# Opioid Risk Tool (Webster 2005) ORT Status: LIVE Price: $0.005 USDC `GET /api/calc/ort` HTML: https://magentlab.com/docs/ort Markdown: https://magentlab.com/docs/ort.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum Webster 2005 Table 1 Opioid Risk Tool item weights for the assigned sex and return the published low, moderate, or high category. ## When to use When an agent has already assigned the ten yes/no flags and sex and needs the published 2005 point total, not an interview, not a diagnosis of opioid use disorder, and not the 2019 ORT-OUD revision. ## When not to use - Not a medical device. - Not a diagnosis of opioid use disorder. Not the 2019 ORT-OUD revision. - The caller assigns each flag. magent does not interview the patient or take free-text abuse history. - Flags are PHI-adjacent. Persist them only encrypted for the allowlisted console. - Age 16-45 is a yes/no flag, not a numeric age. Preadolescent sexual abuse is 3 points for females and 0 for males (Webster 2005 Table 1). ## Formula ``` ORT = Webster 2005 Table 1 sex-specific weights; family_alcohol F1/M3 + family_illegal_drugs F2/M3 + family_prescription_drugs 4 + personal_alcohol 3 + personal_illegal_drugs 4 + personal_prescription_drugs 5 + age_16_to_45 1 + preadolescent_sexual_abuse F3/M0 + add_ocd_bipolar_schizophrenia 2 + depression 1; absent = 0; low 0-3, moderate 4-7, high >=8; max 26 ``` ## Citation [Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool](https://doi.org/10.1111/j.1526-4637.2005.00072.x) Webster LR, Webster RM Pain Med. 2005;6(6):432-442 DOI: [10.1111/j.1526-4637.2005.00072.x](https://doi.org/10.1111/j.1526-4637.2005.00072.x) ## Worked example ### Female, all flags false Given: `add_ocd_bipolar_schizophrenia=false, age_16_to_45=false, depression=false, family_alcohol=false, family_illegal_drugs=false, family_prescription_drugs=false, personal_alcohol=false, personal_illegal_drugs=false, personal_prescription_drugs=false, preadolescent_sexual_abuse=false, sex=female` 1. every Table 1 item absent → 0 2. score = 0; risk low ### Female family prescription drugs, personal alcohol, and age 16-45 Given: `add_ocd_bipolar_schizophrenia=false, age_16_to_45=true, depression=false, family_alcohol=false, family_illegal_drugs=false, family_prescription_drugs=true, personal_alcohol=true, personal_illegal_drugs=false, personal_prescription_drugs=false, preadolescent_sexual_abuse=false, sex=female` 1. family_prescription_drugs 4 + personal_alcohol 3 + age_16_to_45 1 2. score = 8; risk high ## Also searched as - opioid risk tool - Webster ORT - ORT score - opioid aberrant behavior - Webster 2005 opioid risk - ORT Pain Medicine 2005 ## Parameters - `sex` (string, required): female or male. Webster 2005 Table 1 item weights are sex-specific. Assigned by the caller. - `family_alcohol` (boolean, required): Family history of alcohol abuse as assigned by the caller (Webster 2005 Table 1). Female 1, male 3. true or false. magent does not interview the patient. - `family_illegal_drugs` (boolean, required): Family history of illegal-drug abuse as assigned by the caller (Webster 2005 Table 1). Female 2, male 3. true or false. - `family_prescription_drugs` (boolean, required): Family history of prescription-drug abuse as assigned by the caller (Webster 2005 Table 1). 4 points. true or false. - `personal_alcohol` (boolean, required): Personal history of alcohol abuse as assigned by the caller (Webster 2005 Table 1). 3 points. true or false. magent does not interview the patient. - `personal_illegal_drugs` (boolean, required): Personal history of illegal-drug abuse as assigned by the caller (Webster 2005 Table 1). 4 points. true or false. - `personal_prescription_drugs` (boolean, required): Personal history of prescription-drug abuse as assigned by the caller (Webster 2005 Table 1). 5 points. true or false. - `age_16_to_45` (boolean, required): Age 16-45 years as a flag, not a numeric age (Webster 2005 Table 1). true scores 1. Assigned by the caller. - `preadolescent_sexual_abuse` (boolean, required): History of preadolescent sexual abuse as assigned by the caller (Webster 2005 Table 1). Female 3, male 0. true or false. magent does not interview the patient. - `add_ocd_bipolar_schizophrenia` (boolean, required): ADD, OCD, bipolar disorder, or schizophrenia as one flag (Webster 2005 Table 1). true scores 2. Assigned by the caller. magent does not diagnose. - `depression` (boolean, required): Depression as assigned by the caller (Webster 2005 Table 1). true scores 1. magent does not diagnose. ## 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/ort` 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": [ { "add_ocd_bipolar_schizophrenia": "false", "age_16_to_45": "false", "depression": "false", "family_alcohol": "false", "family_illegal_drugs": "false", "family_prescription_drugs": "false", "personal_alcohol": "false", "personal_illegal_drugs": "false", "personal_prescription_drugs": "false", "preadolescent_sexual_abuse": "false", "sex": "female" }, { "add_ocd_bipolar_schizophrenia": "false", "age_16_to_45": "false", "depression": "false", "family_alcohol": "false", "family_illegal_drugs": "false", "family_prescription_drugs": "false", "personal_alcohol": "false", "personal_illegal_drugs": "false", "personal_prescription_drugs": "false", "preadolescent_sexual_abuse": "false", "sex": "female" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/ort Example 200: ```json { "count": 2, "path": "/api/calc/ort", "items": [ { "components": [ { "factor": "family_alcohol", "points": 0, "present": false }, { "factor": "family_illegal_drugs", "points": 0, "present": false }, { "factor": "family_prescription_drugs", "points": 0, "present": false }, { "factor": "personal_alcohol", "points": 0, "present": false }, { "factor": "personal_illegal_drugs", "points": 0, "present": false }, { "factor": "personal_prescription_drugs", "points": 0, "present": false }, { "factor": "age_16_to_45", "points": 0, "present": false }, { "factor": "preadolescent_sexual_abuse", "points": 0, "present": false }, { "factor": "add_ocd_bipolar_schizophrenia", "points": 0, "present": false }, { "factor": "depression", "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": "Webster LR, Webster RM", "doi": "10.1111/j.1526-4637.2005.00072.x", "id": "webster-2005", "pmid": "16336480", "source": "Pain Med. 2005;6(6):432-442", "title": "Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool" }, "formula": "ort", "formula_expression": "ORT = Webster 2005 Table 1 sex-specific weights; family_alcohol F1/M3 + family_illegal_drugs F2/M3 + family_prescription_drugs 4 + personal_alcohol 3 + personal_illegal_drugs 4 + personal_prescription_drugs 5 + age_16_to_45 1 + preadolescent_sexual_abuse F3/M0 + add_ocd_bipolar_schizophrenia 2 + depression 1; absent = 0; low 0-3, moderate 4-7, high >=8; max 26", "max_score": 26, "score": 0, "sex": "female", "risk": "low" }, { "components": [ { "factor": "family_alcohol", "points": 0, "present": false }, { "factor": "family_illegal_drugs", "points": 0, "present": false }, { "factor": "family_prescription_drugs", "points": 0, "present": false }, { "factor": "personal_alcohol", "points": 0, "present": false }, { "factor": "personal_illegal_drugs", "points": 0, "present": false }, { "factor": "personal_prescription_drugs", "points": 0, "present": false }, { "factor": "age_16_to_45", "points": 0, "present": false }, { "factor": "preadolescent_sexual_abuse", "points": 0, "present": false }, { "factor": "add_ocd_bipolar_schizophrenia", "points": 0, "present": false }, { "factor": "depression", "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": "Webster LR, Webster RM", "doi": "10.1111/j.1526-4637.2005.00072.x", "id": "webster-2005", "pmid": "16336480", "source": "Pain Med. 2005;6(6):432-442", "title": "Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool" }, "formula": "ort", "formula_expression": "ORT = Webster 2005 Table 1 sex-specific weights; family_alcohol F1/M3 + family_illegal_drugs F2/M3 + family_prescription_drugs 4 + personal_alcohol 3 + personal_illegal_drugs 4 + personal_prescription_drugs 5 + age_16_to_45 1 + preadolescent_sexual_abuse F3/M0 + add_ocd_bipolar_schizophrenia 2 + depression 1; absent = 0; low 0-3, moderate 4-7, high >=8; max 26", "max_score": 26, "score": 0, "sex": "female", "risk": "low" } ] } ``` ## Response fields - `formula` (string): ort - `formula_expression` (string): Exact expression used - `score` (integer): Webster 2005 Table 1 points 0-26 - `max_score` (integer): 26 - `risk` (string): Webster 2005 category: low (0-3), moderate (4-7), or high (>=8). Not a diagnosis of opioid use disorder. - `sex` (string): female or male - `components` (array): Per-item points for the assigned sex - `citation` (object): Webster and Webster Pain Medicine 2005 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "family_alcohol", "points": 0, "present": false }, { "factor": "family_illegal_drugs", "points": 0, "present": false }, { "factor": "family_prescription_drugs", "points": 0, "present": false }, { "factor": "personal_alcohol", "points": 0, "present": false }, { "factor": "personal_illegal_drugs", "points": 0, "present": false }, { "factor": "personal_prescription_drugs", "points": 0, "present": false }, { "factor": "age_16_to_45", "points": 0, "present": false }, { "factor": "preadolescent_sexual_abuse", "points": 0, "present": false }, { "factor": "add_ocd_bipolar_schizophrenia", "points": 0, "present": false }, { "factor": "depression", "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": "Webster LR, Webster RM", "doi": "10.1111/j.1526-4637.2005.00072.x", "id": "webster-2005", "pmid": "16336480", "source": "Pain Med. 2005;6(6):432-442", "title": "Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool" }, "formula": "ort", "formula_expression": "ORT = Webster 2005 Table 1 sex-specific weights; family_alcohol F1/M3 + family_illegal_drugs F2/M3 + family_prescription_drugs 4 + personal_alcohol 3 + personal_illegal_drugs 4 + personal_prescription_drugs 5 + age_16_to_45 1 + preadolescent_sexual_abuse F3/M0 + add_ocd_bipolar_schizophrenia 2 + depression 1; absent = 0; low 0-3, moderate 4-7, high >=8; max 26", "max_score": 26, "score": 0, "sex": "female", "risk": "low" } ``` ## Errors - HTTP 400 `invalid_sex`: sex must be female or male 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 - [COWS](https://magentlab.com/docs/cows) — Sum the eleven Wesson 2003 Clinical Opiate Withdrawal Scale (COWS) items from caller-assigned appendix integers and return the published total (max 48) with the published severity cutoffs. - [PAWSS](https://magentlab.com/docs/pawss) — Apply the Maldonado 2014 PAWSS Part A threshold and ten yes/no items and return the published 0–10 total with the ≥4 high-risk band. - [CAGE](https://magentlab.com/docs/cage) — Sum the four Ewing 1984 CAGE items and return whether two or more answers are affirmative. ## 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.