# RISK-E score (Olmos 2017) RISK-E Status: LIVE Price: $0.005 USDC `GET /api/calc/riske` HTML: https://magentlab.com/docs/riske Markdown: https://magentlab.com/docs/riske.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Olmos 2017 RISK-E (Risk-Endocarditis) score from age and seven caller-assigned flags for active left-sided infective endocarditis undergoing cardiac surgery, and return the integer score and max_score 68. ## When to use When an agent already has Olmos 2017 inputs (age and caller-assigned prosthetic infection, periannular complications, Staphylococcus aureus or fungi, acute renal failure, septic shock, cardiogenic shock, and thrombocytopenia) and needs the published RISK-E point total, not a mortality percent, diagnosis, or surgery decision. ## When not to use - Not a medical device. Not a diagnosis of infective endocarditis. - magent does not examine the valve, read echocardiography, or decide surgery. Flags are caller-assigned. - Returns score and max_score 68 only. The paper estimated predicted mortality over score combinations; magent does not return a mortality percent or risk band. - Not Park 2016 ICE IE 6-month mortality (ie-mortality). Not Durack 1994 Duke diagnostic criteria. - Age 18-120 is the magent adult clamp via Params.age/1, not a published Olmos 2017 age range. ## Formula ``` RISK-E = age (<=51: 0, 52-63: 9, 64-72: 13, >=73: 14) + prosthetic_infection 6 + periannular_complications 5 + staphylococcus_aureus_or_fungi 9 + acute_renal_failure 5 + septic_shock 7 + cardiogenic_shock 15 + thrombocytopenia 7; max 68. Score and max_score only; not a mortality percent. Olmos 2017 Table 2 and Table 3. Not Park 2016. Not Duke ``` ## Citation [Risk score for cardiac surgery in active left-sided infective endocarditis](https://doi.org/10.1136/heartjnl-2016-311093) Olmos C, Vilacosta I, Fernández C, et al. Heart. 2017;103(18):1435-1442 DOI: [10.1136/heartjnl-2016-311093](https://doi.org/10.1136/heartjnl-2016-311093) ## Worked example ### Age 50, all flags false Given: `acute_renal_failure=false, age=50, cardiogenic_shock=false, periannular_complications=false, prosthetic_infection=false, septic_shock=false, staphylococcus_aureus_or_fungi=false, thrombocytopenia=false` 1. Age <=51 -> 0; all flags false -> 0 2. Score = 0; max_score = 68 ### Olmos 2017 Table 3: age 60, prosthetic, S. aureus, acute renal failure Given: `acute_renal_failure=true, age=60, cardiogenic_shock=false, periannular_complications=false, prosthetic_infection=true, septic_shock=false, staphylococcus_aureus_or_fungi=true, thrombocytopenia=false` 1. Age 52-63 -> 9; prosthetic_infection +6; staphylococcus_aureus_or_fungi +9; acute_renal_failure +5 2. Score = 29; max_score = 68. Not the paper's predicted-mortality percent. ## Also searched as - RISK-E score - Risk-Endocarditis score - Olmos endocarditis surgery score - left-sided IE surgical risk - cardiac surgery infective endocarditis score - Olmos 2017 RISK-E - IE perioperative mortality score ## Parameters - `age` (integer, required): Age in years (integer 18-120). Olmos 2017: <=51 scores 0; 52-63 scores 9; 64-72 scores 13; >=73 scores 14. Age 51 scores 0; 52 scores 9; 63 scores 9; 64 scores 13; 72 scores 13; 73 scores 14. magent does not examine the patient. - `prosthetic_infection` (boolean, required): Prosthetic-valve infection as assigned by the caller (Olmos 2017). true or false. +6 if true. magent does not examine the valve. - `periannular_complications` (boolean, required): Periannular complications (abscess, pseudoaneurysm, fistula, or prosthetic dehiscence) as assigned by the caller (Olmos 2017). true or false. +5 if true. magent does not read echocardiography. - `staphylococcus_aureus_or_fungi` (boolean, required): Staphylococcus aureus or fungi as assigned by the caller (Olmos 2017 virulent microorganism). true or false. +9 if true. magent does not interpret cultures. - `acute_renal_failure` (boolean, required): Acute renal failure as assigned by the caller (Olmos 2017; GFR <60 mL/min/1.73 m2 in the derivation). true or false. +5 if true. magent does not compute GFR. - `septic_shock` (boolean, required): Septic shock as assigned by the caller (Olmos 2017). true or false. +7 if true. magent does not diagnose shock. - `cardiogenic_shock` (boolean, required): Cardiogenic shock as assigned by the caller (Olmos 2017). true or false. +15 if true. magent does not diagnose shock or decide surgery. - `thrombocytopenia` (boolean, required): Thrombocytopenia as assigned by the caller (Olmos 2017 thrombocytopaenia, <150000 platelets/mm3). true or false. +7 if true. magent does not interpret a platelet count. ## 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/riske` 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": [ { "acute_renal_failure": "false", "age": "50", "cardiogenic_shock": "false", "periannular_complications": "false", "prosthetic_infection": "false", "septic_shock": "false", "staphylococcus_aureus_or_fungi": "false", "thrombocytopenia": "false" }, { "acute_renal_failure": "false", "age": "50", "cardiogenic_shock": "false", "periannular_complications": "false", "prosthetic_infection": "false", "septic_shock": "false", "staphylococcus_aureus_or_fungi": "false", "thrombocytopenia": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/riske Example 200: ```json { "count": 2, "path": "/api/calc/riske", "items": [ { "components": [ { "value": 50, "factor": "age", "points": 0, "present": true }, { "factor": "prosthetic_infection", "points": 0, "present": false }, { "factor": "periannular_complications", "points": 0, "present": false }, { "factor": "staphylococcus_aureus_or_fungi", "points": 0, "present": false }, { "factor": "acute_renal_failure", "points": 0, "present": false }, { "factor": "septic_shock", "points": 0, "present": false }, { "factor": "cardiogenic_shock", "points": 0, "present": false }, { "factor": "thrombocytopenia", "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": "Olmos C, Vilacosta I, Fernández C, et al.", "doi": "10.1136/heartjnl-2016-311093", "id": "olmos-2017", "pmid": "28432158", "source": "Heart. 2017;103(18):1435-1442", "title": "Risk score for cardiac surgery in active left-sided infective endocarditis" }, "formula": "riske", "formula_expression": "RISK-E = age (<=51: 0, 52-63: 9, 64-72: 13, >=73: 14) + prosthetic_infection 6 + periannular_complications 5 + staphylococcus_aureus_or_fungi 9 + acute_renal_failure 5 + septic_shock 7 + cardiogenic_shock 15 + thrombocytopenia 7; max 68. Score and max_score only; not a mortality percent. Olmos 2017 Table 2 and Table 3. Not Park 2016. Not Duke", "max_score": 68, "score": 0, "age_years": 50 }, { "components": [ { "value": 50, "factor": "age", "points": 0, "present": true }, { "factor": "prosthetic_infection", "points": 0, "present": false }, { "factor": "periannular_complications", "points": 0, "present": false }, { "factor": "staphylococcus_aureus_or_fungi", "points": 0, "present": false }, { "factor": "acute_renal_failure", "points": 0, "present": false }, { "factor": "septic_shock", "points": 0, "present": false }, { "factor": "cardiogenic_shock", "points": 0, "present": false }, { "factor": "thrombocytopenia", "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": "Olmos C, Vilacosta I, Fernández C, et al.", "doi": "10.1136/heartjnl-2016-311093", "id": "olmos-2017", "pmid": "28432158", "source": "Heart. 2017;103(18):1435-1442", "title": "Risk score for cardiac surgery in active left-sided infective endocarditis" }, "formula": "riske", "formula_expression": "RISK-E = age (<=51: 0, 52-63: 9, 64-72: 13, >=73: 14) + prosthetic_infection 6 + periannular_complications 5 + staphylococcus_aureus_or_fungi 9 + acute_renal_failure 5 + septic_shock 7 + cardiogenic_shock 15 + thrombocytopenia 7; max 68. Score and max_score only; not a mortality percent. Olmos 2017 Table 2 and Table 3. Not Park 2016. Not Duke", "max_score": 68, "score": 0, "age_years": 50 } ] } ``` ## Response fields - `formula` (string): riske - `formula_expression` (string): Exact expression used - `score` (integer): Olmos 2017 RISK-E points 0-68. Not a mortality percent and not a risk band. - `max_score` (integer): Always 68 - `age_years` (integer): Age used for the Olmos 2017 age term - `components` (array): Per-factor points - `citation` (object): Olmos et al. Heart 2017 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 50, "factor": "age", "points": 0, "present": true }, { "factor": "prosthetic_infection", "points": 0, "present": false }, { "factor": "periannular_complications", "points": 0, "present": false }, { "factor": "staphylococcus_aureus_or_fungi", "points": 0, "present": false }, { "factor": "acute_renal_failure", "points": 0, "present": false }, { "factor": "septic_shock", "points": 0, "present": false }, { "factor": "cardiogenic_shock", "points": 0, "present": false }, { "factor": "thrombocytopenia", "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": "Olmos C, Vilacosta I, Fernández C, et al.", "doi": "10.1136/heartjnl-2016-311093", "id": "olmos-2017", "pmid": "28432158", "source": "Heart. 2017;103(18):1435-1442", "title": "Risk score for cardiac surgery in active left-sided infective endocarditis" }, "formula": "riske", "formula_expression": "RISK-E = age (<=51: 0, 52-63: 9, 64-72: 13, >=73: 14) + prosthetic_infection 6 + periannular_complications 5 + staphylococcus_aureus_or_fungi 9 + acute_renal_failure 5 + septic_shock 7 + cardiogenic_shock 15 + thrombocytopenia 7; max 68. Score and max_score only; not a mortality percent. Olmos 2017 Table 2 and Table 3. Not Park 2016. Not Duke", "max_score": 68, "score": 0, "age_years": 50 } ``` ## Errors - 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 - [Duke](https://magentlab.com/docs/duke) — Apply the Durack 1994 original Duke criteria for infective endocarditis and return definite, possible, or rejected from caller-assigned pathologic, major, minor, and rejected flags. - [IE mortality](https://magentlab.com/docs/ie-mortality) — Compute the Park 2016 ICE simplified risk score for 6-month mortality in infective endocarditis from age and caller-assigned Table 5 flags, and return the score, quadratic 6-month mortality percent, and whether score >= 8. - [EuroSCORE II](https://magentlab.com/docs/euroscore-ii) — Compute the Nashef 2012 Table 6 logistic estimated in-hospital mortality after adult cardiac surgery from the published multivariable coefficients. ## 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.