# SEDAN score

SEDAN

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

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

## What it computes

Compute the Strbian 2012 SEDAN score (Sugar, Early infarct signs, (hyper)Dense artery, Age, NIHSS) for symptomatic intracranial hemorrhage after stroke thrombolysis.

## When to use

When an agent has caller-assigned admission glucose, CT early infarct signs, hyperdense artery sign, age, and NIHSS and needs the published SEDAN total and derivation sICH percents for scores 0-5, without inventing a percent for score 6 or a tPA decision.

## When not to use

- Not a medical device and not a tPA withhold, thrombolysis, or treatment decision.
- Derived in intravenous thrombolysis cohorts (Strbian 2012). It is not a recommendation for or against alteplase.
- The caller assigns NIHSS (0-42), early infarct signs, and hyperdense cerebral artery sign. magent does not examine the patient, assign NIHSS, or read CT.
- Glucose uses mmol/L cutoffs after converting mg/dL / 18. 8.1-12.0 inclusive scores 1; >12.0 scores 2; 8.0 and 12.0 follow those bounds.
- Derivation absolute sICH percents are returned for scores 0-5 only (1.4, 2.9, 8.5, 12.2, 21.7, 33.3). Score 6 has no published percent in Strbian 2012; magent does not invent one.

## Formula

```
SEDAN = glucose (8.1-12.0 mmol/L 1; >12.0 mmol/L 2) + early_infarct_signs 1 + hyperdense_artery 1 + (age >75) 1 + (NIHSS >=10) 1; max 6; derivation sICH 1.4/2.9/8.5/12.2/21.7/33.3% for scores 0-5 (Strbian 2012); no published percent for 6
```

## Citation

[Symptomatic intracranial hemorrhage after stroke thrombolysis: the SEDAN score](https://doi.org/10.1002/ana.23546)
Strbian D, Engelter S, Michel P, Meretoja A, Sekoranja L, Ahlhelm FJ, Mustanoja S, Lynch J, Soinne L, Sairanen T, Lyrer P, Tatlisumak T
Ann Neurol. 2012;71(5):634-641
DOI: [10.1002/ana.23546](https://doi.org/10.1002/ana.23546)

## Worked example

### Age 60, NIHSS 5, glucose 6.0 mmol/L, no CT signs

Given: `age=60, early_infarct_signs=false, glucose_mmol_l=6.0, hyperdense_artery=false, nihss=5`

1. Glucose 6.0 < 8.1 → 0; early infarct signs 0; hyperdense artery 0; age 60 is not >75 → 0; NIHSS 5 < 10 → 0
2. Score = 0 (max 6); derivation sICH 1.4%


### All items (score 6; no published sICH percent)

Given: `age=120, early_infarct_signs=true, glucose_mmol_l=20.0, hyperdense_artery=true, nihss=42`

1. Glucose 20.0 > 12.0 → 2; early infarct signs +1; hyperdense artery +1; age 120 >75 → 1; NIHSS 42 ≥10 → 1
2. Score = 6 (max 6); sich_percent omitted


## Also searched as

- SEDAN score
- Strbian SEDAN
- symptomatic intracranial hemorrhage SEDAN
- sICH thrombolysis score
- sugar early infarct dense artery NIHSS
- hyperdense artery sign SEDAN
- Strbian 2012 SEDAN
- SEDAN stroke thrombolysis

## Parameters

- `age` (integer, required): Age in years (18-120). >75 scores 1; 75 does not (Strbian 2012). magent does not date the patient.
- `nihss` (integer, required): Caller-assigned NIH Stroke Scale total (integer 0-42). ≥10 scores 1; 9 does not. magent does not compute NIHSS or examine the patient.
- `glucose_mmol_l` (number, optional): Baseline glucose in mmol/L (2.8-55.5). Provide this or glucose_mg_dl, not both. 8.1-12.0 inclusive scores 1; >12.0 scores 2; else 0 (Strbian 2012).
- `glucose_mg_dl` (number, optional): Baseline glucose in mg/dL (50-1000). Converted as mmol/L = mg/dL / 18. Provide this or glucose_mmol_l, not both.
- `early_infarct_signs` (boolean, required): Early infarct signs on admission CT as assigned by the caller (Strbian 2012). true scores 1; false scores 0. magent does not read the CT.
- `hyperdense_artery` (boolean, required): (Hyper)dense cerebral artery sign on admission CT as assigned by the caller (Strbian 2012). true scores 1; false scores 0. magent does not read the CT.

## 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/sedan`
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": "60",
      "early_infarct_signs": "false",
      "glucose_mmol_l": "6.0",
      "hyperdense_artery": "false",
      "nihss": "5"
    },
    {
      "age": "60",
      "early_infarct_signs": "false",
      "glucose_mmol_l": "6.0",
      "hyperdense_artery": "false",
      "nihss": "5"
    }
  ]
}
```

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

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/sedan",
  "items": [
    {
      "components": [
        {
          "value": 6.0,
          "factor": "glucose",
          "points": 0,
          "present": false
        },
        {
          "factor": "early_infarct_signs",
          "points": 0,
          "present": false
        },
        {
          "factor": "hyperdense_artery",
          "points": 0,
          "present": false
        },
        {
          "value": 60,
          "factor": "age",
          "points": 0,
          "present": false
        },
        {
          "value": 5,
          "factor": "nihss",
          "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.",
      "age_years": 60,
      "citation": {
        "authors": "Strbian D, Engelter S, Michel P, Meretoja A, Sekoranja L, Ahlhelm FJ, Mustanoja S, Lynch J, Soinne L, Sairanen T, Lyrer P, Tatlisumak T",
        "doi": "10.1002/ana.23546",
        "id": "strbian-2012-sedan",
        "source": "Ann Neurol. 2012;71(5):634-641",
        "title": "Symptomatic intracranial hemorrhage after stroke thrombolysis: the SEDAN score"
      },
      "formula": "sedan",
      "formula_expression": "SEDAN = glucose (8.1-12.0 mmol/L 1; >12.0 mmol/L 2) + early_infarct_signs 1 + hyperdense_artery 1 + (age >75) 1 + (NIHSS >=10) 1; max 6; derivation sICH 1.4/2.9/8.5/12.2/21.7/33.3% for scores 0-5 (Strbian 2012); no published percent for 6",
      "max_score": 6,
      "score": 0,
      "glucose_mmol_l": 6.0,
      "nihss": 5,
      "early_infarct_signs": false,
      "hyperdense_artery": false,
      "sich_percent": 1.4
    },
    {
      "components": [
        {
          "value": 6.0,
          "factor": "glucose",
          "points": 0,
          "present": false
        },
        {
          "factor": "early_infarct_signs",
          "points": 0,
          "present": false
        },
        {
          "factor": "hyperdense_artery",
          "points": 0,
          "present": false
        },
        {
          "value": 60,
          "factor": "age",
          "points": 0,
          "present": false
        },
        {
          "value": 5,
          "factor": "nihss",
          "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.",
      "age_years": 60,
      "citation": {
        "authors": "Strbian D, Engelter S, Michel P, Meretoja A, Sekoranja L, Ahlhelm FJ, Mustanoja S, Lynch J, Soinne L, Sairanen T, Lyrer P, Tatlisumak T",
        "doi": "10.1002/ana.23546",
        "id": "strbian-2012-sedan",
        "source": "Ann Neurol. 2012;71(5):634-641",
        "title": "Symptomatic intracranial hemorrhage after stroke thrombolysis: the SEDAN score"
      },
      "formula": "sedan",
      "formula_expression": "SEDAN = glucose (8.1-12.0 mmol/L 1; >12.0 mmol/L 2) + early_infarct_signs 1 + hyperdense_artery 1 + (age >75) 1 + (NIHSS >=10) 1; max 6; derivation sICH 1.4/2.9/8.5/12.2/21.7/33.3% for scores 0-5 (Strbian 2012); no published percent for 6",
      "max_score": 6,
      "score": 0,
      "glucose_mmol_l": 6.0,
      "nihss": 5,
      "early_infarct_signs": false,
      "hyperdense_artery": false,
      "sich_percent": 1.4
    }
  ]
}
```

## Response fields

- `formula` (string): sedan
- `formula_expression` (string): Exact expression used
- `score` (integer): SEDAN points 0-6
- `max_score` (integer): Always 6
- `sich_percent` (number): Strbian 2012 derivation absolute sICH percent for scores 0-5 (1.4, 2.9, 8.5, 12.2, 21.7, 33.3). Omitted for score 6; no published percent.
- `age_years` (integer): Age used for the >75 point
- `nihss` (integer): Caller-assigned NIHSS used for the ≥10 point
- `glucose_mmol_l` (number): Baseline glucose in mmol/L (mg/dL inputs converted /18)
- `early_infarct_signs` (boolean): Whether early infarct signs were scored
- `hyperdense_artery` (boolean): Whether hyperdense cerebral artery sign was scored
- `components` (array): Per-item Strbian 2012 points
- `citation` (object): Strbian 2012 Ann Neurol citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": 6.0,
      "factor": "glucose",
      "points": 0,
      "present": false
    },
    {
      "factor": "early_infarct_signs",
      "points": 0,
      "present": false
    },
    {
      "factor": "hyperdense_artery",
      "points": 0,
      "present": false
    },
    {
      "value": 60,
      "factor": "age",
      "points": 0,
      "present": false
    },
    {
      "value": 5,
      "factor": "nihss",
      "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.",
  "age_years": 60,
  "citation": {
    "authors": "Strbian D, Engelter S, Michel P, Meretoja A, Sekoranja L, Ahlhelm FJ, Mustanoja S, Lynch J, Soinne L, Sairanen T, Lyrer P, Tatlisumak T",
    "doi": "10.1002/ana.23546",
    "id": "strbian-2012-sedan",
    "source": "Ann Neurol. 2012;71(5):634-641",
    "title": "Symptomatic intracranial hemorrhage after stroke thrombolysis: the SEDAN score"
  },
  "formula": "sedan",
  "formula_expression": "SEDAN = glucose (8.1-12.0 mmol/L 1; >12.0 mmol/L 2) + early_infarct_signs 1 + hyperdense_artery 1 + (age >75) 1 + (NIHSS >=10) 1; max 6; derivation sICH 1.4/2.9/8.5/12.2/21.7/33.3% for scores 0-5 (Strbian 2012); no published percent for 6",
  "max_score": 6,
  "score": 0,
  "glucose_mmol_l": 6.0,
  "nihss": 5,
  "early_infarct_signs": false,
  "hyperdense_artery": false,
  "sich_percent": 1.4
}
```

## Errors

- HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged.
- HTTP 400 `invalid_nihss`: nihss must be an integer from 0 to 42. Returned before settlement; you are not charged.
- HTTP 400 `invalid_glucose`: glucose_mg_dl (50-1000) or glucose_mmol_l (2.8-55.5) is required 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

- [THRIVE](https://magentlab.com/docs/thrive) — Compute the Flint 2010 THRIVE (Totaled Health Risks in Vascular Events) score from trichotomized age, trichotomized NIHSS, and the chronic disease scale (hypertension, diabetes mellitus, atrial fibrillation).
- [ASTRAL](https://magentlab.com/docs/astral) — Compute the Ntaios 2012 ASTRAL integer score (Age, Severity NIHSS, Time delay, Range of visual fields, Acute glucose, Level of consciousness) for 3-month mRS >2 after acute ischemic stroke.

## 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.