# Pediatric appendicitis score Pediatric appendicitis score Status: WEDGE Price: $0.005 USDC `GET /api/calc/pas` HTML: https://magentlab.com/docs/pas Markdown: https://magentlab.com/docs/pas.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Samuel 2002 pediatric appendicitis score from eight caller-assigned findings in children aged 4-15. ## When to use When an agent needs the published Samuel 2002 PAS total and must not invent fever or laboratory cutoffs, treat the total as an operating-room protocol, or substitute Alvarado 1986 (MANTRELS). ## When not to use - Not a medical device and not a diagnosis or operating-room protocol. - Samuel 2002 derivation ages 4-15 only. Age does not add points. - This is Samuel 2002 PAS, not Alvarado 1986 (MANTRELS). Pyrexia, leukocytosis, and neutrophilia are caller-assigned flags; magent does not apply unpublished °C or WBC cutoffs. - Findings are caller-assigned. magent does not examine the abdomen. ## Formula ``` PAS = 2*cough_percussion_hopping_rlq + anorexia + pyrexia + nausea_emesis + 2*rif_tenderness + leukocytosis + neutrophilia + migration; max 10 ``` ## Citation [Pediatric appendicitis score](https://doi.org/10.1053/jpsu.2002.32893) Samuel M J Pediatr Surg. 2002;37(6):877-881 DOI: [10.1053/jpsu.2002.32893](https://doi.org/10.1053/jpsu.2002.32893) ## Worked example ### Age 10, all flags false Given: `age=10, anorexia=false, cough_percussion_hopping_rlq=false, leukocytosis=false, migration=false, nausea_emesis=false, neutrophilia=false, pyrexia=false, rif_tenderness=false` 1. Age 10 (in 4-15). Eight flags false. 2. Score = 0; max 10. Age does not add points. ## Also searched as - pediatric appendicitis score - samuel - pas - appendicitis - samuel 2002 - pediatric appendicitis ## Parameters - `age` (integer, required): Age in years as an integer from 4 to 15 (Samuel 2002 derivation cohort). Age does not add points. 3 and 16 are rejected. - `cough_percussion_hopping_rlq` (boolean, required): Cough, percussion, or hopping tenderness in the right lower quadrant (Samuel physical sign 1). true scores 2; false scores 0. - `anorexia` (boolean, required): Anorexia (Samuel). true scores 1; false scores 0. - `pyrexia` (boolean, required): Caller-assigned pyrexia (Samuel named pyrexia; the derivation paper does not publish a °C cutoff). true scores 1; false scores 0. - `nausea_emesis` (boolean, required): Nausea or emesis (Samuel). true scores 1; false scores 0. - `rif_tenderness` (boolean, required): Tenderness over the right iliac fossa (Samuel physical sign 5). true scores 2; false scores 0. - `leukocytosis` (boolean, required): Caller-assigned leukocytosis (Samuel 2002; no published WBC cutoff). true scores 1; false scores 0. - `neutrophilia` (boolean, required): Caller-assigned neutrophilia (Samuel 2002; no published percent or count cutoff). true scores 1; false scores 0. - `migration` (boolean, required): Migration of pain (Samuel). true scores 1; false scores 0. ## 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/pas` 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": [ { "age": "10", "anorexia": "false", "cough_percussion_hopping_rlq": "false", "leukocytosis": "false", "migration": "false", "nausea_emesis": "false", "neutrophilia": "false", "pyrexia": "false", "rif_tenderness": "false" }, { "age": "10", "anorexia": "false", "cough_percussion_hopping_rlq": "false", "leukocytosis": "false", "migration": "false", "nausea_emesis": "false", "neutrophilia": "false", "pyrexia": "false", "rif_tenderness": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/pas Example 200: ```json { "count": 2, "path": "/api/calc/pas", "items": [ { "components": [ { "factor": "cough_percussion_hopping_rlq", "points": 0, "present": false }, { "factor": "anorexia", "points": 0, "present": false }, { "factor": "pyrexia", "points": 0, "present": false }, { "factor": "nausea_emesis", "points": 0, "present": false }, { "factor": "rif_tenderness", "points": 0, "present": false }, { "factor": "leukocytosis", "points": 0, "present": false }, { "factor": "neutrophilia", "points": 0, "present": false }, { "factor": "migration", "points": 0, "present": false } ], "age": 10, "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": "Samuel M", "doi": "10.1053/jpsu.2002.32893", "id": "samuel-2002", "pmid": "12037754", "source": "J Pediatr Surg. 2002;37(6):877-881", "title": "Pediatric appendicitis score" }, "formula": "pas", "formula_expression": "PAS = 2*cough_percussion_hopping_rlq + anorexia + pyrexia + nausea_emesis + 2*rif_tenderness + leukocytosis + neutrophilia + migration; max 10", "max_score": 10, "score": 0 }, { "components": [ { "factor": "cough_percussion_hopping_rlq", "points": 0, "present": false }, { "factor": "anorexia", "points": 0, "present": false }, { "factor": "pyrexia", "points": 0, "present": false }, { "factor": "nausea_emesis", "points": 0, "present": false }, { "factor": "rif_tenderness", "points": 0, "present": false }, { "factor": "leukocytosis", "points": 0, "present": false }, { "factor": "neutrophilia", "points": 0, "present": false }, { "factor": "migration", "points": 0, "present": false } ], "age": 10, "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": "Samuel M", "doi": "10.1053/jpsu.2002.32893", "id": "samuel-2002", "pmid": "12037754", "source": "J Pediatr Surg. 2002;37(6):877-881", "title": "Pediatric appendicitis score" }, "formula": "pas", "formula_expression": "PAS = 2*cough_percussion_hopping_rlq + anorexia + pyrexia + nausea_emesis + 2*rif_tenderness + leukocytosis + neutrophilia + migration; max 10", "max_score": 10, "score": 0 } ] } ``` ## Response fields - `formula` (string): pas - `formula_expression` (string): Exact expression used - `score` (integer): Total points 0-10 - `max_score` (integer): Always 10 - `age` (integer): Age in years used (4-15). Age does not add points. - `components` (array): Per-factor Samuel 2002 points - `citation` (object): Samuel 2002 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "cough_percussion_hopping_rlq", "points": 0, "present": false }, { "factor": "anorexia", "points": 0, "present": false }, { "factor": "pyrexia", "points": 0, "present": false }, { "factor": "nausea_emesis", "points": 0, "present": false }, { "factor": "rif_tenderness", "points": 0, "present": false }, { "factor": "leukocytosis", "points": 0, "present": false }, { "factor": "neutrophilia", "points": 0, "present": false }, { "factor": "migration", "points": 0, "present": false } ], "age": 10, "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": "Samuel M", "doi": "10.1053/jpsu.2002.32893", "id": "samuel-2002", "pmid": "12037754", "source": "J Pediatr Surg. 2002;37(6):877-881", "title": "Pediatric appendicitis score" }, "formula": "pas", "formula_expression": "PAS = 2*cough_percussion_hopping_rlq + anorexia + pyrexia + nausea_emesis + 2*rif_tenderness + leukocytosis + neutrophilia + migration; max 10", "max_score": 10, "score": 0 } ``` ## Errors - HTTP 400 `invalid_pas_age`: age must be an integer from 4 to 15 (Samuel 2002). 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 - [Alvarado score](https://magentlab.com/docs/alvarado) — Compute the Alvarado 1986 MANTRELS score from caller-assigned findings, temperature, WBC, and neutrophil percent. ## 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 echoing accepted, payload, and extensions when present). - 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. - 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.