# OESIL syncope risk score OESIL Status: LIVE Price: $0.005 USDC `GET /api/calc/oesil` HTML: https://magentlab.com/docs/oesil Markdown: https://magentlab.com/docs/oesil.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk score as the Colivicchi 2003 arithmetic sum of four predictors: age >65 years, history of cardiovascular disease, syncope without prodromes, and abnormal ECG. ## When to use When an agent needs the published OESIL point total from caller-assigned flags and must not invent a syncope history, read an ECG, or treat derivation-cohort mortality as an individual prediction. ## When not to use - Not a medical device. Not a disposition protocol, admission order, or syncope diagnosis. - Age 18-120 is an implementation clamp; Colivicchi 2003 scored age >65 (age 65 is 0 points). magent does not apply a high-risk cutoff from later papers. - The 12-month mortality percents reported in the derivation cohort (0%, 0.8%, 19.6%, 34.7%, 57.1% for scores 0-4) are cohort observations, not this patient's predicted risk, and are not returned on the JSON. - The caller assigns cardiovascular_disease, syncope_without_prodromes, and abnormal_ecg. magent does not take a history or read an ECG. ## Formula ``` OESIL = age_gt_65 + cardiovascular_disease + syncope_without_prodromes + abnormal_ecg; 1 point each; range 0-4 (Colivicchi 2003) ``` ## Citation [Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score](https://doi.org/10.1016/S0195-668X(02)00827-8) Colivicchi F, Ammirati F, Melina D, Guido V, Imperoli G, Santini M Eur Heart J. 2003;24(9):811-819 DOI: [10.1016/S0195-668X(02)00827-8](https://doi.org/10.1016/S0195-668X(02)00827-8) ## Worked example ### Age 50, all predictors false Given: `abnormal_ecg=false, age=50, cardiovascular_disease=false, syncope_without_prodromes=false` 1. Age 50 is not >65 → 0; cardiovascular_disease false → 0; syncope_without_prodromes false → 0; abnormal_ecg false → 0 2. Score = 0 (max 4) ## Also searched as - OESIL score - OESIL risk score - Colivicchi syncope score - Osservatorio Epidemiologico sulla Sincope nel Lazio - syncope OESIL 2003 - ED syncope OESIL ## Parameters - `age` (integer, required): Age in years (18-120). Age >65 scores 1; age 65 scores 0. 18 is an implementation clamp. - `cardiovascular_disease` (boolean, required): History of cardiovascular disease (Colivicchi 2003, 1 point). true or false as assigned by the caller. - `syncope_without_prodromes` (boolean, required): Syncope without prodromes (Colivicchi 2003, 1 point). true or false as assigned by the caller. - `abnormal_ecg` (boolean, required): Abnormal ECG (Colivicchi 2003, 1 point). true or false as assigned by the caller. magent does not read an ECG. ## 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/oesil` 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": [ { "abnormal_ecg": "false", "age": "50", "cardiovascular_disease": "false", "syncope_without_prodromes": "false" }, { "abnormal_ecg": "false", "age": "50", "cardiovascular_disease": "false", "syncope_without_prodromes": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/oesil Example 200: ```json { "count": 2, "path": "/api/calc/oesil", "items": [ { "components": [ { "value": 50, "factor": "age_gt_65", "points": 0, "present": false }, { "factor": "cardiovascular_disease", "points": 0, "present": false }, { "factor": "syncope_without_prodromes", "points": 0, "present": false }, { "factor": "abnormal_ecg", "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": "Colivicchi F, Ammirati F, Melina D, Guido V, Imperoli G, Santini M", "doi": "10.1016/S0195-668X(02)00827-8", "id": "colivicchi-2003", "pmid": "12727148", "source": "Eur Heart J. 2003;24(9):811-819", "title": "Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score" }, "formula": "oesil", "formula_expression": "OESIL = age_gt_65 + cardiovascular_disease + syncope_without_prodromes + abnormal_ecg; 1 point each; range 0-4 (Colivicchi 2003)", "max_score": 4, "score": 0, "age_years": 50 }, { "components": [ { "value": 50, "factor": "age_gt_65", "points": 0, "present": false }, { "factor": "cardiovascular_disease", "points": 0, "present": false }, { "factor": "syncope_without_prodromes", "points": 0, "present": false }, { "factor": "abnormal_ecg", "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": "Colivicchi F, Ammirati F, Melina D, Guido V, Imperoli G, Santini M", "doi": "10.1016/S0195-668X(02)00827-8", "id": "colivicchi-2003", "pmid": "12727148", "source": "Eur Heart J. 2003;24(9):811-819", "title": "Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score" }, "formula": "oesil", "formula_expression": "OESIL = age_gt_65 + cardiovascular_disease + syncope_without_prodromes + abnormal_ecg; 1 point each; range 0-4 (Colivicchi 2003)", "max_score": 4, "score": 0, "age_years": 50 } ] } ``` ## Response fields - `formula` (string): oesil - `formula_expression` (string): Exact expression used - `score` (integer): OESIL points 0-4 - `max_score` (integer): Always 4 - `age_years` (integer): Age used for the >65 criterion - `components` (array): Per-factor points - `citation` (object): Colivicchi et al. Eur Heart J 2003 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 50, "factor": "age_gt_65", "points": 0, "present": false }, { "factor": "cardiovascular_disease", "points": 0, "present": false }, { "factor": "syncope_without_prodromes", "points": 0, "present": false }, { "factor": "abnormal_ecg", "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": "Colivicchi F, Ammirati F, Melina D, Guido V, Imperoli G, Santini M", "doi": "10.1016/S0195-668X(02)00827-8", "id": "colivicchi-2003", "pmid": "12727148", "source": "Eur Heart J. 2003;24(9):811-819", "title": "Development and prospective validation of a risk stratification system for patients with syncope in the emergency department: the OESIL risk score" }, "formula": "oesil", "formula_expression": "OESIL = age_gt_65 + cardiovascular_disease + syncope_without_prodromes + abnormal_ecg; 1 point each; range 0-4 (Colivicchi 2003)", "max_score": 4, "score": 0, "age_years": 50 } ``` ## Errors - HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged. - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false 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 - [San Francisco Syncope Rule](https://magentlab.com/docs/sf-syncope) — Compute the San Francisco Syncope Rule (CHESS) criterion count and rule-positive flag from published cutoffs. - [EGSYS](https://magentlab.com/docs/egsys) — Sum the six Del Rosso 2008 EGSYS flags and return whether the total is ≥3 (published cardiac-syncope triage discriminator). ## 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.