# STONE nephrolithometry STONE nephrolithometry Status: LIVE Price: $0.005 USDC `GET /api/calc/stone_nephrolithometry` HTML: https://magentlab.com/docs/stone-nephrolithometry Markdown: https://magentlab.com/docs/stone-nephrolithometry.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the Okhunov 2013 STONE nephrolithometry score for kidney calculi (PCNL) from five caller-assigned published item points and return the integer total (5–13). Does not return stone-free-rate bands. ## When to use When an agent has already assigned Okhunov 2013 size (mm²), tract length, hydronephrosis, involved calyces or staghorn, and Hounsfield-unit essence for renal calculi planned for PCNL and needs the published integer sum, not a PCNL order, CT read, or the ureteral STONE score. ## When not to use - Not a medical device. magent does not measure stone size, tract, hydronephrosis, calyces, or HU. Size, tract, obstruction, calyces, and essence are caller-assigned. - Not an operative or PCNL order. The score is not a command to operate, place a tract, or choose a percutaneous approach. - Not the Moore 2014 ureteral STONE score. This tool is Okhunov 2013 STONE nephrolithometry for kidney calculi / PCNL. - Okhunov 2013 correlated score with stone-free rate but did not publish exclusive SFR cutoffs. magent returns score and max_score only. ## Formula ``` STONE = size (0_399 1, 400_799 2, 800_1599 3, ge_1600 4) + tract (le_100 1, gt_100 2) + obstruction (none_or_mild 1, moderate_or_severe 2) + calyces (1_or_2 1, 3 2, staghorn 3) + essence (le_950 1, gt_950 2); Okhunov 2013 STONE nephrolithometry; sum 5-13; no published SFR bands ``` ## Citation [S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi](https://doi.org/10.1016/j.urology.2012.10.083) Okhunov Z, Friedlander JI, George AK, Duty BD, Moreira DM, Srinivasan AK, Hillelsohn J, Smith AD, Okeke Z Urology. 2013;81(6):1154-1159 DOI: [10.1016/j.urology.2012.10.083](https://doi.org/10.1016/j.urology.2012.10.083) ## Worked example ### All minimum grades Given: `calyces=1_or_2, essence=le_950, obstruction=none_or_mild, size=0_399, tract=le_100` 1. 0_399 1 + le_100 1 + none_or_mild 1 + 1_or_2 1 + le_950 1 2. Score = 5 (max 13). No SFR band. Not a PCNL order ### All maximum grades Given: `calyces=staghorn, essence=gt_950, obstruction=moderate_or_severe, size=ge_1600, tract=gt_100` 1. ge_1600 4 + gt_100 2 + moderate_or_severe 2 + staghorn 3 + gt_950 2 2. Score = 13 (max 13). No SFR band. Not a PCNL order ## Also searched as - Okhunov STONE - STONE score renal calculi - PCNL nephrolithometry - STONE nephrolithometry - Okhunov 2013 - renal STONE score - PCNL stone score - S.T.O.N.E. nephrolithometry ## Parameters - `size` (string, required): Caller-assigned stone size in mm² (Okhunov 2013). 0_399 (0–399 mm²) scores 1; 400_799 (400–799 mm²) scores 2; 800_1599 (800–1599 mm²) scores 3; ge_1600 (≥1600 mm²) scores 4. magent does not measure stone size or CT. - `tract` (string, required): Caller-assigned tract length in mm, skin-to-stone (Okhunov 2013). le_100 (≤100 mm) scores 1; gt_100 (>100 mm) scores 2. magent does not measure tract length or CT. - `obstruction` (string, required): Caller-assigned hydronephrosis / obstruction (Okhunov 2013). none_or_mild scores 1; moderate_or_severe scores 2. magent does not measure hydronephrosis or CT. - `calyces` (string, required): Caller-assigned number of involved calyces or staghorn (Okhunov 2013). 1_or_2 scores 1; 3 scores 2; staghorn scores 3. magent does not count calyces or read CT. - `essence` (string, required): Caller-assigned stone density in Hounsfield units (Okhunov 2013 essence). le_950 (≤950 HU) scores 1; gt_950 (>950 HU) scores 2. magent does not measure HU or 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/stone_nephrolithometry` 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": [ { "calyces": "1_or_2", "essence": "le_950", "obstruction": "none_or_mild", "size": "0_399", "tract": "le_100" }, { "calyces": "1_or_2", "essence": "le_950", "obstruction": "none_or_mild", "size": "0_399", "tract": "le_100" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/stone-nephrolithometry Example 200: ```json { "count": 2, "path": "/api/calc/stone_nephrolithometry", "items": [ { "size": "0_399", "components": [ { "value": "0_399", "factor": "size", "points": 1, "present": true }, { "value": "le_100", "factor": "tract", "points": 1, "present": true }, { "value": "none_or_mild", "factor": "obstruction", "points": 1, "present": true }, { "value": "1_or_2", "factor": "calyces", "points": 1, "present": true }, { "value": "le_950", "factor": "essence", "points": 1, "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": "Okhunov Z, Friedlander JI, George AK, Duty BD, Moreira DM, Srinivasan AK, Hillelsohn J, Smith AD, Okeke Z", "doi": "10.1016/j.urology.2012.10.083", "id": "okhunov-2013", "pmid": "23540858", "source": "Urology. 2013;81(6):1154-1159", "title": "S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi" }, "formula": "stone_nephrolithometry", "formula_expression": "STONE = size (0_399 1, 400_799 2, 800_1599 3, ge_1600 4) + tract (le_100 1, gt_100 2) + obstruction (none_or_mild 1, moderate_or_severe 2) + calyces (1_or_2 1, 3 2, staghorn 3) + essence (le_950 1, gt_950 2); Okhunov 2013 STONE nephrolithometry; sum 5-13; no published SFR bands", "max_score": 13, "score": 5, "calyces": "1_or_2", "essence": "le_950", "obstruction": "none_or_mild", "tract": "le_100" }, { "size": "0_399", "components": [ { "value": "0_399", "factor": "size", "points": 1, "present": true }, { "value": "le_100", "factor": "tract", "points": 1, "present": true }, { "value": "none_or_mild", "factor": "obstruction", "points": 1, "present": true }, { "value": "1_or_2", "factor": "calyces", "points": 1, "present": true }, { "value": "le_950", "factor": "essence", "points": 1, "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": "Okhunov Z, Friedlander JI, George AK, Duty BD, Moreira DM, Srinivasan AK, Hillelsohn J, Smith AD, Okeke Z", "doi": "10.1016/j.urology.2012.10.083", "id": "okhunov-2013", "pmid": "23540858", "source": "Urology. 2013;81(6):1154-1159", "title": "S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi" }, "formula": "stone_nephrolithometry", "formula_expression": "STONE = size (0_399 1, 400_799 2, 800_1599 3, ge_1600 4) + tract (le_100 1, gt_100 2) + obstruction (none_or_mild 1, moderate_or_severe 2) + calyces (1_or_2 1, 3 2, staghorn 3) + essence (le_950 1, gt_950 2); Okhunov 2013 STONE nephrolithometry; sum 5-13; no published SFR bands", "max_score": 13, "score": 5, "calyces": "1_or_2", "essence": "le_950", "obstruction": "none_or_mild", "tract": "le_100" } ] } ``` ## Response fields - `formula` (string): stone_nephrolithometry - `formula_expression` (string): Exact expression used - `score` (integer): Okhunov 2013 STONE nephrolithometry integer sum 5-13. Not a PCNL order. No published SFR band. - `max_score` (integer): 13 - `size` (string): Caller-assigned size used (0_399, 400_799, 800_1599, or ge_1600) - `tract` (string): Caller-assigned tract used (le_100 or gt_100) - `obstruction` (string): Caller-assigned obstruction used (none_or_mild or moderate_or_severe) - `calyces` (string): Caller-assigned calyces used (1_or_2, 3, or staghorn) - `essence` (string): Caller-assigned essence used (le_950 or gt_950) - `components` (array): Per-item Okhunov 2013 points - `citation` (object): Okhunov et al. Urology 2013 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "size": "0_399", "components": [ { "value": "0_399", "factor": "size", "points": 1, "present": true }, { "value": "le_100", "factor": "tract", "points": 1, "present": true }, { "value": "none_or_mild", "factor": "obstruction", "points": 1, "present": true }, { "value": "1_or_2", "factor": "calyces", "points": 1, "present": true }, { "value": "le_950", "factor": "essence", "points": 1, "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": "Okhunov Z, Friedlander JI, George AK, Duty BD, Moreira DM, Srinivasan AK, Hillelsohn J, Smith AD, Okeke Z", "doi": "10.1016/j.urology.2012.10.083", "id": "okhunov-2013", "pmid": "23540858", "source": "Urology. 2013;81(6):1154-1159", "title": "S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi" }, "formula": "stone_nephrolithometry", "formula_expression": "STONE = size (0_399 1, 400_799 2, 800_1599 3, ge_1600 4) + tract (le_100 1, gt_100 2) + obstruction (none_or_mild 1, moderate_or_severe 2) + calyces (1_or_2 1, 3 2, staghorn 3) + essence (le_950 1, gt_950 2); Okhunov 2013 STONE nephrolithometry; sum 5-13; no published SFR bands", "max_score": 13, "score": 5, "calyces": "1_or_2", "essence": "le_950", "obstruction": "none_or_mild", "tract": "le_100" } ``` ## Errors - HTTP 400 `invalid_stone_nephrolithometry`: size must be 0_399, 400_799, 800_1599, or ge_1600; tract must be le_100 or gt_100; obstruction must be none_or_mild or moderate_or_severe; calyces must be 1_or_2, 3, or staghorn; essence must be le_950 or gt_950 (Okhunov 2013 STONE nephrolithometry). 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 - [Urine PCR](https://magentlab.com/docs/urine-pcr) — Compute the Ginsberg 1983 urine protein/creatinine ratio (mg/mg) from a single-void urine protein and urine creatinine, and return that rounded ratio as estimated_g_day (numeric estimate of 24-h protein g/day). ## 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.