# WAT-1 (Withdrawal Assessment Tool-1) WAT-1 Status: LIVE Price: $0.005 USDC `GET /api/calc/wat_1` HTML: https://magentlab.com/docs/wat-1 Markdown: https://magentlab.com/docs/wat-1.md 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 [The Withdrawal Assessment Tool-1 (WAT-1): an assessment instrument for monitoring opioid and benzodiazepine withdrawal symptoms in pediatric patients](https://doi.org/10.1097/PCC.0b013e31818c8328) Franck LS, Harris SK, Soetenga DJ, Amling JK, Curley MAQ Pediatr Crit Care Med. 2008;9(6):573-580 DOI: [10.1097/PCC.0b013e31818c8328](https://doi.org/10.1097/PCC.0b013e31818c8328) ## Worked example ### All items 0 Given: `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` 1. ten signs 0 and time_to_calm 0 as assigned by the caller 2. Score = 0 (max 12); wat1_ge_3 false (below the published ≥3 cutoff) ### Score 3 at the published cutoff Given: `loose_watery_stools=1, muscle_tone=0, startle_to_touch=0, state=0, sweating=0, temperature_gt_37_8=1, time_to_calm=0, tremor=0, uncoordinated_repetitive_movement=0, vomiting_retching_gagging=1, yawning_or_sneezing=0` 1. loose_watery_stools 1 + vomiting_retching_gagging 1 + temperature_gt_37_8 1; remaining signs 0 and time_to_calm 0 2. 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=1, muscle_tone=1, startle_to_touch=1, state=1, sweating=1, temperature_gt_37_8=1, time_to_calm=2, tremor=1, uncoordinated_repetitive_movement=1, vomiting_retching_gagging=1, yawning_or_sneezing=1` 1. each of the ten Franck 2008 signs is 1 and time_to_calm is 2 as assigned by the caller 2. 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 ## Parameters - `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. Method: `POST /api/calc/wat_1` 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": [ { "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" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/wat-1 Example 200: ```json { "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 fields - `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 Frozen fixture. Not a live lookup. ```json { "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 } ``` ## Errors - HTTP 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. - HTTP 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. - 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 - [COWS](https://magentlab.com/docs/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](https://magentlab.com/docs/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. - 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.