# Truelove and Witts ulcerative colitis severity Truelove and Witts Status: LIVE Price: $0.005 USDC `GET /api/calc/truelove_witts` HTML: https://magentlab.com/docs/truelove-witts Markdown: https://magentlab.com/docs/truelove-witts.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Apply the Truelove and Witts 1955 ulcerative colitis severity table and return mild, moderately_severe, or severe from stools_per_day and five caller-assigned flags. ## When to use When an agent already has the 1955 stool count and blood/systemic flags and needs that paper's mild / moderately severe / severe classification. magent does not examine the patient. ## When not to use - Not a medical device. - Not a diagnosis. magent does not diagnose ulcerative colitis or assign a treatment order. - The caller assigns stools_per_day and each blood/systemic flag from the 1955 mild and severe columns. magent does not examine the patient or measure temperature, pulse, haemoglobin, or ESR. - This tool is the 1955 BMJ table only (mild: four or less motions a day, no more than small amounts of macroscopic blood, no fever, no tachycardia, anaemia not severe, ESR not above 30 mm in one hour; severe: six or more motions with macroscopic blood and systemic upset). Moderately severe is intermediate. Not Mayo UC. Not PUCAI. Not later ASUC restatements that use haemoglobin 10.5 g/dL as the anaemia cut. ## Formula ``` severity severe iff stools_per_day >= 6 and macroscopic_blood and systemic_features_met >= 1; mild iff stools_per_day <= 4 and not macroscopic_blood and systemic_features_met == 0; else moderately_severe; systemic_features_met counts fever, tachycardia, anemia, and esr_raised (Truelove and Witts 1955) ``` ## Citation [Cortisone in ulcerative colitis; final report on a therapeutic trial](https://doi.org/10.1136/bmj.2.4947.1041) Truelove SC, Witts LJ Br Med J. 1955;2(4947):1041-1048 DOI: [10.1136/bmj.2.4947.1041](https://doi.org/10.1136/bmj.2.4947.1041) ## Worked example ### Two stools, no blood, no systemic flags Given: `anemia=false, esr_raised=false, fever=false, macroscopic_blood=false, stools_per_day=2, tachycardia=false` 1. stools_per_day is 2 (1955 mild column: four or less motions a day) 2. macroscopic_blood is false (no more than small amounts) 3. fever, tachycardia, anemia, and esr_raised are false (no systemic upset) 4. severity is mild ### Six bloody stools with fever only Given: `anemia=false, esr_raised=false, fever=true, macroscopic_blood=true, stools_per_day=6, tachycardia=false` 1. stools_per_day is 6 with macroscopic blood (1955 severe diarrhoea column) 2. fever is true; the other three systemic flags are false (systemic_features_met 1) 3. severity is severe; one systemic flag is enough ## Also searched as - Truelove and Witts - Truelove-Witts criteria - Truelove Witts severity index - ulcerative colitis severity - Truelove and Witts 1955 - UC severity classification - Truelove Witts mild moderately severe ## Parameters - `stools_per_day` (integer, required): Number of stools (motions) per day as assigned by the caller (integer 0-40). The 1955 mild column is four or less; the severe column is six or more. magent does not count stools. - `macroscopic_blood` (boolean, required): Macroscopic blood in stools as in the 1955 severe column (with macroscopic blood). true or false as assigned by the caller. The 1955 mild column allows no more than small amounts; assign false when blood is absent or no more than small amounts. magent does not examine the stool. - `fever` (boolean, required): Fever as assigned by the caller using the 1955 definition: mean evening temperature more than 99.5 F (37.5 C), or a temperature of 100 F (37.8 C) or more on at least two days out of four. true or false. magent does not measure temperature. - `tachycardia` (boolean, required): Tachycardia as assigned by the caller using the 1955 definition: mean pulse rate more than 90 per minute. true or false. magent does not measure pulse. - `anemia` (boolean, required): Anaemia as assigned by the caller using the 1955 definition: haemoglobin 75% or less, allowance made for recent transfusion. true or false. Not the later 10.5 g/dL restatement. magent does not measure haemoglobin. - `esr_raised` (boolean, required): E.S.R. much raised as assigned by the caller using the 1955 definition: more than 30 mm in one hour. true or false. magent does not measure ESR. ## 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/truelove_witts` 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": [ { "anemia": "false", "esr_raised": "false", "fever": "false", "macroscopic_blood": "false", "stools_per_day": "2", "tachycardia": "false" }, { "anemia": "false", "esr_raised": "false", "fever": "false", "macroscopic_blood": "false", "stools_per_day": "2", "tachycardia": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/truelove-witts Example 200: ```json { "count": 2, "path": "/api/calc/truelove_witts", "items": [ { "severity": "mild", "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": "Truelove SC, Witts LJ", "doi": "10.1136/bmj.2.4947.1041", "id": "truelove-witts-1955", "pmid": "13260656", "source": "Br Med J. 1955;2(4947):1041-1048", "title": "Cortisone in ulcerative colitis; final report on a therapeutic trial" }, "formula": "truelove_witts", "formula_expression": "severity severe iff stools_per_day >= 6 and macroscopic_blood and systemic_features_met >= 1; mild iff stools_per_day <= 4 and not macroscopic_blood and systemic_features_met == 0; else moderately_severe; systemic_features_met counts fever, tachycardia, anemia, and esr_raised (Truelove and Witts 1955)", "criteria": [ { "value": 2, "factor": "stools_le_4", "met": true }, { "value": 2, "factor": "stools_ge_6", "met": false }, { "factor": "macroscopic_blood", "met": false }, { "value": 2, "factor": "frequent_bloody_stools", "met": false }, { "factor": "fever", "met": false }, { "factor": "tachycardia", "met": false }, { "factor": "anemia", "met": false }, { "factor": "esr_raised", "met": false }, { "value": 0, "factor": "no_systemic", "met": true }, { "value": 0, "factor": "systemic_ge_1", "met": false } ], "stools_per_day": 2, "systemic_features_met": 0 }, { "severity": "mild", "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": "Truelove SC, Witts LJ", "doi": "10.1136/bmj.2.4947.1041", "id": "truelove-witts-1955", "pmid": "13260656", "source": "Br Med J. 1955;2(4947):1041-1048", "title": "Cortisone in ulcerative colitis; final report on a therapeutic trial" }, "formula": "truelove_witts", "formula_expression": "severity severe iff stools_per_day >= 6 and macroscopic_blood and systemic_features_met >= 1; mild iff stools_per_day <= 4 and not macroscopic_blood and systemic_features_met == 0; else moderately_severe; systemic_features_met counts fever, tachycardia, anemia, and esr_raised (Truelove and Witts 1955)", "criteria": [ { "value": 2, "factor": "stools_le_4", "met": true }, { "value": 2, "factor": "stools_ge_6", "met": false }, { "factor": "macroscopic_blood", "met": false }, { "value": 2, "factor": "frequent_bloody_stools", "met": false }, { "factor": "fever", "met": false }, { "factor": "tachycardia", "met": false }, { "factor": "anemia", "met": false }, { "factor": "esr_raised", "met": false }, { "value": 0, "factor": "no_systemic", "met": true }, { "value": 0, "factor": "systemic_ge_1", "met": false } ], "stools_per_day": 2, "systemic_features_met": 0 } ] } ``` ## Response fields - `formula` (string): truelove_witts - `formula_expression` (string): Truelove and Witts 1955 mild / moderately severe / severe classification from stools, blood, and four systemic flags - `severity` (string): mild, moderately_severe, or severe (1955 classification). Not Mayo. Not PUCAI. Not a treatment order. - `stools_per_day` (integer): Echo of the caller-assigned stool count (0-40) - `systemic_features_met` (integer): Count of true systemic flags among fever, tachycardia, anemia, and esr_raised (0-4) - `criteria` (array): Per-factor rows with factor and met; stools_le_4, stools_ge_6, frequent_bloody_stools, no_systemic, and systemic_ge_1 include value - `citation` (object): Truelove and Witts 1955 BMJ citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "severity": "mild", "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": "Truelove SC, Witts LJ", "doi": "10.1136/bmj.2.4947.1041", "id": "truelove-witts-1955", "pmid": "13260656", "source": "Br Med J. 1955;2(4947):1041-1048", "title": "Cortisone in ulcerative colitis; final report on a therapeutic trial" }, "formula": "truelove_witts", "formula_expression": "severity severe iff stools_per_day >= 6 and macroscopic_blood and systemic_features_met >= 1; mild iff stools_per_day <= 4 and not macroscopic_blood and systemic_features_met == 0; else moderately_severe; systemic_features_met counts fever, tachycardia, anemia, and esr_raised (Truelove and Witts 1955)", "criteria": [ { "value": 2, "factor": "stools_le_4", "met": true }, { "value": 2, "factor": "stools_ge_6", "met": false }, { "factor": "macroscopic_blood", "met": false }, { "value": 2, "factor": "frequent_bloody_stools", "met": false }, { "factor": "fever", "met": false }, { "factor": "tachycardia", "met": false }, { "factor": "anemia", "met": false }, { "factor": "esr_raised", "met": false }, { "value": 0, "factor": "no_systemic", "met": true }, { "value": 0, "factor": "systemic_ge_1", "met": false } ], "stools_per_day": 2, "systemic_features_met": 0 } ``` ## Errors - HTTP 400 `invalid_truelove_stools`: stools_per_day must be an integer from 0 to 40 (Truelove and Witts 1955). 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 - [Mayo DAI](https://magentlab.com/docs/mayo-uc) — Sum four caller-assigned Schroeder 1987 ulcerative colitis disease-activity index items (each integer 0-3) and return the total (max 12). Does not return later remission or activity bands. - [PUCAI](https://magentlab.com/docs/pucai) — Sum six caller-assigned Turner 2007 PUCAI item points and return the published total (max 85) with activity band. ## 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.