# PLASMIC score PLASMIC score Status: LIVE Price: $0.005 USDC `GET /api/calc/plasmic` HTML: https://magentlab.com/docs/plasmic Markdown: https://magentlab.com/docs/plasmic.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the seven Bendapudi 2017 PLASMIC items and return the published 0-4 / 5 / 6-7 pretest band for severe ADAMTS13 deficiency. ## When to use When an agent needs the published PLASMIC point total and pretest band and must not invent a plasma-exchange order or an ADAMTS13 activity result. ## When not to use - Not a medical device. - Not a plasma-exchange order and not a diagnosis of TTP. - magent does not assay hemolysis. hemolysis is a caller-assigned flag (reticulocyte count >2.5% or undetectable haptoglobin or indirect bilirubin >2.0 mg/dL per Bendapudi 2017). - Does not return percents or ADAMTS13 activity. Bands 0-4 / 5 / 6-7 are pretest groups for severe ADAMTS13 deficiency. - Platelets 30×10^9/L, MCV 90 fL, INR 1.5, and creatinine 2.0 mg/dL do not score (strict <). - A point is given for no active cancer and for no solid-organ or stem-cell transplant (those flags true score 0). ## Formula ``` PLASMIC = (platelets_10e9_l<30) + hemolysis + (not active_cancer) + (not solid_organ_or_stem_cell_transplant) + (mcv_fl<90) + (inr<1.5) + (creatinine_mg_dl<2.0); each 1; max 7; bands 0-4 / 5 / 6-7 ``` ## Citation [Derivation and external validation of the PLASMIC score for rapid assessment of adults with thrombotic microangiopathies: a cohort study](https://doi.org/10.1016/S2352-3026(17)30026-1) Bendapudi PK, Hurwitz S, Fry A, et al. Lancet Haematol. 2017;4(4):e157-e164 DOI: [10.1016/S2352-3026(17)30026-1](https://doi.org/10.1016/S2352-3026(17)30026-1) ## Worked example ### All seven items present Given: `active_cancer=false, creatinine_mg_dl=1.0, hemolysis=true, inr=1.1, mcv_fl=85, platelets_10e9_l=15, solid_organ_or_stem_cell_transplant=false` 1. Platelets 15 < 30 → 1; hemolysis true → 1; no active cancer → 1; no transplant → 1; MCV 85 < 90 → 1; INR 1.1 < 1.5 → 1; creatinine 1.0 < 2.0 → 1 2. Score = 7 (max 7); band 6-7 ## Also searched as - PLASMIC score - Bendapudi PLASMIC - TMA PLASMIC - ADAMTS13 pretest - thrombotic microangiopathy score - PLASMIC TTP - severe ADAMTS13 deficiency score - hemolytic TMA score ## Parameters - `platelets_10e9_l` (number, required): Platelet count ×10^9/L (1-2000). Scores 1 when <30; 30 does not score (Bendapudi 2017). - `hemolysis` (boolean, required): Caller-assigned hemolysis (Bendapudi 2017: reticulocyte count >2.5% or undetectable haptoglobin or indirect bilirubin >2.0 mg/dL). true or false. magent does not assay. 1 point if true. - `active_cancer` (boolean, required): Active cancer as assigned by the caller. true or false. 1 point when false (no active cancer). - `solid_organ_or_stem_cell_transplant` (boolean, required): History of solid-organ or stem-cell transplant as assigned by the caller. true or false. 1 point when false (no transplant history). - `mcv_fl` (number, required): Mean corpuscular volume in fL (50-120). Scores 1 when <90; 90.0 does not score. - `inr` (number, required): INR (0.8-10). Scores 1 when <1.5; 1.5 does not score. - `creatinine_mg_dl` (number, optional): Serum creatinine in mg/dL (0.1-20). Provide this or creatinine_umol_l. Scores 1 when <2.0; 2.0 does not score. - `creatinine_umol_l` (number, optional): Serum creatinine in µmol/L (9-1768). Converted as mg/dL = µmol/L / 88.42. Provide this or creatinine_mg_dl. ## 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/plasmic` 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": [ { "active_cancer": "false", "creatinine_mg_dl": "1.0", "hemolysis": "true", "inr": "1.1", "mcv_fl": "85", "platelets_10e9_l": "15", "solid_organ_or_stem_cell_transplant": "false" }, { "active_cancer": "false", "creatinine_mg_dl": "1.0", "hemolysis": "true", "inr": "1.1", "mcv_fl": "85", "platelets_10e9_l": "15", "solid_organ_or_stem_cell_transplant": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/plasmic Example 200: ```json { "count": 2, "path": "/api/calc/plasmic", "items": [ { "components": [ { "value": 15.0, "factor": "platelets_lt_30", "points": 1, "present": true }, { "factor": "hemolysis", "points": 1, "present": true }, { "factor": "no_active_cancer", "points": 1, "present": true }, { "factor": "no_solid_organ_or_stem_cell_transplant", "points": 1, "present": true }, { "value": 85.0, "factor": "mcv_lt_90", "points": 1, "present": true }, { "value": 1.1, "factor": "inr_lt_1_5", "points": 1, "present": true }, { "value": 1.0, "factor": "creatinine_lt_2", "points": 1, "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": "Bendapudi PK, Hurwitz S, Fry A, et al.", "doi": "10.1016/S2352-3026(17)30026-1", "id": "bendapudi-2017", "pmid": "28259520", "source": "Lancet Haematol. 2017;4(4):e157-e164", "title": "Derivation and external validation of the PLASMIC score for rapid assessment of adults with thrombotic microangiopathies: a cohort study" }, "formula": "plasmic", "formula_expression": "PLASMIC = (platelets_10e9_l<30) + hemolysis + (not active_cancer) + (not solid_organ_or_stem_cell_transplant) + (mcv_fl<90) + (inr<1.5) + (creatinine_mg_dl<2.0); each 1; max 7; bands 0-4 / 5 / 6-7", "inr": 1.1, "max_score": 7, "score": 7, "platelets_10e9_l": 15.0, "creatinine_mg_dl": 1.0, "mcv_fl": 85.0, "active_cancer": false, "hemolysis": true, "plasmic_band": "6-7", "solid_organ_or_stem_cell_transplant": false }, { "components": [ { "value": 15.0, "factor": "platelets_lt_30", "points": 1, "present": true }, { "factor": "hemolysis", "points": 1, "present": true }, { "factor": "no_active_cancer", "points": 1, "present": true }, { "factor": "no_solid_organ_or_stem_cell_transplant", "points": 1, "present": true }, { "value": 85.0, "factor": "mcv_lt_90", "points": 1, "present": true }, { "value": 1.1, "factor": "inr_lt_1_5", "points": 1, "present": true }, { "value": 1.0, "factor": "creatinine_lt_2", "points": 1, "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": "Bendapudi PK, Hurwitz S, Fry A, et al.", "doi": "10.1016/S2352-3026(17)30026-1", "id": "bendapudi-2017", "pmid": "28259520", "source": "Lancet Haematol. 2017;4(4):e157-e164", "title": "Derivation and external validation of the PLASMIC score for rapid assessment of adults with thrombotic microangiopathies: a cohort study" }, "formula": "plasmic", "formula_expression": "PLASMIC = (platelets_10e9_l<30) + hemolysis + (not active_cancer) + (not solid_organ_or_stem_cell_transplant) + (mcv_fl<90) + (inr<1.5) + (creatinine_mg_dl<2.0); each 1; max 7; bands 0-4 / 5 / 6-7", "inr": 1.1, "max_score": 7, "score": 7, "platelets_10e9_l": 15.0, "creatinine_mg_dl": 1.0, "mcv_fl": 85.0, "active_cancer": false, "hemolysis": true, "plasmic_band": "6-7", "solid_organ_or_stem_cell_transplant": false } ] } ``` ## Response fields - `formula` (string): plasmic - `formula_expression` (string): Exact expression used - `score` (integer): Total points 0-7 - `max_score` (integer): Always 7 - `plasmic_band` (string): 0-4, 5, or 6-7 (Bendapudi 2017 pretest groups for severe ADAMTS13 deficiency). Not a percent and not a plasma-exchange order. - `platelets_10e9_l` (number): Platelet count used (×10^9/L) - `hemolysis` (boolean): Caller-assigned hemolysis flag used - `active_cancer` (boolean): Caller-assigned active-cancer flag used - `solid_organ_or_stem_cell_transplant` (boolean): Caller-assigned transplant-history flag used - `mcv_fl` (number): MCV used, fL - `inr` (number): INR used - `creatinine_mg_dl` (number): Creatinine used in mg/dL (after µmol/L conversion when that unit is supplied) - `components` (array): Per-item points - `citation` (object): Bendapudi 2017 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 15.0, "factor": "platelets_lt_30", "points": 1, "present": true }, { "factor": "hemolysis", "points": 1, "present": true }, { "factor": "no_active_cancer", "points": 1, "present": true }, { "factor": "no_solid_organ_or_stem_cell_transplant", "points": 1, "present": true }, { "value": 85.0, "factor": "mcv_lt_90", "points": 1, "present": true }, { "value": 1.1, "factor": "inr_lt_1_5", "points": 1, "present": true }, { "value": 1.0, "factor": "creatinine_lt_2", "points": 1, "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": "Bendapudi PK, Hurwitz S, Fry A, et al.", "doi": "10.1016/S2352-3026(17)30026-1", "id": "bendapudi-2017", "pmid": "28259520", "source": "Lancet Haematol. 2017;4(4):e157-e164", "title": "Derivation and external validation of the PLASMIC score for rapid assessment of adults with thrombotic microangiopathies: a cohort study" }, "formula": "plasmic", "formula_expression": "PLASMIC = (platelets_10e9_l<30) + hemolysis + (not active_cancer) + (not solid_organ_or_stem_cell_transplant) + (mcv_fl<90) + (inr<1.5) + (creatinine_mg_dl<2.0); each 1; max 7; bands 0-4 / 5 / 6-7", "inr": 1.1, "max_score": 7, "score": 7, "platelets_10e9_l": 15.0, "creatinine_mg_dl": 1.0, "mcv_fl": 85.0, "active_cancer": false, "hemolysis": true, "plasmic_band": "6-7", "solid_organ_or_stem_cell_transplant": false } ``` ## Errors - HTTP 400 `invalid_platelets`: platelets_10e9_l must be a number from 1 to 2000 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_mcv`: mcv_fl must be a number from 50 to 120. Returned before settlement; you are not charged. - HTTP 400 `invalid_inr`: inr must be a number from 0.8 to 10 Returned before settlement; you are not charged. - HTTP 400 `invalid_creatinine`: creatinine_mg_dl (0.1-20) or creatinine_umol_l (9-1768) is required 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 - [4Ts score](https://magentlab.com/docs/four-ts) — Compute the Lo 2006 4Ts score as the sum of four caller-assigned integers 0-2 (thrombocytopenia, timing, thrombosis, other causes). - [NLR](https://magentlab.com/docs/nlr) — Compute the Zahorec 2001 neutrophil-to-lymphocyte ratio from relative neutrophil and lymphocyte percents. - [ANC](https://magentlab.com/docs/anc) — Compute absolute neutrophil count from WBC and neutrophil plus band percents, plus a Bodey 1966 granulocyte band. ## 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.