{"uid":"cap_ZDwtxfqGwuTJzBhC9OpZ9","slug":"magent-tokyo-guidelines-2018-acute-cholecystitis-grader-2742f605","name":"magent Tokyo Guidelines 2018 Acute Cholecystitis Grader","description":"Yokoe 2018 TG18 (=TG13) acute cholecystitis. Definite if local signs (Murphy or RUQ mass/pain/tenderness), systemic signs (fever, elevated CRP or WBC), and imaging; suspected if local and systemic without imaging; else none. Suspected/definite: Grade III if any organ dysfunction, else Grade II if any Grade II flag, else Grade I. Severity none when diagnosis is none. Not cholangitis or Alvarado/RIPASA. magent does not examine, assay, or read imaging. Not a medical device.","url":"https://api.magentlab.com/api/calc/tokyo_cholecystitis","method":"GET","headers":{},"bodySchema":{"type":"object","$schema":"https://json-schema.org/draft/2020-12/schema","required":["input"],"properties":{"input":{"type":"object","required":["type","method"],"properties":{"type":{"type":"string","const":"http"},"method":{"enum":["GET","HEAD","DELETE"],"type":"string"},"headers":{"type":"object","additionalProperties":{"type":"string"}},"queryParams":{"type":"object","required":["murphy","ruq_mass_pain_tenderness","fever","elevated_crp","elevated_wbc","imaging_findings","hypotension_vasopressors","decreased_consciousness","pfr_lt_300","oliguria_or_creatinine_gt_2","pt_inr_gt_1_5","platelets_lt_100k","wbc_gt_18000","palpable_tender_ruq_mass","duration_gt_72h","marked_local_inflammation"],"properties":{"fever":{"type":"boolean","description":"Fever as assigned by the caller (Yokoe 2018 TG18 systemic sign of inflammation B). true or false. magent does not measure temperature."},"murphy":{"type":"boolean","description":"Murphy's sign as assigned by the caller (Yokoe 2018 TG18 local sign of inflammation A). true or false. magent does not examine the patient."},"pfr_lt_300":{"type":"boolean","description":"PaO2/FiO2 <300 as assigned by the caller (Yokoe 2018 TG18 Grade III respiratory dysfunction). true or false. magent does not interpret blood gas or ventilator settings."},"elevated_crp":{"type":"boolean","description":"Elevated C-reactive protein as assigned by the caller (Yokoe 2018 TG18 systemic sign of inflammation B). true or false. magent does not assay CRP."},"elevated_wbc":{"type":"boolean","description":"Elevated white blood cell count as assigned by the caller (Yokoe 2018 TG18 systemic sign of inflammation B). true or false. magent does not assay WBC."},"wbc_gt_18000":{"type":"boolean","description":"White blood cell count >18,000/mm³ as assigned by the caller (Yokoe 2018 TG18 Grade II). true or false. magent does not assay WBC."},"pt_inr_gt_1_5":{"type":"boolean","description":"PT-INR >1.5 as assigned by the caller (Yokoe 2018 TG18 Grade III hepatic dysfunction). true or false. magent does not interpret coagulation assays."},"duration_gt_72h":{"type":"boolean","description":"Duration of complaints >72 h as assigned by the caller (Yokoe 2018 TG18 Grade II). true or false. magent does not take a history."},"imaging_findings":{"type":"boolean","description":"Imaging findings characteristic of acute cholecystitis as assigned by the caller (Yokoe 2018 TG18 diagnostic criterion C). true or false. magent does not read imaging."},"platelets_lt_100k":{"type":"boolean","description":"Platelet count <100,000/mm³ as assigned by the caller (Yokoe 2018 TG18 Grade III hematological dysfunction). true or false. magent does not assay platelets."},"decreased_consciousness":{"type":"boolean","description":"Decreased level of consciousness as assigned by the caller (Yokoe 2018 TG18 Grade III neurological dysfunction). true or false. magent does not examine the patient."},"hypotension_vasopressors":{"type":"boolean","description":"Hypotension requiring dopamine ≥5 µg/kg/min or any norepinephrine as assigned by the caller (Yokoe 2018 TG18 Grade III cardiovascular dysfunction). true or false. magent does not measure blood pressure or order vasopressors."},"palpable_tender_ruq_mass":{"type":"boolean","description":"Palpable tender mass in the right upper quadrant as assigned by the caller (Yokoe 2018 TG18 Grade II). true or false. magent does not examine the patient."},"ruq_mass_pain_tenderness":{"type":"boolean","description":"Right upper quadrant mass, pain, or tenderness as assigned by the caller (Yokoe 2018 TG18 local sign of inflammation A). true or false. magent does not examine the patient."},"marked_local_inflammation":{"type":"boolean","description":"Marked local inflammation (gangrenous cholecystitis, pericholecystic abscess, hepatic abscess, biliary peritonitis, or emphysematous cholecystitis) as assigned by the caller (Yokoe 2018 TG18 Grade II). true or false. magent does not interpret imaging or operative findings."},"oliguria_or_creatinine_gt_2":{"type":"boolean","description":"Oliguria or creatinine >2.0 mg/dL as assigned by the caller (Yokoe 2018 TG18 Grade III renal dysfunction). true or false. magent does not assay creatinine or measure urine output."}}}},"additionalProperties":false},"output":{"type":"object","required":["type"],"properties":{"type":{"type":"string"},"example":{"type":"object"}}}}},"responseSchema":null,"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.005","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.005/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.005","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_VrJQEP3CWgczsxHdUoC7t","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.005","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Applies the Yokoe 2018 TG18 criteria to classify acute cholecystitis diagnosis (none/suspected/definite) and severity grade (I/II/III) from caller-assigned clinical findings","exampleAgentPrompt":"Grade this patient's acute cholecystitis using the Tokyo 2018 TG18 criteria: Murphy's sign is positive, RUQ tenderness is present, fever is true, elevated CRP is true, elevated WBC is true, imaging findings are positive; for severity flags: hypotension requiring vasopressors is false, decreased consciousness is false, PF ratio <300 is false, oliguria or creatinine >2 is false, PT-INR >1.5 is false, platelets <100k is false, WBC >18000 is true, palpable tender RUQ mass is false, duration >72h is false, marked local inflammation is false.","exampleUseCases":[{"title":"ED triage for acute cholecystitis","prompt":"I'm seeing a patient in the ED with RUQ tenderness and positive Murphy's sign, fever, elevated CRP, elevated WBC, and ultrasound showing cholecystitis findings — no organ dysfunction, WBC is over 18,000. Can you classify this using the Tokyo 2018 TG18 criteria and tell me the severity grade?"},{"title":"Post-lab severity reassessment","prompt":"My patient was admitted with suspected cholecystitis — local signs present, fever and elevated WBC positive, but no imaging yet. Now labs show PT-INR of 1.8 and creatinine of 2.4. Imaging still pending. Can you re-run the TG18 cholecystitis grading with those organ dysfunction flags set to true and imaging false?"},{"title":"Automated surgical consult triage","prompt":"For our surgical consult triage workflow, classify this patient: Murphy's sign negative, RUQ mass with pain and tenderness positive, fever true, CRP elevated true, WBC elevated true, imaging positive; no organ dysfunction flags, WBC not above 18k, duration over 72 hours is true, marked local inflammation is true. What's the TG18 diagnosis and grade?"}],"resultDescription":"Returns the Tokyo Guidelines 2018 (TG18/TG13) acute cholecystitis diagnosis category (none, suspected, or definite) and severity grade (I, II, or III) based on the caller-supplied boolean clinical findings. No physical examination, laboratory assay, or imaging interpretation is performed by the API.","failureModes":["Missing required query parameters returns a validation error","All local/systemic signs false yields diagnosis 'none' and no severity grade","Imaging absent with local and systemic signs present yields 'suspected' rather than 'definite'","Misclassification risk if caller incorrectly assigns boolean flags (garbage in, garbage out)","Not applicable to cholangitis or appendicitis — wrong endpoint for those conditions"],"whenToPreferThis":"Use this endpoint when you need to programmatically apply the Yokoe 2018 TG18 acute cholecystitis diagnosis and severity grading criteria to pre-assessed clinical findings. Prefer this over manual lookup when building clinical decision support workflows, automated triage pipelines, or EHR integrations that need consistent, rules-based TG18 grading. Do not use for cholangitis (different guideline), appendicitis (Alvarado/RIPASA/PAS), or when imaging or lab interpretation is needed — the caller must supply all boolean flags.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-14T13:10:21.290Z","isFirstParty":false}