# Prediction of Alcohol Withdrawal Severity Scale (PAWSS) PAWSS Status: LIVE Price: $0.005 USDC `GET /api/calc/pawss` HTML: https://magentlab.com/docs/pawss Markdown: https://magentlab.com/docs/pawss.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes 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. ## When to use When an agent has already assigned the PAWSS threshold and ten item flags and needs the published score and high-risk cutoff, not a later prophylaxis protocol. ## When not to use - Not a medical device and not a diagnosis of alcohol withdrawal syndrome (AWS) or a prophylaxis order. - Not CIWA-Ar. - The Part A threshold (any alcohol in the last 30 days or positive BAL on admission) is required. If it is false, magent returns score 0 and pawss_band outside_window and does not add the ten item points. - magent does not interview the patient or measure BAL. Each flag is caller-assigned. - Published cutoff is ≥4 high risk for complicated AWS. Scores 0–3 with a true threshold are low. magent does not invent a moderate class. ## Formula ``` PAWSS = if alcohol_last_30d_or_positive_bal then recently_intoxicated_30d + alcohol_rehab + previous_withdrawal + blackouts + withdrawal_seizures + delirium_tremens + combined_downers_90d + combined_other_substances_90d + bal_ge_200 + increased_autonomic_activity else 0; each item 1 if true; Part A threshold 0 points; max 10; threshold false → outside_window; 0-3 low; >=4 high; Maldonado 2014 ``` ## Citation [The "Prediction of Alcohol Withdrawal Severity Scale" (PAWSS): systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome](https://doi.org/10.1016/j.alcohol.2014.01.004) Maldonado JR, Sher Y, Ashouri JF, Hills-Evans K, Swendsen H, Lolak S, Miller AC Alcohol. 2014;48(4):375-390 DOI: [10.1016/j.alcohol.2014.01.004](https://doi.org/10.1016/j.alcohol.2014.01.004) ## Worked example ### Threshold false Given: `alcohol_last_30d_or_positive_bal=false, alcohol_rehab=false, bal_ge_200=false, blackouts=false, combined_downers_90d=false, combined_other_substances_90d=false, delirium_tremens=false, increased_autonomic_activity=false, previous_withdrawal=false, recently_intoxicated_30d=false, withdrawal_seizures=false` 1. alcohol_last_30d_or_positive_bal false 2. ten item flags false 3. score = 0 (items not added) 4. pawss_band = outside_window ### Four items with threshold true Given: `alcohol_last_30d_or_positive_bal=true, alcohol_rehab=true, bal_ge_200=false, blackouts=true, combined_downers_90d=false, combined_other_substances_90d=false, delirium_tremens=false, increased_autonomic_activity=false, previous_withdrawal=true, recently_intoxicated_30d=true, withdrawal_seizures=false` 1. alcohol_last_30d_or_positive_bal true 2. four items true → 4 3. score = 4 4. pawss_band = high ## Also searched as - PAWSS - Prediction of Alcohol Withdrawal Severity Scale - Maldonado PAWSS - alcohol withdrawal severity scale - complicated alcohol withdrawal prediction - PAWSS score - PAWSS high risk ## Parameters - `alcohol_last_30d_or_positive_bal` (boolean, required): Part A threshold (0 points). Caller-assigned: consumed any alcohol in the last 30 days or a positive BAL on admission (Maldonado 2014). If false, score is 0 and pawss_band is outside_window; the ten items are not added. magent does not interview the patient or measure BAL. - `recently_intoxicated_30d` (boolean, required): Recently intoxicated or drunk within the last 30 days as assigned by the caller (Maldonado 2014). true scores 1 when the Part A threshold is true. magent does not interview the patient. - `alcohol_rehab` (boolean, required): Ever alcohol-use-disorder rehabilitation or AA as assigned by the caller (Maldonado 2014). true scores 1 when the Part A threshold is true. magent does not interview the patient. - `previous_withdrawal` (boolean, required): Any previous alcohol withdrawal as assigned by the caller (Maldonado 2014). true scores 1 when the Part A threshold is true. magent does not interview the patient. - `blackouts` (boolean, required): Ever blackouts as assigned by the caller (Maldonado 2014). true scores 1 when the Part A threshold is true. magent does not interview the patient. - `withdrawal_seizures` (boolean, required): Ever alcohol withdrawal seizures as assigned by the caller (Maldonado 2014). true scores 1 when the Part A threshold is true. magent does not interview the patient. - `delirium_tremens` (boolean, required): Ever delirium tremens as assigned by the caller (Maldonado 2014). true scores 1 when the Part A threshold is true. magent does not interview the patient. - `combined_downers_90d` (boolean, required): Combined alcohol with benzodiazepines or barbiturates in the last 90 days as assigned by the caller (Maldonado 2014). true scores 1 when the Part A threshold is true. magent does not interview the patient. - `combined_other_substances_90d` (boolean, required): Combined alcohol with any other substance of abuse in the last 90 days as assigned by the caller (Maldonado 2014). true scores 1 when the Part A threshold is true. magent does not interview the patient. - `bal_ge_200` (boolean, required): BAL on presentation ≥200 as assigned by the caller (Maldonado 2014). true scores 1 when the Part A threshold is true. magent does not measure BAL. - `increased_autonomic_activity` (boolean, required): Increased autonomic activity as assigned by the caller (Maldonado 2014), for example HR>120, tremor, sweating, agitation, or nausea. true scores 1 when the Part A threshold is true. magent does not observe 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/pawss` 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": [ { "alcohol_last_30d_or_positive_bal": "false", "alcohol_rehab": "false", "bal_ge_200": "false", "blackouts": "false", "combined_downers_90d": "false", "combined_other_substances_90d": "false", "delirium_tremens": "false", "increased_autonomic_activity": "false", "previous_withdrawal": "false", "recently_intoxicated_30d": "false", "withdrawal_seizures": "false" }, { "alcohol_last_30d_or_positive_bal": "false", "alcohol_rehab": "false", "bal_ge_200": "false", "blackouts": "false", "combined_downers_90d": "false", "combined_other_substances_90d": "false", "delirium_tremens": "false", "increased_autonomic_activity": "false", "previous_withdrawal": "false", "recently_intoxicated_30d": "false", "withdrawal_seizures": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/pawss Example 200: ```json { "count": 2, "path": "/api/calc/pawss", "items": [ { "components": [ { "factor": "alcohol_last_30d_or_positive_bal", "points": 0, "present": false }, { "factor": "recently_intoxicated_30d", "points": 0, "present": false }, { "factor": "alcohol_rehab", "points": 0, "present": false }, { "factor": "previous_withdrawal", "points": 0, "present": false }, { "factor": "blackouts", "points": 0, "present": false }, { "factor": "withdrawal_seizures", "points": 0, "present": false }, { "factor": "delirium_tremens", "points": 0, "present": false }, { "factor": "combined_downers_90d", "points": 0, "present": false }, { "factor": "combined_other_substances_90d", "points": 0, "present": false }, { "factor": "bal_ge_200", "points": 0, "present": false }, { "factor": "increased_autonomic_activity", "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": "Maldonado JR, Sher Y, Ashouri JF, Hills-Evans K, Swendsen H, Lolak S, Miller AC", "doi": "10.1016/j.alcohol.2014.01.004", "id": "maldonado-2014", "pmid": "24657098", "source": "Alcohol. 2014;48(4):375-390", "title": "The \"Prediction of Alcohol Withdrawal Severity Scale\" (PAWSS): systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome" }, "formula": "pawss", "formula_expression": "PAWSS = if alcohol_last_30d_or_positive_bal then recently_intoxicated_30d + alcohol_rehab + previous_withdrawal + blackouts + withdrawal_seizures + delirium_tremens + combined_downers_90d + combined_other_substances_90d + bal_ge_200 + increased_autonomic_activity else 0; each item 1 if true; Part A threshold 0 points; max 10; threshold false → outside_window; 0-3 low; >=4 high; Maldonado 2014", "max_score": 10, "score": 0, "pawss_band": "outside_window" }, { "components": [ { "factor": "alcohol_last_30d_or_positive_bal", "points": 0, "present": false }, { "factor": "recently_intoxicated_30d", "points": 0, "present": false }, { "factor": "alcohol_rehab", "points": 0, "present": false }, { "factor": "previous_withdrawal", "points": 0, "present": false }, { "factor": "blackouts", "points": 0, "present": false }, { "factor": "withdrawal_seizures", "points": 0, "present": false }, { "factor": "delirium_tremens", "points": 0, "present": false }, { "factor": "combined_downers_90d", "points": 0, "present": false }, { "factor": "combined_other_substances_90d", "points": 0, "present": false }, { "factor": "bal_ge_200", "points": 0, "present": false }, { "factor": "increased_autonomic_activity", "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": "Maldonado JR, Sher Y, Ashouri JF, Hills-Evans K, Swendsen H, Lolak S, Miller AC", "doi": "10.1016/j.alcohol.2014.01.004", "id": "maldonado-2014", "pmid": "24657098", "source": "Alcohol. 2014;48(4):375-390", "title": "The \"Prediction of Alcohol Withdrawal Severity Scale\" (PAWSS): systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome" }, "formula": "pawss", "formula_expression": "PAWSS = if alcohol_last_30d_or_positive_bal then recently_intoxicated_30d + alcohol_rehab + previous_withdrawal + blackouts + withdrawal_seizures + delirium_tremens + combined_downers_90d + combined_other_substances_90d + bal_ge_200 + increased_autonomic_activity else 0; each item 1 if true; Part A threshold 0 points; max 10; threshold false → outside_window; 0-3 low; >=4 high; Maldonado 2014", "max_score": 10, "score": 0, "pawss_band": "outside_window" } ] } ``` ## Response fields - `formula` (string): pawss - `formula_expression` (string): Exact expression used - `score` (integer): PAWSS points 0-10 - `max_score` (integer): 10 - `pawss_band` (string): outside_window when the Part A threshold is false; low when the threshold is true and score is 0-3; high when the threshold is true and score is ≥4 (Maldonado 2014 cutoff for complicated AWS). Not a diagnosis. - `components` (array): Part A threshold (0 points) then per-item points - `citation` (object): Maldonado et al. Alcohol 2014 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "alcohol_last_30d_or_positive_bal", "points": 0, "present": false }, { "factor": "recently_intoxicated_30d", "points": 0, "present": false }, { "factor": "alcohol_rehab", "points": 0, "present": false }, { "factor": "previous_withdrawal", "points": 0, "present": false }, { "factor": "blackouts", "points": 0, "present": false }, { "factor": "withdrawal_seizures", "points": 0, "present": false }, { "factor": "delirium_tremens", "points": 0, "present": false }, { "factor": "combined_downers_90d", "points": 0, "present": false }, { "factor": "combined_other_substances_90d", "points": 0, "present": false }, { "factor": "bal_ge_200", "points": 0, "present": false }, { "factor": "increased_autonomic_activity", "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": "Maldonado JR, Sher Y, Ashouri JF, Hills-Evans K, Swendsen H, Lolak S, Miller AC", "doi": "10.1016/j.alcohol.2014.01.004", "id": "maldonado-2014", "pmid": "24657098", "source": "Alcohol. 2014;48(4):375-390", "title": "The \"Prediction of Alcohol Withdrawal Severity Scale\" (PAWSS): systematic literature review and pilot study of a new scale for the prediction of complicated alcohol withdrawal syndrome" }, "formula": "pawss", "formula_expression": "PAWSS = if alcohol_last_30d_or_positive_bal then recently_intoxicated_30d + alcohol_rehab + previous_withdrawal + blackouts + withdrawal_seizures + delirium_tremens + combined_downers_90d + combined_other_substances_90d + bal_ge_200 + increased_autonomic_activity else 0; each item 1 if true; Part A threshold 0 points; max 10; threshold false → outside_window; 0-3 low; >=4 high; Maldonado 2014", "max_score": 10, "score": 0, "pawss_band": "outside_window" } ``` ## Errors - 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 - [CIWA-Ar](https://magentlab.com/docs/ciwa-ar) — Sum the ten Sullivan 1989 CIWA-Ar items (nine caller-assigned 0-7 plus orientation 0-4) and return the published total (max 67). ## 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. - 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.