# Migraine Treatment Optimization Questionnaire-4 (mTOQ-4) mTOQ-4 Status: LIVE Price: $0.005 USDC `GET /api/calc/mtoq_4` HTML: https://magentlab.com/docs/mtoq-4 Markdown: https://magentlab.com/docs/mtoq-4.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum four caller-assigned Lipton 2015 mTOQ-4 frequency items and return the 0-8 total and published treatment-efficacy bands. ## When to use When an agent has already assigned the four Lipton 2015 frequency tokens and needs the published mTOQ-4 total and efficacy band, not a migraine diagnosis, abortive-drug order, or patient interview. ## When not to use - Not a medical device and not a diagnosis. - Not an abortive-drug order. - magent does not interview the patient. - pain_free_2h, sustained_24h, able_to_plan, and in_control are caller-assigned Lipton 2015 frequency tokens (never=0, rarely=0, less_than_half=1, half_or_greater=2). magent does not assign the frequencies. - This is the 4-item Lipton 2015 instrument only (table e-1 / methods cuts very_poor 0, poor 1-5, moderate 6-7, maximum 8). magent does not score the 19-item or 6-item mTOQ. ## Formula ``` mTOQ-4 = pain_free_2h + sustained_24h + able_to_plan + in_control; each never=0, rarely=0, less_than_half=1, half_or_greater=2; max 8; very_poor=0, poor=1-5, moderate=6-7, maximum=8 ``` ## Citation [Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine](https://doi.org/10.1212/WNL.0000000000001256) Lipton RB, Fanning KM, Serrano D, Reed ML, Cady R, Buse DC Neurology. 2015;84(7):688-695 DOI: [10.1212/WNL.0000000000001256](https://doi.org/10.1212/WNL.0000000000001256) ## Worked example ### All four never Given: `able_to_plan=never, in_control=never, pain_free_2h=never, sustained_24h=never` 1. pain_free_2h never 0 + sustained_24h never 0 + able_to_plan never 0 + in_control never 0 2. Score = 0 (max 8); treatment_efficacy very_poor ### Three half_or_greater, one never Given: `able_to_plan=half_or_greater, in_control=never, pain_free_2h=half_or_greater, sustained_24h=half_or_greater` 1. pain_free_2h 2 + sustained_24h 2 + able_to_plan 2 + in_control never 0 2. Score = 6 (max 8); treatment_efficacy moderate ### All four half_or_greater Given: `able_to_plan=half_or_greater, in_control=half_or_greater, pain_free_2h=half_or_greater, sustained_24h=half_or_greater` 1. pain_free_2h 2 + sustained_24h 2 + able_to_plan 2 + in_control 2 2. Score = 8 (max 8); treatment_efficacy maximum ## Also searched as - mTOQ-4 - Migraine Treatment Optimization Questionnaire - Lipton mTOQ - migraine treatment optimization - mTOQ 4 item - acute migraine treatment efficacy - mTOQ-4 score - Lipton 2015 mTOQ-4 ## Parameters - `pain_free_2h` (string, required): Caller-assigned Lipton 2015 mTOQ-4 item 1. After taking your migraine medication, are you pain-free within 2 hours for most attacks? never=0, rarely=0, less_than_half=1, half_or_greater=2. magent does not interview the patient. - `sustained_24h` (string, required): Caller-assigned Lipton 2015 mTOQ-4 item 2. Does one dose of your migraine medication usually relieve your headache and keep it away for at least 24 hours? never=0, rarely=0, less_than_half=1, half_or_greater=2. magent does not interview the patient. - `able_to_plan` (string, required): Caller-assigned Lipton 2015 mTOQ-4 item 3. Are you comfortable enough with your migraine medication to be able to plan your daily activities? never=0, rarely=0, less_than_half=1, half_or_greater=2. magent does not interview the patient. - `in_control` (string, required): Caller-assigned Lipton 2015 mTOQ-4 item 4. After taking your migraine medication, do you feel in control of your migraines enough so that you feel you can return to normal function? never=0, rarely=0, less_than_half=1, half_or_greater=2. magent does not interview 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/mtoq_4` 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": [ { "able_to_plan": "never", "in_control": "never", "pain_free_2h": "never", "sustained_24h": "never" }, { "able_to_plan": "never", "in_control": "never", "pain_free_2h": "never", "sustained_24h": "never" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/mtoq-4 Example 200: ```json { "count": 2, "path": "/api/calc/mtoq_4", "items": [ { "components": [ { "value": "never", "factor": "pain_free_2h", "points": 0, "present": true }, { "value": "never", "factor": "sustained_24h", "points": 0, "present": true }, { "value": "never", "factor": "able_to_plan", "points": 0, "present": true }, { "value": "never", "factor": "in_control", "points": 0, "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": "Lipton RB, Fanning KM, Serrano D, Reed ML, Cady R, Buse DC", "doi": "10.1212/WNL.0000000000001256", "id": "lipton-2015", "pmid": "25616416", "source": "Neurology. 2015;84(7):688-695", "title": "Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine" }, "formula": "mtoq_4", "formula_expression": "mTOQ-4 = pain_free_2h + sustained_24h + able_to_plan + in_control; each never=0, rarely=0, less_than_half=1, half_or_greater=2; max 8; very_poor=0, poor=1-5, moderate=6-7, maximum=8", "max_score": 8, "score": 0, "treatment_efficacy": "very_poor" }, { "components": [ { "value": "never", "factor": "pain_free_2h", "points": 0, "present": true }, { "value": "never", "factor": "sustained_24h", "points": 0, "present": true }, { "value": "never", "factor": "able_to_plan", "points": 0, "present": true }, { "value": "never", "factor": "in_control", "points": 0, "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": "Lipton RB, Fanning KM, Serrano D, Reed ML, Cady R, Buse DC", "doi": "10.1212/WNL.0000000000001256", "id": "lipton-2015", "pmid": "25616416", "source": "Neurology. 2015;84(7):688-695", "title": "Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine" }, "formula": "mtoq_4", "formula_expression": "mTOQ-4 = pain_free_2h + sustained_24h + able_to_plan + in_control; each never=0, rarely=0, less_than_half=1, half_or_greater=2; max 8; very_poor=0, poor=1-5, moderate=6-7, maximum=8", "max_score": 8, "score": 0, "treatment_efficacy": "very_poor" } ] } ``` ## Response fields - `formula` (string): mtoq_4 - `formula_expression` (string): Exact expression used - `score` (integer): mTOQ-4 points 0-8 - `max_score` (integer): 8 - `treatment_efficacy` (string): Lipton 2015 efficacy band: very_poor (0), poor (1-5), moderate (6-7), or maximum (8). Not a diagnosis. - `components` (array): Per-item caller-assigned points - `citation` (object): Lipton et al. Neurology 2015 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": "never", "factor": "pain_free_2h", "points": 0, "present": true }, { "value": "never", "factor": "sustained_24h", "points": 0, "present": true }, { "value": "never", "factor": "able_to_plan", "points": 0, "present": true }, { "value": "never", "factor": "in_control", "points": 0, "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": "Lipton RB, Fanning KM, Serrano D, Reed ML, Cady R, Buse DC", "doi": "10.1212/WNL.0000000000001256", "id": "lipton-2015", "pmid": "25616416", "source": "Neurology. 2015;84(7):688-695", "title": "Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine" }, "formula": "mtoq_4", "formula_expression": "mTOQ-4 = pain_free_2h + sustained_24h + able_to_plan + in_control; each never=0, rarely=0, less_than_half=1, half_or_greater=2; max 8; very_poor=0, poor=1-5, moderate=6-7, maximum=8", "max_score": 8, "score": 0, "treatment_efficacy": "very_poor" } ``` ## Errors - HTTP 400 `invalid_mtoq4`: mTOQ-4 items must each be never, rarely, less_than_half, or half_or_greater (Lipton 2015). 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 - [MIDAS](https://magentlab.com/docs/midas) — Sum five caller-assigned MIDAS day counts over the last 3 months and return the 0-450 total and published grades I–IV. - [Modified Rankin](https://magentlab.com/docs/modified-rankin) — Return the van Swieten 1988 modified Rankin handicap grade 0-5 from a caller-assigned integer, with the published grade wording. ## 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.