Lidocaine continuous infusion present as assigned by the caller (Gwynn 2019). true adds 2 points.
lithium boolean required Lithium present as assigned by the caller (Gwynn 2019). true adds 3 points.
prostacyclins integer required Count of prostacyclins (epoprostenol, iloprost, treprostinil) as assigned by the caller (integer 0-20). Gwynn 2019 printed 2×.
theophylline boolean required Theophylline present as assigned by the caller (Gwynn 2019). true adds 3 points.
therapeutic_heparins integer required Count of therapeutic heparins (enoxaparin, heparin infusion) as assigned by the caller (integer 0-20). Gwynn 2019 printed 2×.
vancomycin_iv boolean required Intravenous vancomycin present as assigned by the caller (Gwynn 2019). true adds 3 points.
warfarin boolean required Warfarin present as assigned by the caller (Gwynn 2019). true adds 3 points.
neuromuscular_blockade boolean required Neuromuscular blockade present as assigned by the caller (Gwynn 2019). true adds 2 points.
continuous_infusions integer required Count of continuous infusions not listed on another Gwynn 2019 row, as assigned by the caller (integer 0-20). Printed 1×.
tpn_non_pharmacist boolean required Total parenteral nutrition managed by a non-pharmacist service as assigned by the caller (Gwynn 2019). true adds 1 point.
tpn_clinical_pharmacist boolean required Total parenteral nutrition managed by a clinical specialist pharmacist as assigned by the caller (Gwynn 2019). true adds 3 points.
thromboembolic_prophylaxis boolean required Thromboembolic prophylaxis present, excluding heparin infusion and therapeutic enoxaparin, as assigned by the caller (Gwynn 2019). true adds 1 point.
stress_ulcer_prophylaxis boolean required Stress ulcer prophylaxis present, excluding pantoprazole infusion, as assigned by the caller (Gwynn 2019). true adds 1 point.
glycemic_control boolean required Glycemic control with subcutaneous insulin, excluding intravenous insulin, as assigned by the caller (Gwynn 2019). true adds 1 point.
bowel_regimen boolean required Bowel regimen present as assigned by the caller (Gwynn 2019). true adds 1 point.
chlorhexidine boolean required Chlorhexidine present as assigned by the caller (Gwynn 2019). true adds 1 point.
opioids_sedatives integer required Count of scheduled or PRN opioids and sedatives as assigned by the caller (integer 0-20). Gwynn 2019 printed 1×.
continuous_opioids_sedatives integer required Count of continuous-infusion opioids and sedatives (propofol, fentanyl, dexmedetomidine, ketamine, benzodiazepines) as assigned by the caller (integer 0-20). Gwynn 2019 printed 2×.
antimicrobials integer required Count of antimicrobials including HIV medications and excluding agents listed on other Gwynn 2019 rows, as assigned by the caller (integer 0-20). Printed 1×.
restricted_antimicrobials integer required Count of restricted antimicrobials (4th-5th generation cephalosporins, carbapenems, linezolid, daptomycin, colistin/polymyxins) as assigned by the caller (integer 0-20). Gwynn 2019 printed 2×.
dialysis boolean required Dialysis present as assigned by the caller (Gwynn 2019). true adds 2 points.
ecmo boolean required Extracorporeal membrane oxygenation (ECMO) present as assigned by the caller (Gwynn 2019). true adds 2 points.
iabp boolean required Intra-aortic balloon pump (IABP) present as assigned by the caller (Gwynn 2019). true adds 1 point.
lvad boolean required Left ventricular assist device (LVAD) present as assigned by the caller (Gwynn 2019). true adds 1 point.
mechanical_ventilation boolean required Mechanical ventilation present as assigned by the caller (Gwynn 2019). true adds 2 points.

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/mrc_icu 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": [
    {
      "tpn_clinical_pharmacist": "false",
      "blood_products": "0",
      "amphotericin_b": "false",
      "lvad": "false",
      "chemotherapy": "0",
      "iabp": "false",
      "prostacyclins": "0",
      "stress_ulcer_prophylaxis": "false",
      "vancomycin_iv": "false",
      "antiarrhythmics": "0",
      "immunosuppressants": "0",
      "aminoglycosides": "0",
      "bowel_regimen": "false",
      "azole_antifungals": "0",
      "hyperosmolar_fluids": "0",
      "ganciclovir_valganciclovir": "0",
      "glycemic_control": "false",
      "ecmo": "false",
      "continuous_opioids_sedatives": "0",
      "antimicrobials": "0",
      "anticoagulants": "0",
      "anticonvulsants": "0",
      "restricted_antimicrobials": "0",
      "thromboembolic_prophylaxis": "false",
      "neuromuscular_blockade": "false",
      "theophylline": "false",
      "argatroban": "false",
      "warfarin": "false",
      "dialysis": "false",
      "continuous_infusions": "0",
      "clozapine": "false",
      "lidocaine_infusion": "false",
      "tpn_non_pharmacist": "false",
      "opioids_sedatives": "0",
      "mechanical_ventilation": "false",
      "chlorhexidine": "false",
      "digoxin": "false",
      "therapeutic_heparins": "0",
      "lithium": "false"
    },
    {
      "tpn_clinical_pharmacist": "false",
      "blood_products": "0",
      "amphotericin_b": "false",
      "lvad": "false",
      "chemotherapy": "0",
      "iabp": "false",
      "prostacyclins": "0",
      "stress_ulcer_prophylaxis": "false",
      "vancomycin_iv": "false",
      "antiarrhythmics": "0",
      "immunosuppressants": "0",
      "aminoglycosides": "0",
      "bowel_regimen": "false",
      "azole_antifungals": "0",
      "hyperosmolar_fluids": "0",
      "ganciclovir_valganciclovir": "0",
      "glycemic_control": "false",
      "ecmo": "false",
      "continuous_opioids_sedatives": "0",
      "antimicrobials": "0",
      "anticoagulants": "0",
      "anticonvulsants": "0",
      "restricted_antimicrobials": "0",
      "thromboembolic_prophylaxis": "false",
      "neuromuscular_blockade": "false",
      "theophylline": "false",
      "argatroban": "false",
      "warfarin": "false",
      "dialysis": "false",
      "continuous_infusions": "0",
      "clozapine": "false",
      "lidocaine_infusion": "false",
      "tpn_non_pharmacist": "false",
      "opioids_sedatives": "0",
      "mechanical_ventilation": "false",
      "chlorhexidine": "false",
      "digoxin": "false",
      "therapeutic_heparins": "0",
      "lithium": "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/mrc_icu",
  "items": [
    {
      "components": [
        {
          "value": 0,
          "factor": "aminoglycosides",
          "points": 0,
          "present": false
        },
        {
          "factor": "amphotericin_b",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "antiarrhythmics",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "anticoagulants",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "anticonvulsants",
          "points": 0,
          "present": false
        },
        {
          "factor": "argatroban",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "azole_antifungals",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "blood_products",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "chemotherapy",
          "points": 0,
          "present": false
        },
        {
          "factor": "clozapine",
          "points": 0,
          "present": false
        },
        {
          "factor": "digoxin",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "ganciclovir_valganciclovir",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "hyperosmolar_fluids",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "immunosuppressants",
          "points": 0,
          "present": false
        },
        {
          "factor": "lidocaine_infusion",
          "points": 0,
          "present": false
        },
        {
          "factor": "lithium",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "prostacyclins",
          "points": 0,
          "present": false
        },
        {
          "factor": "theophylline",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "therapeutic_heparins",
          "points": 0,
          "present": false
        },
        {
          "factor": "vancomycin_iv",
          "points": 0,
          "present": false
        },
        {
          "factor": "warfarin",
          "points": 0,
          "present": false
        },
        {
          "factor": "neuromuscular_blockade",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "continuous_infusions",
          "points": 0,
          "present": false
        },
        {
          "factor": "tpn_non_pharmacist",
          "points": 0,
          "present": false
        },
        {
          "factor": "tpn_clinical_pharmacist",
          "points": 0,
          "present": false
        },
        {
          "factor": "thromboembolic_prophylaxis",
          "points": 0,
          "present": false
        },
        {
          "factor": "stress_ulcer_prophylaxis",
          "points": 0,
          "present": false
        },
        {
          "factor": "glycemic_control",
          "points": 0,
          "present": false
        },
        {
          "factor": "bowel_regimen",
          "points": 0,
          "present": false
        },
        {
          "factor": "chlorhexidine",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "opioids_sedatives",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "continuous_opioids_sedatives",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "antimicrobials",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "restricted_antimicrobials",
          "points": 0,
          "present": false
        },
        {
          "factor": "dialysis",
          "points": 0,
          "present": false
        },
        {
          "factor": "ecmo",
          "points": 0,
          "present": false
        },
        {
          "factor": "iabp",
          "points": 0,
          "present": false
        },
        {
          "factor": "lvad",
          "points": 0,
          "present": false
        },
        {
          "factor": "mechanical_ventilation",
          "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": "Gwynn ME, Poisson MO, Waller JL, Newsome AS",
        "doi": "10.1093/ajhp/zxy054",
        "id": "gwynn-2019",
        "pmid": "31067298",
        "source": "Am J Health Syst Pharm. 2019;76(Supplement_2):S34-S40",
        "title": "Development and validation of a medication regimen complexity scoring tool for critically ill patients"
      },
      "formula": "mrc_icu",
      "formula_expression": "MRC-ICU (Gwynn 2019) = sum of 39 printed item weights. Multiplier classes (printed ×) are weight × caller-assigned count of qualifying medications (0-20): aminoglycosides 3, antiarrhythmics 1, anticoagulants 1, anticonvulsants 3, azole_antifungals 2, blood_products 2, chemotherapy 3, ganciclovir_valganciclovir 1, hyperosmolar_fluids 1, immunosuppressants 3, prostacyclins 2, therapeutic_heparins 2, continuous_infusions 1, opioids_sedatives 1, continuous_opioids_sedatives 2, antimicrobials 1, restricted_antimicrobials 2. Flags add the printed weight when present: amphotericin_b 1, argatroban 2, clozapine 3, digoxin 3, lidocaine_infusion 2, lithium 3, theophylline 3, vancomycin_iv 3, warfarin 3, neuromuscular_blockade 2, tpn_non_pharmacist 1, tpn_clinical_pharmacist 3, thromboembolic_prophylaxis 1, stress_ulcer_prophylaxis 1, glycemic_control 1, bowel_regimen 1, chlorhexidine 1, dialysis 2, ecmo 2, iabp 1, lvad 1, mechanical_ventilation 2",
      "score": 0
    },
    {
      "components": [
        {
          "value": 0,
          "factor": "aminoglycosides",
          "points": 0,
          "present": false
        },
        {
          "factor": "amphotericin_b",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "antiarrhythmics",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "anticoagulants",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "anticonvulsants",
          "points": 0,
          "present": false
        },
        {
          "factor": "argatroban",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "azole_antifungals",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "blood_products",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "chemotherapy",
          "points": 0,
          "present": false
        },
        {
          "factor": "clozapine",
          "points": 0,
          "present": false
        },
        {
          "factor": "digoxin",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "ganciclovir_valganciclovir",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "hyperosmolar_fluids",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "immunosuppressants",
          "points": 0,
          "present": false
        },
        {
          "factor": "lidocaine_infusion",
          "points": 0,
          "present": false
        },
        {
          "factor": "lithium",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "prostacyclins",
          "points": 0,
          "present": false
        },
        {
          "factor": "theophylline",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "therapeutic_heparins",
          "points": 0,
          "present": false
        },
        {
          "factor": "vancomycin_iv",
          "points": 0,
          "present": false
        },
        {
          "factor": "warfarin",
          "points": 0,
          "present": false
        },
        {
          "factor": "neuromuscular_blockade",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "continuous_infusions",
          "points": 0,
          "present": false
        },
        {
          "factor": "tpn_non_pharmacist",
          "points": 0,
          "present": false
        },
        {
          "factor": "tpn_clinical_pharmacist",
          "points": 0,
          "present": false
        },
        {
          "factor": "thromboembolic_prophylaxis",
          "points": 0,
          "present": false
        },
        {
          "factor": "stress_ulcer_prophylaxis",
          "points": 0,
          "present": false
        },
        {
          "factor": "glycemic_control",
          "points": 0,
          "present": false
        },
        {
          "factor": "bowel_regimen",
          "points": 0,
          "present": false
        },
        {
          "factor": "chlorhexidine",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "opioids_sedatives",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "continuous_opioids_sedatives",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "antimicrobials",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "restricted_antimicrobials",
          "points": 0,
          "present": false
        },
        {
          "factor": "dialysis",
          "points": 0,
          "present": false
        },
        {
          "factor": "ecmo",
          "points": 0,
          "present": false
        },
        {
          "factor": "iabp",
          "points": 0,
          "present": false
        },
        {
          "factor": "lvad",
          "points": 0,
          "present": false
        },
        {
          "factor": "mechanical_ventilation",
          "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": "Gwynn ME, Poisson MO, Waller JL, Newsome AS",
        "doi": "10.1093/ajhp/zxy054",
        "id": "gwynn-2019",
        "pmid": "31067298",
        "source": "Am J Health Syst Pharm. 2019;76(Supplement_2):S34-S40",
        "title": "Development and validation of a medication regimen complexity scoring tool for critically ill patients"
      },
      "formula": "mrc_icu",
      "formula_expression": "MRC-ICU (Gwynn 2019) = sum of 39 printed item weights. Multiplier classes (printed ×) are weight × caller-assigned count of qualifying medications (0-20): aminoglycosides 3, antiarrhythmics 1, anticoagulants 1, anticonvulsants 3, azole_antifungals 2, blood_products 2, chemotherapy 3, ganciclovir_valganciclovir 1, hyperosmolar_fluids 1, immunosuppressants 3, prostacyclins 2, therapeutic_heparins 2, continuous_infusions 1, opioids_sedatives 1, continuous_opioids_sedatives 2, antimicrobials 1, restricted_antimicrobials 2. Flags add the printed weight when present: amphotericin_b 1, argatroban 2, clozapine 3, digoxin 3, lidocaine_infusion 2, lithium 3, theophylline 3, vancomycin_iv 3, warfarin 3, neuromuscular_blockade 2, tpn_non_pharmacist 1, tpn_clinical_pharmacist 3, thromboembolic_prophylaxis 1, stress_ulcer_prophylaxis 1, glycemic_control 1, bowel_regimen 1, chlorhexidine 1, dialysis 2, ecmo 2, iabp 1, lvad 1, mechanical_ventilation 2",
      "score": 0
    }
  ]
}

Response

Field Type Description
formula string mrc_icu
formula_expression string Exact Gwynn 2019 expression used
score integer MRC-ICU point total
components array Per-item points in printed table order
citation object Gwynn et al. AJHP 2019 citation
disclaimer string Not-a-device notice

Example JSON

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

{
  "components": [
    {
      "value": 0,
      "factor": "aminoglycosides",
      "points": 0,
      "present": false
    },
    {
      "factor": "amphotericin_b",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "antiarrhythmics",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "anticoagulants",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "anticonvulsants",
      "points": 0,
      "present": false
    },
    {
      "factor": "argatroban",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "azole_antifungals",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "blood_products",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "chemotherapy",
      "points": 0,
      "present": false
    },
    {
      "factor": "clozapine",
      "points": 0,
      "present": false
    },
    {
      "factor": "digoxin",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "ganciclovir_valganciclovir",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "hyperosmolar_fluids",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "immunosuppressants",
      "points": 0,
      "present": false
    },
    {
      "factor": "lidocaine_infusion",
      "points": 0,
      "present": false
    },
    {
      "factor": "lithium",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "prostacyclins",
      "points": 0,
      "present": false
    },
    {
      "factor": "theophylline",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "therapeutic_heparins",
      "points": 0,
      "present": false
    },
    {
      "factor": "vancomycin_iv",
      "points": 0,
      "present": false
    },
    {
      "factor": "warfarin",
      "points": 0,
      "present": false
    },
    {
      "factor": "neuromuscular_blockade",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "continuous_infusions",
      "points": 0,
      "present": false
    },
    {
      "factor": "tpn_non_pharmacist",
      "points": 0,
      "present": false
    },
    {
      "factor": "tpn_clinical_pharmacist",
      "points": 0,
      "present": false
    },
    {
      "factor": "thromboembolic_prophylaxis",
      "points": 0,
      "present": false
    },
    {
      "factor": "stress_ulcer_prophylaxis",
      "points": 0,
      "present": false
    },
    {
      "factor": "glycemic_control",
      "points": 0,
      "present": false
    },
    {
      "factor": "bowel_regimen",
      "points": 0,
      "present": false
    },
    {
      "factor": "chlorhexidine",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "opioids_sedatives",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "continuous_opioids_sedatives",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "antimicrobials",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "restricted_antimicrobials",
      "points": 0,
      "present": false
    },
    {
      "factor": "dialysis",
      "points": 0,
      "present": false
    },
    {
      "factor": "ecmo",
      "points": 0,
      "present": false
    },
    {
      "factor": "iabp",
      "points": 0,
      "present": false
    },
    {
      "factor": "lvad",
      "points": 0,
      "present": false
    },
    {
      "factor": "mechanical_ventilation",
      "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": "Gwynn ME, Poisson MO, Waller JL, Newsome AS",
    "doi": "10.1093/ajhp/zxy054",
    "id": "gwynn-2019",
    "pmid": "31067298",
    "source": "Am J Health Syst Pharm. 2019;76(Supplement_2):S34-S40",
    "title": "Development and validation of a medication regimen complexity scoring tool for critically ill patients"
  },
  "formula": "mrc_icu",
  "formula_expression": "MRC-ICU (Gwynn 2019) = sum of 39 printed item weights. Multiplier classes (printed ×) are weight × caller-assigned count of qualifying medications (0-20): aminoglycosides 3, antiarrhythmics 1, anticoagulants 1, anticonvulsants 3, azole_antifungals 2, blood_products 2, chemotherapy 3, ganciclovir_valganciclovir 1, hyperosmolar_fluids 1, immunosuppressants 3, prostacyclins 2, therapeutic_heparins 2, continuous_infusions 1, opioids_sedatives 1, continuous_opioids_sedatives 2, antimicrobials 1, restricted_antimicrobials 2. Flags add the printed weight when present: amphotericin_b 1, argatroban 2, clozapine 3, digoxin 3, lidocaine_infusion 2, lithium 3, theophylline 3, vancomycin_iv 3, warfarin 3, neuromuscular_blockade 2, tpn_non_pharmacist 1, tpn_clinical_pharmacist 3, thromboembolic_prophylaxis 1, stress_ulcer_prophylaxis 1, glycemic_control 1, bowel_regimen 1, chlorhexidine 1, dialysis 2, ecmo 2, iabp 1, lvad 1, mechanical_ventilation 2",
  "score": 0
}

Client errors (HTTP 400)

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

HTTP Code When
400 invalid_mrc_icu Gwynn 2019 MRC-ICU inputs must match that scoring tool's item counts and device flags. 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

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  • SAPS II — Compute the Le Gall 1993 SAPS II integer from 12 physiology variables, age, type of admission, and one chronic disease, then the paper's logit hospital-mortality probability.

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.