# sPESI sPESI ## Also searched as - sPESI - simplified PESI - simplified pulmonary embolism severity index - Jiménez sPESI - sPESI score - PE simplified severity index Status: LIVE Price: $0.005 USDC `GET /api/calc/spesi` HTML: https://magentlab.com/docs/spesi Markdown: https://magentlab.com/docs/spesi.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the Jiménez 2010 simplified Pulmonary Embolism Severity Index (sPESI) from age and five caller-assigned findings. ## When to use When an agent already has a diagnosis of acute symptomatic pulmonary embolism, as in the paper, and needs the published six-point sPESI total and low/high split. ## When not to use - Not a diagnosis or outpatient-treatment protocol. magent does not diagnose PE. - Only for patients with already diagnosed acute symptomatic pulmonary embolism, as in Jiménez 2010. - This tool is sPESI (simplified PESI), not PESI. It does not output original PESI classes. - The age cutoff is >80, not >=80 (80 does not score). Heart failure and chronic lung disease are scored as one combined cardiopulmonary item. - The caller assigns age, cancer, chronic cardiopulmonary disease, heart rate, systolic BP, and SpO2. magent does not examine the patient. ## Formula ``` sPESI = age_gt_80 + cancer + chronic_cardiopulmonary_disease + heart_rate_ge_110 + systolic_mm_hg_lt_100 + spo2_lt_90; each 1 if present; max 6; 0 low, >=1 high ``` ## Citation [Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism](https://doi.org/10.1001/archinternmed.2010.199) Jiménez D, Aujesky D, Moores L, et al. Arch Intern Med. 2010;170(15):1383-1389 DOI: [10.1001/archinternmed.2010.199](https://doi.org/10.1001/archinternmed.2010.199) ## Worked example ### All items absent Given: `age=70, cancer=false, chronic_cardiopulmonary_disease=false, heart_rate_bpm=80, spo2_percent=96, systolic_mm_hg=120` 1. Age 70 is not >80 → 0; cancer false → 0; chronic cardiopulmonary disease false → 0 2. Heart rate 80 is not ≥110 → 0; SBP 120 is not <100 → 0; SpO2 96 is not <90 → 0 3. Score = 0 (max 6); spesi_risk low ### Age 81 scores 1 (high) Given: `age=81, cancer=false, chronic_cardiopulmonary_disease=false, heart_rate_bpm=80, spo2_percent=96, systolic_mm_hg=120` 1. Age 81 > 80 → 1; remaining items absent 2. Score = 1 (max 6); spesi_risk high ## Parameters - `age` (integer, required): Age in years (18-120). Scores 1 when age >80; 80 does not score. - `cancer` (boolean, required): Active cancer as assigned by the caller. true or false. 1 point if true. - `chronic_cardiopulmonary_disease` (boolean, required): Chronic cardiopulmonary disease as one combined flag (heart failure and chronic lung disease were combined in Jiménez 2010). true or false. 1 point if true. - `heart_rate_bpm` (integer, required): Heart rate in beats per minute (integer 30-220). Scores 1 when ≥110; 109 does not score. - `systolic_mm_hg` (number, required): Systolic blood pressure in mm Hg (50-250). Scores 1 when <100; 100 does not score. - `spo2_percent` (number, required): Oxygen saturation percent (50-100). Scores 1 when <90; 90 does not score. ## Bulk (POST) POST the same path with a JSON items array. Price is n times the GET unit. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/spesi` Max items: 25 Price: unit_amount * n (unit 5000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - 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": "70", "cancer": "false", "chronic_cardiopulmonary_disease": "false", "heart_rate_bpm": "80", "spo2_percent": "96", "systolic_mm_hg": "120" }, { "age": "70", "cancer": "false", "chronic_cardiopulmonary_disease": "false", "heart_rate_bpm": "80", "spo2_percent": "96", "systolic_mm_hg": "120" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/spesi Example 200: ```json { "count": 2, "path": "/api/calc/spesi", "items": [ { "components": [ { "value": 70, "factor": "age_gt_80", "points": 0, "present": false }, { "factor": "cancer", "points": 0, "present": false }, { "factor": "chronic_cardiopulmonary_disease", "points": 0, "present": false }, { "value": 80, "factor": "heart_rate_ge_110", "points": 0, "present": false }, { "value": 120.0, "factor": "systolic_mm_hg_lt_100", "points": 0, "present": false }, { "value": 96.0, "factor": "spo2_lt_90", "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": "Jiménez D, Aujesky D, Moores L, et al.", "doi": "10.1001/archinternmed.2010.199", "id": "jimenez-2010", "source": "Arch Intern Med. 2010;170(15):1383-1389", "title": "Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism" }, "formula": "spesi", "formula_expression": "sPESI = age_gt_80 + cancer + chronic_cardiopulmonary_disease + heart_rate_ge_110 + systolic_mm_hg_lt_100 + spo2_lt_90; each 1 if present; max 6; 0 low, >=1 high", "max_score": 6, "score": 0, "age_years": 70, "spesi_risk": "low" }, { "components": [ { "value": 70, "factor": "age_gt_80", "points": 0, "present": false }, { "factor": "cancer", "points": 0, "present": false }, { "factor": "chronic_cardiopulmonary_disease", "points": 0, "present": false }, { "value": 80, "factor": "heart_rate_ge_110", "points": 0, "present": false }, { "value": 120.0, "factor": "systolic_mm_hg_lt_100", "points": 0, "present": false }, { "value": 96.0, "factor": "spo2_lt_90", "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": "Jiménez D, Aujesky D, Moores L, et al.", "doi": "10.1001/archinternmed.2010.199", "id": "jimenez-2010", "source": "Arch Intern Med. 2010;170(15):1383-1389", "title": "Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism" }, "formula": "spesi", "formula_expression": "sPESI = age_gt_80 + cancer + chronic_cardiopulmonary_disease + heart_rate_ge_110 + systolic_mm_hg_lt_100 + spo2_lt_90; each 1 if present; max 6; 0 low, >=1 high", "max_score": 6, "score": 0, "age_years": 70, "spesi_risk": "low" } ] } ``` ## Response fields - `formula` (string): spesi - `formula_expression` (string): Exact expression used - `score` (integer): Total points 0-6 - `max_score` (integer): Always 6 - `spesi_risk` (string): low when score is 0; high when score is ≥1. Not original PESI classes. - `age_years` (integer): Age used for the >80 criterion - `components` (array): Per-item points - `citation` (object): Jiménez 2010 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 70, "factor": "age_gt_80", "points": 0, "present": false }, { "factor": "cancer", "points": 0, "present": false }, { "factor": "chronic_cardiopulmonary_disease", "points": 0, "present": false }, { "value": 80, "factor": "heart_rate_ge_110", "points": 0, "present": false }, { "value": 120.0, "factor": "systolic_mm_hg_lt_100", "points": 0, "present": false }, { "value": 96.0, "factor": "spo2_lt_90", "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": "Jiménez D, Aujesky D, Moores L, et al.", "doi": "10.1001/archinternmed.2010.199", "id": "jimenez-2010", "source": "Arch Intern Med. 2010;170(15):1383-1389", "title": "Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism" }, "formula": "spesi", "formula_expression": "sPESI = age_gt_80 + cancer + chronic_cardiopulmonary_disease + heart_rate_ge_110 + systolic_mm_hg_lt_100 + spo2_lt_90; each 1 if present; max 6; 0 low, >=1 high", "max_score": 6, "score": 0, "age_years": 70, "spesi_risk": "low" } ``` ## 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_heart_rate`: heart_rate_bpm must be an integer from 30 to 220 Returned before settlement; you are not charged. - HTTP 400 `invalid_systolic_bp`: systolic_mm_hg or systolic_bp_mm_hg must be a number from 50 to 250. Returned before settlement; you are not charged. - HTTP 400 `invalid_spo2`: spo2_percent must be a number from 50 to 100. 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 - [PERC rule](https://magentlab.com/docs/perc) — Apply the Kline 2004 eight-factor pulmonary embolism rule-out criteria and return whether all eight are met (PERC-negative). - [Wells PE](https://magentlab.com/docs/wells-pe) — Compute the Wells pulmonary-embolism probability score and return three-tier and two-tier bands. ## Payment Required query parameters must be present and valid. 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 EIP-3009 (scheme exact, assetTransferMethod eip3009) with validBefore = now + accepts[0].maxTimeoutSeconds (600 seconds). That window starts when you sign and must cover wallet confirmation plus CDP verify and settle. Magent retries transient facilitator 429/5xx before answering. Do not send upto or batch-settlement payloads; magent does not offer those schemes. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON echoing accepted, payload, and extensions when present). - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. Settlement happens before the tool runs. HTTP 503 settlement_uncertain or settle_failed: retry the same PAYMENT-SIGNATURE. Mint a new 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. - 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. - not offered `batch-settlement`: Not offered. Payment-channel vouchers claimed later in batches. Not the same as POST {items} bulk (that is still exact). Same-path POST {items} is still scheme exact: one EIP-3009 authorization for n times the GET unit. 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 - Invalid query parameters return HTTP 400 before settlement. You are not charged. - Settlement finishes before the tool executes (paymentFlow upfront). 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.