# Pregnancy-unique quantification of emesis and nausea

PUQE

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/puqe`
HTML: https://magentlab.com/docs/puqe
Markdown: https://magentlab.com/docs/puqe.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Sum three caller-assigned Koren 2002 12-hour PUQE items (nausea_duration, vomiting_episodes, retching_episodes; each integer 1-5) and return the published 3-15 total. Does not apply later 24-hour, trimester-long, or 3-6 / 7-12 / ≥13 cuts.

## When to use

When an agent already has Koren 2002 last-12-hour 1-5 integers for nausea duration, vomiting episodes, and retching episodes and needs the published total. magent does not interview the patient, order an antiemetic, or score a later 24-hour or trimester-long form.

## When not to use

- Not a medical device and not an antiemetic order.
- Each of the three items is a caller-assigned integer 1-5 from the Koren 2002 last-12-hour table. magent does not interview the patient.
- This is Koren 2002 12-hour PUQE only (nausea duration, vomiting episodes, retching episodes; total 3-15). magent does not score later 24-hour or trimester-long forms.
- Koren 2002 published no 3-6 / 7-12 / ≥13 total-score severity bands. This tool returns score and max_score only. It does not apply later website or review cuts.

## Formula

```
PUQE = nausea_duration + vomiting_episodes + retching_episodes; each caller-assigned 1-5 as in Koren 2002 (last 12 hours); total 3-15; Koren 2002 published no 3-6 / 7-12 / ≥13 total-score severity bands
```

## Citation

[Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy](https://doi.org/10.1067/mob.2002.123054)
Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A
Am J Obstet Gynecol. 2002;186(5 Suppl Understanding):S228-S231
DOI: [10.1067/mob.2002.123054](https://doi.org/10.1067/mob.2002.123054)

## Worked example

### All items 1

Given: `nausea_duration=1, retching_episodes=1, vomiting_episodes=1`

1. nausea_duration, vomiting_episodes, and retching_episodes are 1 as assigned by the caller
2. Score = 3 (max 15). Koren 2002 published no total-score severity band.


### All items 5

Given: `nausea_duration=5, retching_episodes=5, vomiting_episodes=5`

1. each of the three Koren 2002 items is 5 as assigned by the caller
2. Score = 15 (max 15). No total-score severity band.


## Also searched as

- PUQE
- pregnancy-unique quantification of emesis
- Koren 2002 PUQE
- 12-hour PUQE
- nausea and vomiting of pregnancy score
- PUQE score
- pregnancy nausea emesis score
- NVP quantification

## Parameters

- `nausea_duration` (integer, required): Caller-assigned Koren 2002 PUQE nausea duration in the last 12 hours (integer 1-5): 1 not at all; 2 1 hour or less; 3 2-3 hours; 4 4-6 hours; 5 more than 6 hours. magent does not interview the patient.
- `vomiting_episodes` (integer, required): Caller-assigned Koren 2002 PUQE vomiting episodes in the last 12 hours (integer 1-5): 1 did not throw up; 2 1-2 times; 3 3-4 times; 4 5-6 times; 5 7 or more times. magent does not interview the patient.
- `retching_episodes` (integer, required): Caller-assigned Koren 2002 PUQE retching or dry heaves without bringing anything up in the last 12 hours (integer 1-5): 1 no time; 2 1-2 times; 3 3-4 times; 4 5-6 times; 5 7 or more times. magent does not interview 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/puqe`
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": [
    {
      "nausea_duration": "1",
      "retching_episodes": "1",
      "vomiting_episodes": "1"
    },
    {
      "nausea_duration": "1",
      "retching_episodes": "1",
      "vomiting_episodes": "1"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/puqe

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/puqe",
  "items": [
    {
      "components": [
        {
          "value": 1,
          "factor": "nausea_duration",
          "points": 1,
          "present": true
        },
        {
          "value": 1,
          "factor": "vomiting_episodes",
          "points": 1,
          "present": true
        },
        {
          "value": 1,
          "factor": "retching_episodes",
          "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": "Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A",
        "doi": "10.1067/mob.2002.123054",
        "id": "koren-2002",
        "pmid": "12011891",
        "source": "Am J Obstet Gynecol. 2002;186(5 Suppl Understanding):S228-S231",
        "title": "Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy"
      },
      "formula": "puqe",
      "formula_expression": "PUQE = nausea_duration + vomiting_episodes + retching_episodes; each caller-assigned 1-5 as in Koren 2002 (last 12 hours); total 3-15; Koren 2002 published no 3-6 / 7-12 / ≥13 total-score severity bands",
      "max_score": 15,
      "score": 3
    },
    {
      "components": [
        {
          "value": 1,
          "factor": "nausea_duration",
          "points": 1,
          "present": true
        },
        {
          "value": 1,
          "factor": "vomiting_episodes",
          "points": 1,
          "present": true
        },
        {
          "value": 1,
          "factor": "retching_episodes",
          "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": "Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A",
        "doi": "10.1067/mob.2002.123054",
        "id": "koren-2002",
        "pmid": "12011891",
        "source": "Am J Obstet Gynecol. 2002;186(5 Suppl Understanding):S228-S231",
        "title": "Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy"
      },
      "formula": "puqe",
      "formula_expression": "PUQE = nausea_duration + vomiting_episodes + retching_episodes; each caller-assigned 1-5 as in Koren 2002 (last 12 hours); total 3-15; Koren 2002 published no 3-6 / 7-12 / ≥13 total-score severity bands",
      "max_score": 15,
      "score": 3
    }
  ]
}
```

## Response fields

- `formula` (string): puqe
- `formula_expression` (string): Exact expression used
- `score` (integer): Koren 2002 12-hour PUQE sum of three caller-assigned 1-5 items (3-15). No later total-score severity band.
- `max_score` (integer): Always 15
- `components` (array): Per-item caller-assigned points
- `citation` (object): Koren et al. Am J Obstet Gynecol 2002 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": 1,
      "factor": "nausea_duration",
      "points": 1,
      "present": true
    },
    {
      "value": 1,
      "factor": "vomiting_episodes",
      "points": 1,
      "present": true
    },
    {
      "value": 1,
      "factor": "retching_episodes",
      "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": "Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A",
    "doi": "10.1067/mob.2002.123054",
    "id": "koren-2002",
    "pmid": "12011891",
    "source": "Am J Obstet Gynecol. 2002;186(5 Suppl Understanding):S228-S231",
    "title": "Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy"
  },
  "formula": "puqe",
  "formula_expression": "PUQE = nausea_duration + vomiting_episodes + retching_episodes; each caller-assigned 1-5 as in Koren 2002 (last 12 hours); total 3-15; Koren 2002 published no 3-6 / 7-12 / ≥13 total-score severity bands",
  "max_score": 15,
  "score": 3
}
```

## Errors

- HTTP 400 `invalid_puqe`: PUQE inputs must match Koren 2002 nausea duration, vomiting episodes, and retching episodes from that paper. 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

- [Apgar score](https://magentlab.com/docs/apgar) — Compute the Apgar newborn evaluation score as the sum of five caller-assigned 0-2 signs.
- [Bishop score](https://magentlab.com/docs/bishop) — Return the Bishop 1964 pelvic score as the sum of five caller-assigned integer components (dilation, effacement, station, consistency, position).

## 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.