# Shorr score for MRSA pneumonia Shorr score Status: LIVE Price: $0.005 USDC `GET /api/calc/shorr` HTML: https://magentlab.com/docs/shorr Markdown: https://magentlab.com/docs/shorr.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the Shorr 2013 Table 2 MRSA pneumonia risk points and return score, max_score, and the published low, medium, or high band. ## When to use When an agent needs the published Shorr 2013 MRSA pneumonia point total and must not invent an antibiotic order, HCAP criteria, or DRIP. ## When not to use - Not a medical device. - Not an antibiotic order and not a MRSA diagnosis. This tool returns score, max_score, and risk_band only. - Shorr 2013 Table 2 only. Not HCAP (healthcare-associated pneumonia) criteria and not the Webb 2016 DRIP score. - hospitalization_90d is a recent inpatient stay of ≥2 days within 90 days as in Shorr 2013. The caller assigns the flag. - nursing_home_ltac_snf is recent nursing home, LTAC, or SNF exposure as in Shorr 2013. magent does not classify the facility. - Female with diabetes scores 1; diabetes in a male scores 0. Age <30 or >79 scores 1 (29 scores 1, 30 scores 0, 79 scores 0, 80 scores 1). ## Formula ``` Shorr = hospitalization_90d (2) + icu_admission (2) + age_lt_30_or_gt_79 (1) + prior_iv_antibiotics (1) + dementia (1) + cerebrovascular_disease (1) + female_and_diabetes (1) + nursing_home_ltac_snf (1); max 10; 0-1 low, 2-5 medium, >=6 high ``` ## Citation [A risk score for identifying methicillin-resistant Staphylococcus aureus in patients presenting to the hospital with pneumonia](https://doi.org/10.1186/1471-2334-13-268) Shorr AF, Myers DE, Huang DB, Nathanson BH, Emons MF, Kollef MH BMC Infect Dis. 2013;13:268 DOI: [10.1186/1471-2334-13-268](https://doi.org/10.1186/1471-2334-13-268) ## Worked example ### Age 50, male, all flags false Given: `age=50, cerebrovascular_disease=false, dementia=false, diabetes=false, hospitalization_90d=false, icu_admission=false, nursing_home_ltac_snf=false, prior_iv_antibiotics=false, sex=male` 1. Age 50 is not <30 or >79 → 0; sex male and diabetes false → 0 2. hospitalization_90d, icu_admission, prior_iv_antibiotics, dementia, cerebrovascular_disease, and nursing_home_ltac_snf false → 0 3. Score = 0 (max 10); risk_band low ### Age 80, female, all Table 2 items present Given: `age=80, cerebrovascular_disease=true, dementia=true, diabetes=true, hospitalization_90d=true, icu_admission=true, nursing_home_ltac_snf=true, prior_iv_antibiotics=true, sex=female` 1. hospitalization_90d 2 + icu_admission 2 + age >79 1 + prior_iv_antibiotics 1 2. dementia 1 + cerebrovascular_disease 1 + female and diabetes 1 + nursing_home_ltac_snf 1 3. Score = 10 (max 10); risk_band high ## Also searched as - Shorr score - Shorr MRSA pneumonia - MRSA pneumonia risk score - Shorr 2013 - methicillin-resistant Staphylococcus aureus pneumonia score - hospital pneumonia MRSA score ## Parameters - `age` (integer, required): Age in years (18-120). Shorr 2013 Table 2: <30 or >79 scores 1; 30 through 79 scores 0. 29 scores 1; 30 scores 0; 79 scores 0; 80 scores 1. - `sex` (string, required): female or male. Female with diabetes scores 1 (Shorr 2013 Table 2). Male with diabetes scores 0. Sex alone does not score. - `hospitalization_90d` (boolean, required): Recent inpatient hospitalization for ≥2 days within 90 days (Shorr 2013 Table 2, 2 points). true or false as assigned by the caller. - `icu_admission` (boolean, required): ICU admission (Shorr 2013 Table 2, 2 points). true or false as assigned by the caller. - `prior_iv_antibiotics` (boolean, required): Prior IV antibiotic exposure (Shorr 2013 Table 2, 1 point). true or false as assigned by the caller. - `dementia` (boolean, required): Dementia (Shorr 2013 Table 2, 1 point). true or false as assigned by the caller. - `cerebrovascular_disease` (boolean, required): Cerebrovascular disease (Shorr 2013 Table 2, 1 point). true or false as assigned by the caller. - `diabetes` (boolean, required): Diabetes mellitus. Scores 1 only when sex is female (Shorr 2013 Table 2). Male with diabetes scores 0. true or false as assigned by the caller. - `nursing_home_ltac_snf` (boolean, required): Recent nursing home, long-term acute care, or skilled nursing facility exposure (Shorr 2013 Table 2, 1 point). true or false as assigned by the caller. magent does not classify the facility. ## 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/shorr` 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": "50", "cerebrovascular_disease": "false", "dementia": "false", "diabetes": "false", "hospitalization_90d": "false", "icu_admission": "false", "nursing_home_ltac_snf": "false", "prior_iv_antibiotics": "false", "sex": "male" }, { "age": "50", "cerebrovascular_disease": "false", "dementia": "false", "diabetes": "false", "hospitalization_90d": "false", "icu_admission": "false", "nursing_home_ltac_snf": "false", "prior_iv_antibiotics": "false", "sex": "male" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/shorr Example 200: ```json { "count": 2, "path": "/api/calc/shorr", "items": [ { "components": [ { "factor": "hospitalization_90d", "points": 0, "present": false }, { "factor": "icu_admission", "points": 0, "present": false }, { "value": 50, "factor": "age", "points": 0, "present": false }, { "factor": "prior_iv_antibiotics", "points": 0, "present": false }, { "factor": "dementia", "points": 0, "present": false }, { "factor": "cerebrovascular_disease", "points": 0, "present": false }, { "factor": "female_diabetes", "points": 0, "present": false }, { "factor": "nursing_home_ltac_snf", "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": "Shorr AF, Myers DE, Huang DB, Nathanson BH, Emons MF, Kollef MH", "doi": "10.1186/1471-2334-13-268", "id": "shorr-2013", "pmid": "23742753", "source": "BMC Infect Dis. 2013;13:268", "title": "A risk score for identifying methicillin-resistant Staphylococcus aureus in patients presenting to the hospital with pneumonia" }, "formula": "shorr", "formula_expression": "Shorr = hospitalization_90d (2) + icu_admission (2) + age_lt_30_or_gt_79 (1) + prior_iv_antibiotics (1) + dementia (1) + cerebrovascular_disease (1) + female_and_diabetes (1) + nursing_home_ltac_snf (1); max 10; 0-1 low, 2-5 medium, >=6 high", "max_score": 10, "score": 0, "age_years": 50, "risk_band": "low", "sex": "male" }, { "components": [ { "factor": "hospitalization_90d", "points": 0, "present": false }, { "factor": "icu_admission", "points": 0, "present": false }, { "value": 50, "factor": "age", "points": 0, "present": false }, { "factor": "prior_iv_antibiotics", "points": 0, "present": false }, { "factor": "dementia", "points": 0, "present": false }, { "factor": "cerebrovascular_disease", "points": 0, "present": false }, { "factor": "female_diabetes", "points": 0, "present": false }, { "factor": "nursing_home_ltac_snf", "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": "Shorr AF, Myers DE, Huang DB, Nathanson BH, Emons MF, Kollef MH", "doi": "10.1186/1471-2334-13-268", "id": "shorr-2013", "pmid": "23742753", "source": "BMC Infect Dis. 2013;13:268", "title": "A risk score for identifying methicillin-resistant Staphylococcus aureus in patients presenting to the hospital with pneumonia" }, "formula": "shorr", "formula_expression": "Shorr = hospitalization_90d (2) + icu_admission (2) + age_lt_30_or_gt_79 (1) + prior_iv_antibiotics (1) + dementia (1) + cerebrovascular_disease (1) + female_and_diabetes (1) + nursing_home_ltac_snf (1); max 10; 0-1 low, 2-5 medium, >=6 high", "max_score": 10, "score": 0, "age_years": 50, "risk_band": "low", "sex": "male" } ] } ``` ## Response fields - `formula` (string): shorr - `formula_expression` (string): Exact expression used - `score` (integer): Shorr 2013 Table 2 points 0-10 - `max_score` (integer): 10 - `risk_band` (string): Shorr 2013 band: low (0-1), medium (2-5), or high (≥6). A band, not a MRSA prevalence and not an antibiotic order. - `age_years` (integer): Age used for the <30 or >79 criterion - `sex` (string): female or male used for the female-with-diabetes item - `components` (array): Per-factor points - `citation` (object): Shorr et al. BMC Infect Dis 2013 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "factor": "hospitalization_90d", "points": 0, "present": false }, { "factor": "icu_admission", "points": 0, "present": false }, { "value": 50, "factor": "age", "points": 0, "present": false }, { "factor": "prior_iv_antibiotics", "points": 0, "present": false }, { "factor": "dementia", "points": 0, "present": false }, { "factor": "cerebrovascular_disease", "points": 0, "present": false }, { "factor": "female_diabetes", "points": 0, "present": false }, { "factor": "nursing_home_ltac_snf", "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": "Shorr AF, Myers DE, Huang DB, Nathanson BH, Emons MF, Kollef MH", "doi": "10.1186/1471-2334-13-268", "id": "shorr-2013", "pmid": "23742753", "source": "BMC Infect Dis. 2013;13:268", "title": "A risk score for identifying methicillin-resistant Staphylococcus aureus in patients presenting to the hospital with pneumonia" }, "formula": "shorr", "formula_expression": "Shorr = hospitalization_90d (2) + icu_admission (2) + age_lt_30_or_gt_79 (1) + prior_iv_antibiotics (1) + dementia (1) + cerebrovascular_disease (1) + female_and_diabetes (1) + nursing_home_ltac_snf (1); max 10; 0-1 low, 2-5 medium, >=6 high", "max_score": 10, "score": 0, "age_years": 50, "risk_band": "low", "sex": "male" } ``` ## Errors - HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged. - HTTP 400 `invalid_sex`: sex must be female or male 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_shorr`: each Shorr 2013 MRSA pneumonia item must be a published value. 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 - [DRIP](https://magentlab.com/docs/drip) — Sum the Webb 2016 DRIP (drug resistance in pneumonia) major and minor flags and return score, max, and high_risk at ≥4. - [CURB-65](https://magentlab.com/docs/curb65) — Compute the CURB-65 community-acquired pneumonia severity score from age and discrete flags. ## 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.