# PHASES aneurysm rupture score (Greving 2014) PHASES Status: LIVE Price: $0.005 USDC `GET /api/calc/phases` HTML: https://magentlab.com/docs/phases Markdown: https://magentlab.com/docs/phases.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum Greving 2014 PHASES points (population, hypertension, age, size, earlier SAH, site; max 22) and return the published grouped 5-year rupture risk percent. ## When to use When an agent already has caller-assigned PHASES factors for an unruptured intracranial aneurysm and needs the published 5-year rupture-risk percent, not a treatment order or PHASES of care. ## When not to use - Not a medical device, not a diagnosis of rupture, and not a treatment, clipping, or coiling order. - Not PHASES of care. Geographic population is caller-assigned (north_america_europe, japanese, or finnish as in Greving 2014). magent does not assign ancestry. - Size bands and site groups follow Greving 2014 only (ica 0; mca 2; aca_pcom_posterior 4). magent does not read imaging. - five_year_rupture_risk_percent is the paper's grouped table (score ≤2 → 0.4%; 3 → 0.7%; 4 → 0.9%; 5 → 1.3%; 6 → 1.7%; 7 → 2.4%; 8 → 3.2%; 9 → 4.3%; 10 → 5.3%; 11 → 7.2%; ≥12 → 17.8%). Scores 0 and 1 use the ≤2 row. The paper does not split ≥12 further. ## Formula ``` PHASES = population (north_america_europe 0, japanese 3, finnish 5) + hypertension 1 + age>=70 1 + size (<7.0 0, 7.0-9.9 3, 10.0-19.9 6, >=20.0 10) + earlier_sah 1 + site (ica 0, mca 2, aca_pcom_posterior 4); max 22 ``` ## Citation [Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies](https://doi.org/10.1016/S1474-4422(13)70263-1) Greving JP, Wermer MJH, Brown RD Jr, et al. Lancet Neurol. 2014;13(1):59-66 DOI: [10.1016/S1474-4422(13)70263-1](https://doi.org/10.1016/S1474-4422(13)70263-1) ## Worked example ### North America/Europe, small ICA aneurysm Given: `age=50, aneurysm_mm=5, earlier_sah=false, hypertension=false, population=north_america_europe, site=ica` 1. population north_america_europe 0; hypertension false 0; age 50 (<70) 0; aneurysm_mm 5 (<7.0) 0; earlier_sah false 0; site ica 0 2. Score = 0 (max 22); five_year_rupture_risk_percent 0.4 (Greving 2014 ≤2 row) ### Japanese population, otherwise the same small ICA aneurysm Given: `age=50, aneurysm_mm=5, earlier_sah=false, hypertension=false, population=japanese, site=ica` 1. japanese 3; remaining factors 0 2. Score = 3; five_year_rupture_risk_percent 0.7 ## Also searched as - PHASES score - Greving PHASES - aneurysm rupture risk - unruptured intracranial aneurysm - PHASES aneurysm - 5-year aneurysm rupture ## Parameters - `population` (string, required): Caller-assigned Greving 2014 geographic study population: north_america_europe (0; North America and Europe other than Finland), japanese (3), or finnish (5). magent does not assign ancestry. - `hypertension` (boolean, required): Caller-assigned history of hypertension (Greving 2014). true scores 1. magent does not take a blood-pressure reading. - `age` (integer, required): Age in years (integer 18-120). <70 scores 0; ≥70 scores 1 (Greving 2014). - `aneurysm_mm` (number, required): Caller-assigned maximum aneurysm diameter in millimetres (1.0-50.0). <7.0 scores 0; 7.0-9.9 scores 3; 10.0-19.9 scores 6; ≥20.0 scores 10. magent does not read imaging. - `earlier_sah` (boolean, required): Earlier subarachnoid hemorrhage from another aneurysm (Greving 2014). true scores 1. Not a diagnosis of current rupture. - `site` (string, required): Caller-assigned aneurysm site as grouped in Greving 2014: ica (0), mca (2), or aca_pcom_posterior (4; anterior cerebral, anterior communicating, posterior communicating, or posterior circulation). magent does not read imaging. ## 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/phases` 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": "50", "aneurysm_mm": "5", "earlier_sah": "false", "hypertension": "false", "population": "north_america_europe", "site": "ica" }, { "age": "50", "aneurysm_mm": "5", "earlier_sah": "false", "hypertension": "false", "population": "north_america_europe", "site": "ica" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/phases Example 200: ```json { "count": 2, "path": "/api/calc/phases", "items": [ { "components": [ { "value": "north_america_europe", "factor": "population", "points": 0, "present": true }, { "factor": "hypertension", "points": 0, "present": false }, { "value": 50, "factor": "age", "points": 0, "present": false }, { "value": 5.0, "factor": "aneurysm_mm", "points": 0, "present": true }, { "factor": "earlier_sah", "points": 0, "present": false }, { "value": "ica", "factor": "site", "points": 0, "present": true } ], "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": "Greving JP, Wermer MJH, Brown RD Jr, et al.", "doi": "10.1016/S1474-4422(13)70263-1", "id": "greving-2014", "pmid": "24290159", "source": "Lancet Neurol. 2014;13(1):59-66", "title": "Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies" }, "formula": "phases", "formula_expression": "PHASES = population (north_america_europe 0, japanese 3, finnish 5) + hypertension 1 + age>=70 1 + size (<7.0 0, 7.0-9.9 3, 10.0-19.9 6, >=20.0 10) + earlier_sah 1 + site (ica 0, mca 2, aca_pcom_posterior 4); max 22", "age_years": 50, "max_score": 22, "score": 0, "site": "ica", "aneurysm_mm": 5.0, "five_year_rupture_risk_percent": 0.4, "population": "north_america_europe" }, { "components": [ { "value": "north_america_europe", "factor": "population", "points": 0, "present": true }, { "factor": "hypertension", "points": 0, "present": false }, { "value": 50, "factor": "age", "points": 0, "present": false }, { "value": 5.0, "factor": "aneurysm_mm", "points": 0, "present": true }, { "factor": "earlier_sah", "points": 0, "present": false }, { "value": "ica", "factor": "site", "points": 0, "present": true } ], "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": "Greving JP, Wermer MJH, Brown RD Jr, et al.", "doi": "10.1016/S1474-4422(13)70263-1", "id": "greving-2014", "pmid": "24290159", "source": "Lancet Neurol. 2014;13(1):59-66", "title": "Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies" }, "formula": "phases", "formula_expression": "PHASES = population (north_america_europe 0, japanese 3, finnish 5) + hypertension 1 + age>=70 1 + size (<7.0 0, 7.0-9.9 3, 10.0-19.9 6, >=20.0 10) + earlier_sah 1 + site (ica 0, mca 2, aca_pcom_posterior 4); max 22", "age_years": 50, "max_score": 22, "score": 0, "site": "ica", "aneurysm_mm": 5.0, "five_year_rupture_risk_percent": 0.4, "population": "north_america_europe" } ] } ``` ## Response fields - `formula` (string): phases - `formula_expression` (string): Exact expression used - `score` (integer): PHASES points 0-22 - `max_score` (integer): 22 - `five_year_rupture_risk_percent` (number): Greving 2014 grouped 5-year rupture risk percent (≤2 → 0.4 through ≥12 → 17.8). Not a treatment order. - `population` (string): Caller-assigned population token used for scoring - `age_years` (integer): Age used for the ≥70 criterion - `aneurysm_mm` (number): Aneurysm diameter in millimetres used for size points - `site` (string): Caller-assigned site token used for scoring - `components` (array): Per-factor PHASES points - `citation` (object): Greving et al. Lancet Neurol 2014 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": "north_america_europe", "factor": "population", "points": 0, "present": true }, { "factor": "hypertension", "points": 0, "present": false }, { "value": 50, "factor": "age", "points": 0, "present": false }, { "value": 5.0, "factor": "aneurysm_mm", "points": 0, "present": true }, { "factor": "earlier_sah", "points": 0, "present": false }, { "value": "ica", "factor": "site", "points": 0, "present": true } ], "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": "Greving JP, Wermer MJH, Brown RD Jr, et al.", "doi": "10.1016/S1474-4422(13)70263-1", "id": "greving-2014", "pmid": "24290159", "source": "Lancet Neurol. 2014;13(1):59-66", "title": "Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies" }, "formula": "phases", "formula_expression": "PHASES = population (north_america_europe 0, japanese 3, finnish 5) + hypertension 1 + age>=70 1 + size (<7.0 0, 7.0-9.9 3, 10.0-19.9 6, >=20.0 10) + earlier_sah 1 + site (ica 0, mca 2, aca_pcom_posterior 4); max 22", "age_years": 50, "max_score": 22, "score": 0, "site": "ica", "aneurysm_mm": 5.0, "five_year_rupture_risk_percent": 0.4, "population": "north_america_europe" } ``` ## Errors - HTTP 400 `invalid_phases_population`: population must be north_america_europe, japanese, or finnish (Greving 2014 PHASES). Returned before settlement; you are not charged. - HTTP 400 `invalid_phases_size`: aneurysm_mm must be a number from 1.0 to 50.0 (Greving 2014 PHASES). Returned before settlement; you are not charged. - HTTP 400 `invalid_phases_site`: site must be ica, mca, or aca_pcom_posterior (Greving 2014 PHASES). Returned before settlement; you are not charged. - 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 - [Hunt-Hess](https://magentlab.com/docs/hunt-hess) — Return the Hunt and Hess 1968 subarachnoid-hemorrhage surgical-risk grade from a caller-assigned grade 1-5, applying the paper's next-less-favorable bump when serious systemic disease is present. - [Modified Fisher](https://magentlab.com/docs/modified-fisher) — Return the Frontera 2006 modified Fisher CT grade 0-4 from a caller-assigned grade, with the published grade description. - [Ottawa SAH Rule](https://magentlab.com/docs/ottawa-sah) — Apply the Perry 2013 Ottawa SAH Rule and return whether investigation is indicated from age and five caller-assigned high-risk findings. ## 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.