Emergency · LIVE

ROSE syncope rule

ROSE

Compute the Reed 2010 ROSE (BRACES) criterion count and high-risk flag from published cutoffs.

LIVE $0.005 USDC GET /api/calc/rose

Markdown: /docs/rose.md · Canonical: https://magentlab.com/docs/rose

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

What it computes

Compute the Reed 2010 ROSE (BRACES) criterion count and high-risk flag from published cutoffs.

When to use

When an agent needs the published ROSE BRACES arithmetic and must not invent a disposition from a syncope narrative.

When not to use

Not a medical device. Not a disposition protocol, admission order, or discharge decision.
High-risk means any BRACES criterion (score ≥ 1), not a diagnosis.
magent does not measure BNP, hemoglobin, or SpO2, and does not read an ECG. The caller assigns fecal occult blood, chest pain, and the Q-wave-not-lead-III flag.

Formula

ROSE = bnp_ge_300 + heart_rate_le_50 + fecal_occult_blood + hemoglobin_le_90 + chest_pain + q_wave_not_lead_iii + spo2_le_94; each 1 if present; rose_high_risk iff score >= 1; max 7 (Reed 2010 BRACES)

Citation

Title: The ROSE (Risk Stratification of Syncope in the Emergency Department) Study
Authors: Reed MJ, Newby DE, Coull AJ, Prescott RJ, Jacques KG, Gray AJ
Source: J Am Coll Cardiol. 2010;55(8):713-721
DOI: 10.1016/j.jacc.2009.09.049

Worked example

All BRACES criteria negative

Given: bnp_pg_ml=50chest_pain=falsefecal_occult_blood=falseheart_rate_bpm=70hemoglobin_g_l=130q_wave_not_lead_iii=falsespo2_percent=98

BNP 50 (<300); heart rate 70 (>50); FOB false; hemoglobin 130 g/L (>90); no chest pain; Q wave not assigned; SpO2 98% (>94)
Score = 0; rose_high_risk false

Also searched as

ROSE syncope
Reed ROSE score
BRACES syncope
Risk Stratification of Syncope in the Emergency Department
ROSE ED syncope
BNP syncope rule

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/rose?bnp_pg_ml=50&heart_rate_bpm=70&fecal_occult_blood=false&hemoglobin_g_l=130&chest_pain=false&q_wave_not_lead_iii=false&spo2_percent=98

Full URL: https://api.magentlab.com/api/calc/rose?bnp_pg_ml=50&heart_rate_bpm=70&fecal_occult_blood=false&hemoglobin_g_l=130&chest_pain=false&q_wave_not_lead_iii=false&spo2_percent=98

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/rose?bnp_pg_ml=50&heart_rate_bpm=70&fecal_occult_blood=false&hemoglobin_g_l=130&chest_pain=false&q_wave_not_lead_iii=false&spo2_percent=98"

Parameters

Name	Type	Required	Description
`bnp_pg_ml`	number	required	BNP in pg/mL (0-35000). Reed 2010 BRACES scores 1 when ≥300; 300 is high-risk. magent does not measure BNP.
`heart_rate_bpm`	integer	required	Heart rate in beats/min (integer 30-220). Reed 2010 bradycardia ≤50 (ED or pre-hospital in the paper; this tool takes one integer). 50 scores 1. magent does not measure heart rate.
`fecal_occult_blood`	boolean	required	Rectal exam showing fecal occult blood if GI-bleed suspicion (Reed 2010 R). true or false as assigned by the caller.
`hemoglobin_g_l`	number	required	Hemoglobin in g/L (30-220). Reed 2010 anemia scores 1 when ≤90; 90 is high-risk. magent does not assay hemoglobin.
`chest_pain`	boolean	required	Chest pain associated with syncope (Reed 2010 C). true or false as assigned by the caller.
`q_wave_not_lead_iii`	boolean	required	Q wave not in lead III (Reed 2010 E). true or false as assigned by the caller. magent does not read an ECG.
`spo2_percent`	number	required	Room-air SpO2 percent (50-100). Reed 2010 scores 1 when ≤94; 94 is high-risk. magent does not measure SpO2.

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.

POST /api/calc/rose Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 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 (fixture)

{
  "items": [
    {
      "bnp_pg_ml": "50",
      "chest_pain": "false",
      "fecal_occult_blood": "false",
      "heart_rate_bpm": "70",
      "hemoglobin_g_l": "130",
      "q_wave_not_lead_iii": "false",
      "spo2_percent": "98"
    },
    {
      "bnp_pg_ml": "50",
      "chest_pain": "false",
      "fecal_occult_blood": "false",
      "heart_rate_bpm": "70",
      "hemoglobin_g_l": "130",
      "q_wave_not_lead_iii": "false",
      "spo2_percent": "98"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/rose",
  "items": [
    {
      "components": [
        {
          "value": 50.0,
          "factor": "bnp_ge_300",
          "points": 0,
          "present": false
        },
        {
          "value": 70,
          "factor": "heart_rate_le_50",
          "points": 0,
          "present": false
        },
        {
          "factor": "fecal_occult_blood",
          "points": 0,
          "present": false
        },
        {
          "value": 130.0,
          "factor": "hemoglobin_le_90",
          "points": 0,
          "present": false
        },
        {
          "factor": "chest_pain",
          "points": 0,
          "present": false
        },
        {
          "factor": "q_wave_not_lead_iii",
          "points": 0,
          "present": false
        },
        {
          "value": 98.0,
          "factor": "spo2_le_94",
          "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": "Reed MJ, Newby DE, Coull AJ, Prescott RJ, Jacques KG, Gray AJ",
        "doi": "10.1016/j.jacc.2009.09.049",
        "id": "reed-2010",
        "pmid": "20170806",
        "source": "J Am Coll Cardiol. 2010;55(8):713-721",
        "title": "The ROSE (Risk Stratification of Syncope in the Emergency Department) Study"
      },
      "formula": "rose",
      "formula_expression": "ROSE = bnp_ge_300 + heart_rate_le_50 + fecal_occult_blood + hemoglobin_le_90 + chest_pain + q_wave_not_lead_iii + spo2_le_94; each 1 if present; rose_high_risk iff score >= 1; max 7 (Reed 2010 BRACES)",
      "max_score": 7,
      "score": 0,
      "heart_rate_bpm": 70,
      "spo2_percent": 98.0,
      "hemoglobin_g_l": 130.0,
      "bnp_pg_ml": 50.0,
      "rose_high_risk": false
    },
    {
      "components": [
        {
          "value": 50.0,
          "factor": "bnp_ge_300",
          "points": 0,
          "present": false
        },
        {
          "value": 70,
          "factor": "heart_rate_le_50",
          "points": 0,
          "present": false
        },
        {
          "factor": "fecal_occult_blood",
          "points": 0,
          "present": false
        },
        {
          "value": 130.0,
          "factor": "hemoglobin_le_90",
          "points": 0,
          "present": false
        },
        {
          "factor": "chest_pain",
          "points": 0,
          "present": false
        },
        {
          "factor": "q_wave_not_lead_iii",
          "points": 0,
          "present": false
        },
        {
          "value": 98.0,
          "factor": "spo2_le_94",
          "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": "Reed MJ, Newby DE, Coull AJ, Prescott RJ, Jacques KG, Gray AJ",
        "doi": "10.1016/j.jacc.2009.09.049",
        "id": "reed-2010",
        "pmid": "20170806",
        "source": "J Am Coll Cardiol. 2010;55(8):713-721",
        "title": "The ROSE (Risk Stratification of Syncope in the Emergency Department) Study"
      },
      "formula": "rose",
      "formula_expression": "ROSE = bnp_ge_300 + heart_rate_le_50 + fecal_occult_blood + hemoglobin_le_90 + chest_pain + q_wave_not_lead_iii + spo2_le_94; each 1 if present; rose_high_risk iff score >= 1; max 7 (Reed 2010 BRACES)",
      "max_score": 7,
      "score": 0,
      "heart_rate_bpm": 70,
      "spo2_percent": 98.0,
      "hemoglobin_g_l": 130.0,
      "bnp_pg_ml": 50.0,
      "rose_high_risk": false
    }
  ]
}

Response

Field	Type	Description
`formula`	string	rose
`formula_expression`	string	Exact expression used
`score`	integer	Count of positive BRACES criteria (0-7)
`max_score`	integer	Always 7
`rose_high_risk`	boolean	true when score ≥ 1 (any BRACES criterion). Not a diagnosis or disposition.
`bnp_pg_ml`	number	BNP used for the ≥300 pg/mL cutoff
`heart_rate_bpm`	integer	Heart rate used for the ≤50 cutoff
`hemoglobin_g_l`	number	Hemoglobin used for the ≤90 g/L cutoff
`spo2_percent`	number	Room-air SpO2 used for the ≤94% cutoff
`components`	array	Per-factor points
`citation`	object	Reed et al. JACC 2010 citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "value": 50.0,
      "factor": "bnp_ge_300",
      "points": 0,
      "present": false
    },
    {
      "value": 70,
      "factor": "heart_rate_le_50",
      "points": 0,
      "present": false
    },
    {
      "factor": "fecal_occult_blood",
      "points": 0,
      "present": false
    },
    {
      "value": 130.0,
      "factor": "hemoglobin_le_90",
      "points": 0,
      "present": false
    },
    {
      "factor": "chest_pain",
      "points": 0,
      "present": false
    },
    {
      "factor": "q_wave_not_lead_iii",
      "points": 0,
      "present": false
    },
    {
      "value": 98.0,
      "factor": "spo2_le_94",
      "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": "Reed MJ, Newby DE, Coull AJ, Prescott RJ, Jacques KG, Gray AJ",
    "doi": "10.1016/j.jacc.2009.09.049",
    "id": "reed-2010",
    "pmid": "20170806",
    "source": "J Am Coll Cardiol. 2010;55(8):713-721",
    "title": "The ROSE (Risk Stratification of Syncope in the Emergency Department) Study"
  },
  "formula": "rose",
  "formula_expression": "ROSE = bnp_ge_300 + heart_rate_le_50 + fecal_occult_blood + hemoglobin_le_90 + chest_pain + q_wave_not_lead_iii + spo2_le_94; each 1 if present; rose_high_risk iff score >= 1; max 7 (Reed 2010 BRACES)",
  "max_score": 7,
  "score": 0,
  "heart_rate_bpm": 70,
  "spo2_percent": 98.0,
  "hemoglobin_g_l": 130.0,
  "bnp_pg_ml": 50.0,
  "rose_high_risk": false
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_bnp_pg_ml`	bnp_pg_ml must be a number from 0 to 35000 (Reed 2010 ROSE). Returned before settlement; you are not charged.
400	`invalid_heart_rate`	heart_rate_bpm must be an integer from 30 to 220 Returned before settlement; you are not charged.
400	`invalid_flag`	boolean clinical flags must be true or false Returned before settlement; you are not charged.
400	`invalid_hemoglobin`	hemoglobin_g_l (30-220) or hemoglobin_g_dl (3-22) is required, not both. Returned before settlement; you are not charged.
400	`invalid_spo2`	spo2_percent must be a number from 50 to 100. Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

San Francisco Syncope Rule — Compute the San Francisco Syncope Rule (CHESS) criterion count and rule-positive flag from published cutoffs.
EGSYS — Sum the six Del Rosso 2008 EGSYS flags and return whether the total is ≥3 (published cardiac-syncope triage discriminator).

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. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /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.