# Simplified Motor Score

SMS

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

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

## What it computes

Return the Gill 2005 Simplified Motor Score (0-2) from a caller-assigned motor category: obeys commands (2), localizes pain (1), or withdrawal to pain or less (0).

## When to use

When an agent needs the published Gill 2005 Simplified Motor Score and must not invent a GCS total, a simplified verbal score, or a triage or intubation order.

## When not to use

- Not a GCS replacement protocol and not a triage or intubation order.
- Not a medical device and not a diagnosis. magent does not examine the patient.
- Motor is caller-assigned as obeys, localizes, or withdrawal_or_less. This is Gill 2005 Simplified Motor Score only, not the simplified verbal score and not full GCS.

## Formula

```
SMS = 2 if motor=obeys (obeys commands), 1 if motor=localizes (localizes pain), 0 if motor=withdrawal_or_less (withdrawal to pain or less); Gill 2005 Simplified Motor Score; max 2
```

## Citation

[A comparison of the Glasgow Coma Scale score to simplified alternative scores for the prediction of traumatic brain injury outcomes](https://doi.org/10.1016/j.annemergmed.2004.07.429)
Gill M, Windemuth R, Steele R, Green SM
Ann Emerg Med. 2005;45(1):37-42
DOI: [10.1016/j.annemergmed.2004.07.429](https://doi.org/10.1016/j.annemergmed.2004.07.429)

## Worked example

### Obeys commands

Given: `motor=obeys`

1. motor=obeys → 2 (obeys commands)
2. Score = 2 (max 2)


### Localizes pain

Given: `motor=localizes`

1. motor=localizes → 1 (localizes pain)
2. Score = 1 (max 2)


### Withdrawal to pain or less

Given: `motor=withdrawal_or_less`

1. motor=withdrawal_or_less → 0 (withdrawal to pain or less)
2. Score = 0 (max 2)


## Also searched as

- SMS
- simplified motor score
- Gill SMS
- Gill Simplified Motor Score
- SMS trauma score
- simplified GCS motor
- obeys localizes withdrawal

## Parameters

- `motor` (string, required): Gill 2005 Simplified Motor Score motor category as assigned by the caller. obeys (2, obeys commands), localizes (1, localizes pain), or withdrawal_or_less (0, withdrawal to pain or less). magent does not examine 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/sms`
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": [
    {
      "motor": "obeys"
    },
    {
      "motor": "obeys"
    }
  ]
}
```

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

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/sms",
  "items": [
    {
      "components": [
        {
          "value": "obeys",
          "factor": "motor",
          "points": 2,
          "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": "Gill M, Windemuth R, Steele R, Green SM",
        "doi": "10.1016/j.annemergmed.2004.07.429",
        "id": "gill-2005",
        "pmid": "15635308",
        "source": "Ann Emerg Med. 2005;45(1):37-42",
        "title": "A comparison of the Glasgow Coma Scale score to simplified alternative scores for the prediction of traumatic brain injury outcomes"
      },
      "formula": "sms",
      "formula_expression": "SMS = 2 if motor=obeys (obeys commands), 1 if motor=localizes (localizes pain), 0 if motor=withdrawal_or_less (withdrawal to pain or less); Gill 2005 Simplified Motor Score; max 2",
      "max_score": 2,
      "score": 2,
      "motor": "obeys"
    },
    {
      "components": [
        {
          "value": "obeys",
          "factor": "motor",
          "points": 2,
          "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": "Gill M, Windemuth R, Steele R, Green SM",
        "doi": "10.1016/j.annemergmed.2004.07.429",
        "id": "gill-2005",
        "pmid": "15635308",
        "source": "Ann Emerg Med. 2005;45(1):37-42",
        "title": "A comparison of the Glasgow Coma Scale score to simplified alternative scores for the prediction of traumatic brain injury outcomes"
      },
      "formula": "sms",
      "formula_expression": "SMS = 2 if motor=obeys (obeys commands), 1 if motor=localizes (localizes pain), 0 if motor=withdrawal_or_less (withdrawal to pain or less); Gill 2005 Simplified Motor Score; max 2",
      "max_score": 2,
      "score": 2,
      "motor": "obeys"
    }
  ]
}
```

## Response fields

- `formula` (string): sms
- `formula_expression` (string): Published SMS rule
- `motor` (string): Canonical motor category: obeys, localizes, or withdrawal_or_less
- `score` (integer): SMS points 0-2
- `max_score` (integer): 2
- `components` (array): Motor component
- `citation` (object): Gill 2005
- `disclaimer` (string): Not a medical device

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": "obeys",
      "factor": "motor",
      "points": 2,
      "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": "Gill M, Windemuth R, Steele R, Green SM",
    "doi": "10.1016/j.annemergmed.2004.07.429",
    "id": "gill-2005",
    "pmid": "15635308",
    "source": "Ann Emerg Med. 2005;45(1):37-42",
    "title": "A comparison of the Glasgow Coma Scale score to simplified alternative scores for the prediction of traumatic brain injury outcomes"
  },
  "formula": "sms",
  "formula_expression": "SMS = 2 if motor=obeys (obeys commands), 1 if motor=localizes (localizes pain), 0 if motor=withdrawal_or_less (withdrawal to pain or less); Gill 2005 Simplified Motor Score; max 2",
  "max_score": 2,
  "score": 2,
  "motor": "obeys"
}
```

## Errors

- HTTP 400 `invalid_sms_motor`: motor must be obeys, localizes, or withdrawal_or_less (Gill 2005 SMS). 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

- [Glasgow Coma Scale](https://magentlab.com/docs/gcs) — Compute the Glasgow Coma Scale as the sum of caller-assigned eye, verbal, and motor integers. The 1974 or 1976 edition is required.
- [RTS](https://magentlab.com/docs/rts) — Compute Champion 1989 coded GCS, SBP, and respiratory-rate values, the triage T-RTS sum, and the weighted RTS used for outcome evaluation.
- [ISS](https://magentlab.com/docs/iss) — Compute the Baker 1974 Injury Severity Score as the sum of squares of the three highest caller-assigned AIS body-region grades, or 75 if any region is AIS 6.

## 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 echoing accepted, payload, and extensions when present).
- 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.
- 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.