WAT-1 (Withdrawal Assessment Tool-1)

WAT-1

Sum the eleven Franck 2008 WAT-1 items (ten caller-assigned 0/1 signs and time_to_calm 0-2) and return the published 0-12 total plus wat1_ge_3 (true iff score ≥3 versus NRS ≥4).

LIVE $0.005 USDC GET /api/calc/wat_1

Markdown: /docs/wat-1.md · Canonical: https://magentlab.com/docs/wat-1

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

What it computes

Sum the eleven Franck 2008 WAT-1 items (ten caller-assigned 0/1 signs and time_to_calm 0-2) and return the published 0-12 total plus wat1_ge_3 (true iff score ≥3 versus NRS ≥4).

When to use

When an agent already has Franck 2008 Table 4 integers for a pediatric patient being monitored for iatrogenic opioid or benzodiazepine withdrawal and needs the published WAT-1 total and ≥3 cutoff. magent does not observe the child, diagnose withdrawal, score NAS, score COWS, or score CIWA-Ar.

When not to use

Not a medical device and not a withdrawal diagnosis or treatment order.
Each of the eleven items is a caller-assigned Franck 2008 Table 4 integer. magent does not observe the child.
Pediatric iatrogenic opioid/benzodiazepine withdrawal monitoring only. This is not NAS, not COWS, and not CIWA-Ar.
Franck 2008 published one cutoff: WAT-1 ≥3 versus NRS ≥4. This tool returns wat1_ge_3. It does not invent mild/moderate/severe stages.

Formula

WAT-1 = loose_watery_stools + vomiting_retching_gagging + temperature_gt_37_8 + state + tremor + sweating + uncoordinated_repetitive_movement + yawning_or_sneezing + startle_to_touch + muscle_tone + time_to_calm; ten signs 0 or 1; time_to_calm 0, 1, or 2; Franck 2008 Table 4; max 12; wat1_ge_3 iff total >= 3

Citation

Title: The Withdrawal Assessment Tool-1 (WAT-1): an assessment instrument for monitoring opioid and benzodiazepine withdrawal symptoms in pediatric patients
Authors: Franck LS, Harris SK, Soetenga DJ, Amling JK, Curley MAQ
Source: Pediatr Crit Care Med. 2008;9(6):573-580
DOI: 10.1097/PCC.0b013e31818c8328

Worked example

All items 0

Given: loose_watery_stools=0muscle_tone=0startle_to_touch=0state=0sweating=0temperature_gt_37_8=0time_to_calm=0tremor=0uncoordinated_repetitive_movement=0vomiting_retching_gagging=0yawning_or_sneezing=0

ten signs 0 and time_to_calm 0 as assigned by the caller
Score = 0 (max 12); wat1_ge_3 false (below the published ≥3 cutoff)

Score 3 at the published cutoff

Given: loose_watery_stools=1muscle_tone=0startle_to_touch=0state=0sweating=0temperature_gt_37_8=1time_to_calm=0tremor=0uncoordinated_repetitive_movement=0vomiting_retching_gagging=1yawning_or_sneezing=0

loose_watery_stools 1 + vomiting_retching_gagging 1 + temperature_gt_37_8 1; remaining signs 0 and time_to_calm 0
Score = 3 (max 12); wat1_ge_3 true (Franck 2008 WAT-1 ≥3 versus NRS ≥4)

All ten signs 1 and time_to_calm 2

Given: loose_watery_stools=1muscle_tone=1startle_to_touch=1state=1sweating=1temperature_gt_37_8=1time_to_calm=2tremor=1uncoordinated_repetitive_movement=1vomiting_retching_gagging=1yawning_or_sneezing=1

each of the ten Franck 2008 signs is 1 and time_to_calm is 2 as assigned by the caller
Score = 12 (max 12); wat1_ge_3 true

Also searched as

WAT-1
Withdrawal Assessment Tool-1
Franck WAT-1
pediatric opioid withdrawal
iatrogenic benzodiazepine withdrawal
WAT1 score
pediatric withdrawal scale
Franck 2008 WAT-1

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/wat_1?loose_watery_stools=0&vomiting_retching_gagging=0&temperature_gt_37_8=0&state=0&tremor=0&sweating=0&uncoordinated_repetitive_movement=0&yawning_or_sneezing=0&startle_to_touch=0&muscle_tone=0&time_to_calm=0

Full URL: https://api.magentlab.com/api/calc/wat_1?loose_watery_stools=0&vomiting_retching_gagging=0&temperature_gt_37_8=0&state=0&tremor=0&sweating=0&uncoordinated_repetitive_movement=0&yawning_or_sneezing=0&startle_to_touch=0&muscle_tone=0&time_to_calm=0

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/wat_1?loose_watery_stools=0&vomiting_retching_gagging=0&temperature_gt_37_8=0&state=0&tremor=0&sweating=0&uncoordinated_repetitive_movement=0&yawning_or_sneezing=0&startle_to_touch=0&muscle_tone=0&time_to_calm=0"

Parameters

Name	Type	Required	Description
`loose_watery_stools`	integer	required	Caller-assigned Franck 2008 Table 4 loose/watery stools from the record in the previous 12 hours (integer 0 or 1): 0 none, 1 any loose or watery stools. magent does not observe the child.
`vomiting_retching_gagging`	integer	required	Caller-assigned Franck 2008 Table 4 vomiting, retching, or gagging from the record in the previous 12 hours (integer 0 or 1): 0 none, 1 any vomiting, retching, or gagging. magent does not observe the child.
`temperature_gt_37_8`	integer	required	Caller-assigned Franck 2008 Table 4 modal temperature > 37.8°C from the record in the previous 12 hours (integer 0 or 1): 0 no, 1 yes. magent does not observe the child.
`state`	integer	required	Caller-assigned Franck 2008 Table 4 2-minute pre-stimulus state (integer 0 or 1): 0 SBS ≤0 or asleep/awake/calm, 1 SBS ≥+1 or awake/distressed. magent does not observe the child.
`tremor`	integer	required	Caller-assigned Franck 2008 Table 4 2-minute pre-stimulus tremor (integer 0 or 1): 0 none/mild, 1 moderate/severe. magent does not observe the child.
`sweating`	integer	required	Caller-assigned Franck 2008 Table 4 2-minute pre-stimulus sweating (integer 0 or 1): 0 no, 1 any sweating. magent does not observe the child.
`uncoordinated_repetitive_movement`	integer	required	Caller-assigned Franck 2008 Table 4 2-minute pre-stimulus uncoordinated or repetitive movement (integer 0 or 1): 0 none/mild, 1 moderate/severe. magent does not observe the child.
`yawning_or_sneezing`	integer	required	Caller-assigned Franck 2008 Table 4 2-minute pre-stimulus yawning or sneezing (integer 0 or 1): 0 none or 1 yawn/sneeze, 1 two or more. magent does not observe the child.
`startle_to_touch`	integer	required	Caller-assigned Franck 2008 Table 4 1-minute stimulus startle to touch (integer 0 or 1): 0 none/mild, 1 moderate/severe. magent does not observe the child.
`muscle_tone`	integer	required	Caller-assigned Franck 2008 Table 4 1-minute stimulus muscle tone (integer 0 or 1): 0 normal, 1 increased. magent does not observe the child.
`time_to_calm`	integer	required	Caller-assigned Franck 2008 Table 4 post-stimulus time to gain a calm state (integer 0, 1, or 2): 0 if <2 min, 1 if 2-5 min, 2 if >5 min. magent does not observe the child.

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.

POST /api/calc/wat_1 Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 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 (fixture)

{
  "items": [
    {
      "loose_watery_stools": "0",
      "muscle_tone": "0",
      "startle_to_touch": "0",
      "state": "0",
      "sweating": "0",
      "temperature_gt_37_8": "0",
      "time_to_calm": "0",
      "tremor": "0",
      "uncoordinated_repetitive_movement": "0",
      "vomiting_retching_gagging": "0",
      "yawning_or_sneezing": "0"
    },
    {
      "loose_watery_stools": "0",
      "muscle_tone": "0",
      "startle_to_touch": "0",
      "state": "0",
      "sweating": "0",
      "temperature_gt_37_8": "0",
      "time_to_calm": "0",
      "tremor": "0",
      "uncoordinated_repetitive_movement": "0",
      "vomiting_retching_gagging": "0",
      "yawning_or_sneezing": "0"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/wat_1",
  "items": [
    {
      "components": [
        {
          "value": 0,
          "factor": "loose_watery_stools",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "vomiting_retching_gagging",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "temperature_gt_37_8",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "state",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "tremor",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "sweating",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "uncoordinated_repetitive_movement",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "yawning_or_sneezing",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "startle_to_touch",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "muscle_tone",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "time_to_calm",
          "points": 0,
          "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": "Franck LS, Harris SK, Soetenga DJ, Amling JK, Curley MAQ",
        "doi": "10.1097/PCC.0b013e31818c8328",
        "id": "franck-2008",
        "pmid": "18838937",
        "source": "Pediatr Crit Care Med. 2008;9(6):573-580",
        "title": "The Withdrawal Assessment Tool-1 (WAT-1): an assessment instrument for monitoring opioid and benzodiazepine withdrawal symptoms in pediatric patients"
      },
      "formula": "wat_1",
      "formula_expression": "WAT-1 = loose_watery_stools + vomiting_retching_gagging + temperature_gt_37_8 + state + tremor + sweating + uncoordinated_repetitive_movement + yawning_or_sneezing + startle_to_touch + muscle_tone + time_to_calm; ten signs 0 or 1; time_to_calm 0, 1, or 2; Franck 2008 Table 4; max 12; wat1_ge_3 iff total >= 3",
      "max_score": 12,
      "score": 0,
      "wat1_ge_3": false
    },
    {
      "components": [
        {
          "value": 0,
          "factor": "loose_watery_stools",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "vomiting_retching_gagging",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "temperature_gt_37_8",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "state",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "tremor",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "sweating",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "uncoordinated_repetitive_movement",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "yawning_or_sneezing",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "startle_to_touch",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "muscle_tone",
          "points": 0,
          "present": true
        },
        {
          "value": 0,
          "factor": "time_to_calm",
          "points": 0,
          "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": "Franck LS, Harris SK, Soetenga DJ, Amling JK, Curley MAQ",
        "doi": "10.1097/PCC.0b013e31818c8328",
        "id": "franck-2008",
        "pmid": "18838937",
        "source": "Pediatr Crit Care Med. 2008;9(6):573-580",
        "title": "The Withdrawal Assessment Tool-1 (WAT-1): an assessment instrument for monitoring opioid and benzodiazepine withdrawal symptoms in pediatric patients"
      },
      "formula": "wat_1",
      "formula_expression": "WAT-1 = loose_watery_stools + vomiting_retching_gagging + temperature_gt_37_8 + state + tremor + sweating + uncoordinated_repetitive_movement + yawning_or_sneezing + startle_to_touch + muscle_tone + time_to_calm; ten signs 0 or 1; time_to_calm 0, 1, or 2; Franck 2008 Table 4; max 12; wat1_ge_3 iff total >= 3",
      "max_score": 12,
      "score": 0,
      "wat1_ge_3": false
    }
  ]
}

Response

Field	Type	Description
`formula`	string	wat_1
`formula_expression`	string	Exact expression used
`score`	integer	Franck 2008 WAT-1 sum of eleven caller-assigned items (total 0-12)
`max_score`	integer	Always 12
`wat1_ge_3`	boolean	true iff score ≥ 3 (Franck 2008 ROC: WAT-1 ≥3 best sensitivity/specificity versus NRS ≥4). Not a diagnosis. Not a mild/moderate/severe stage.
`components`	array	Per-item caller-assigned points
`citation`	object	Franck et al. Pediatr Crit Care Med 2008 citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "value": 0,
      "factor": "loose_watery_stools",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "vomiting_retching_gagging",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "temperature_gt_37_8",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "state",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "tremor",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "sweating",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "uncoordinated_repetitive_movement",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "yawning_or_sneezing",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "startle_to_touch",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "muscle_tone",
      "points": 0,
      "present": true
    },
    {
      "value": 0,
      "factor": "time_to_calm",
      "points": 0,
      "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": "Franck LS, Harris SK, Soetenga DJ, Amling JK, Curley MAQ",
    "doi": "10.1097/PCC.0b013e31818c8328",
    "id": "franck-2008",
    "pmid": "18838937",
    "source": "Pediatr Crit Care Med. 2008;9(6):573-580",
    "title": "The Withdrawal Assessment Tool-1 (WAT-1): an assessment instrument for monitoring opioid and benzodiazepine withdrawal symptoms in pediatric patients"
  },
  "formula": "wat_1",
  "formula_expression": "WAT-1 = loose_watery_stools + vomiting_retching_gagging + temperature_gt_37_8 + state + tremor + sweating + uncoordinated_repetitive_movement + yawning_or_sneezing + startle_to_touch + muscle_tone + time_to_calm; ten signs 0 or 1; time_to_calm 0, 1, or 2; Franck 2008 Table 4; max 12; wat1_ge_3 iff total >= 3",
  "max_score": 12,
  "score": 0,
  "wat1_ge_3": false
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_wat`	WAT-1 needs the eleven Franck 2008 items (ten 0/1 signs and time_to_calm 0-2). Returned before settlement; you are not charged.
400	`invalid_wat_item`	each WAT-1 sign is 0 or 1; time_to_calm is 0, 1, or 2 (Franck 2008). Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

COWS — Sum the eleven Wesson 2003 Clinical Opiate Withdrawal Scale (COWS) items from caller-assigned appendix integers and return the published total (max 48) with the published severity cutoffs.
CIWA-Ar — Sum the ten Sullivan 1989 CIWA-Ar items (nine caller-assigned 0-7 plus orientation 0-4) and return the published total (max 67).

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. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /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.