Emergency · LIVE

Newsom CXR rule

Apply the Newsom 2014 modified Rothrock rule and return whether a chest radiograph is indicated from caller-assigned age and five history or exam flags.

LIVE $0.005 USDC GET /api/calc/newsom

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

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

What it computes

Apply the Newsom 2014 modified Rothrock rule and return whether a chest radiograph is indicated from caller-assigned age and five history or exam flags.

When to use

When an agent has caller-assigned findings for an adult with nontraumatic chest pain in the emergency department and needs the published 2014 modified Rothrock CXR-indicated result. magent does not examine the patient or read a radiograph. Not the original Rothrock 2002 rule and not the 2018 prospective refinement.

When not to use

• Not a medical device. Not a diagnosis. magent does not examine the patient or read a radiograph.
• This tool is the Newsom 2014 modified Rothrock rule only. It does not include hypoxia, rales, hemoptysis, history of tuberculosis, or thromboembolic disease (removed in the 2014 modification). It is not the original Rothrock 2002 ten-item rule and not the 2018 Academic Emergency Medicine prospective refinement.
• Age is an integer 18-120; the age criterion is met at 65 or older. CHF, alcohol abuse, decreased breath sounds, fever, and tachypnea are caller-assigned booleans. magent does not measure temperature or respiratory rate or auscultate the chest.
• Presence of a criterion does not order a chest radiograph. A negative rule does not exclude all clinically significant radiographic findings.

Formula

CXR indicated iff age >= 65 or congestive heart failure or alcohol abuse or decreased breath sounds or fever or tachypnea (Newsom 2014 modified Rothrock; not hypoxia, rales, hemoptysis, TB, or thromboembolic disease; not the 2018 Academic Emergency Medicine prospective refinement)

Citation

Title

Validation of a Decision Rule and Derivation of a Modified Rule to Obtain Chest Radiograph in Patients with Nontraumatic Chest Pain in the Emergency Department

Authors

Newsom C, Jeanmonod R, Weller K, Boutros N, Reiter M, Jeanmonod D

Source

Adv Emerg Med. 2014;2014:241935

DOI

10.1155/2014/241935

Worked example

Also searched as

• Newsom CXR rule
• modified Rothrock CXR
• Newsom 2014 chest radiograph
• nontraumatic chest pain CXR rule
• Newsom modified Rothrock
• chest x-ray decision rule chest pain
• Newsom chest radiograph rule

Try

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

/api/calc/newsom?age=40&chf=false&alcohol_abuse=false&decreased_breath_sounds=false&fever=false&tachypnea=false

Full URL: https://api.magentlab.com/api/calc/newsom?age=40&chf=false&alcohol_abuse=false&decreased_breath_sounds=false&fever=false&tachypnea=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/newsom?age=40&chf=false&alcohol_abuse=false&decreased_breath_sounds=false&fever=false&tachypnea=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/newsom 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": [
    {
      "age": "40",
      "alcohol_abuse": "false",
      "chf": "false",
      "decreased_breath_sounds": "false",
      "fever": "false",
      "tachypnea": "false"
    },
    {
      "age": "40",
      "alcohol_abuse": "false",
      "chf": "false",
      "decreased_breath_sounds": "false",
      "fever": "false",
      "tachypnea": "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/newsom",
  "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": "Newsom C, Jeanmonod R, Weller K, Boutros N, Reiter M, Jeanmonod D",
        "doi": "10.1155/2014/241935",
        "id": "newsom-2014",
        "source": "Adv Emerg Med. 2014;2014:241935",
        "title": "Validation of a Decision Rule and Derivation of a Modified Rule to Obtain Chest Radiograph in Patients with Nontraumatic Chest Pain in the Emergency Department"
      },
      "formula": "newsom",
      "formula_expression": "CXR indicated iff age >= 65 or congestive heart failure or alcohol abuse or decreased breath sounds or fever or tachypnea (Newsom 2014 modified Rothrock; not hypoxia, rales, hemoptysis, TB, or thromboembolic disease; not the 2018 Academic Emergency Medicine prospective refinement)",
      "criteria": [
        {
          "value": 40,
          "factor": "age_ge_65",
          "met": false
        },
        {
          "factor": "chf",
          "met": false
        },
        {
          "factor": "alcohol_abuse",
          "met": false
        },
        {
          "factor": "decreased_breath_sounds",
          "met": false
        },
        {
          "factor": "fever",
          "met": false
        },
        {
          "factor": "tachypnea",
          "met": false
        }
      ],
      "cxr_indicated": 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": "Newsom C, Jeanmonod R, Weller K, Boutros N, Reiter M, Jeanmonod D",
        "doi": "10.1155/2014/241935",
        "id": "newsom-2014",
        "source": "Adv Emerg Med. 2014;2014:241935",
        "title": "Validation of a Decision Rule and Derivation of a Modified Rule to Obtain Chest Radiograph in Patients with Nontraumatic Chest Pain in the Emergency Department"
      },
      "formula": "newsom",
      "formula_expression": "CXR indicated iff age >= 65 or congestive heart failure or alcohol abuse or decreased breath sounds or fever or tachypnea (Newsom 2014 modified Rothrock; not hypoxia, rales, hemoptysis, TB, or thromboembolic disease; not the 2018 Academic Emergency Medicine prospective refinement)",
      "criteria": [
        {
          "value": 40,
          "factor": "age_ge_65",
          "met": false
        },
        {
          "factor": "chf",
          "met": false
        },
        {
          "factor": "alcohol_abuse",
          "met": false
        },
        {
          "factor": "decreased_breath_sounds",
          "met": false
        },
        {
          "factor": "fever",
          "met": false
        },
        {
          "factor": "tachypnea",
          "met": false
        }
      ],
      "cxr_indicated": 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": "Newsom C, Jeanmonod R, Weller K, Boutros N, Reiter M, Jeanmonod D",
    "doi": "10.1155/2014/241935",
    "id": "newsom-2014",
    "source": "Adv Emerg Med. 2014;2014:241935",
    "title": "Validation of a Decision Rule and Derivation of a Modified Rule to Obtain Chest Radiograph in Patients with Nontraumatic Chest Pain in the Emergency Department"
  },
  "formula": "newsom",
  "formula_expression": "CXR indicated iff age >= 65 or congestive heart failure or alcohol abuse or decreased breath sounds or fever or tachypnea (Newsom 2014 modified Rothrock; not hypoxia, rales, hemoptysis, TB, or thromboembolic disease; not the 2018 Academic Emergency Medicine prospective refinement)",
  "criteria": [
    {
      "value": 40,
      "factor": "age_ge_65",
      "met": false
    },
    {
      "factor": "chf",
      "met": false
    },
    {
      "factor": "alcohol_abuse",
      "met": false
    },
    {
      "factor": "decreased_breath_sounds",
      "met": false
    },
    {
      "factor": "fever",
      "met": false
    },
    {
      "factor": "tachypnea",
      "met": false
    }
  ],
  "cxr_indicated": false
}

Client errors (HTTP 400)

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

Related tools

• HEAR score — Compute the HEAR score as age points plus caller-assigned history, ECG, and risk factors (each 0-2). No troponin.
• Vancouver Chest Pain Rule — Apply the Christenson 2006 Vancouver Chest Pain Rule derivation tree and return whether caller-assigned ECG, 2-hour troponin, prior ACS or nitrate, palpation, age, and radiation nodes are early-discharge eligible.

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.