{"uid":"cap_rzduzGi_86n7Z5cllA2ec","slug":"magent-irae-hypothyroidism-grader-brahmer-2018-table-4-1-1-c55f9e4d","name":"magent irAE Hypothyroidism Grader (Brahmer 2018 Table 4.1.1)","description":"Brahmer 2018 ASCO Table 4.1.1 irAE primary hypothyroidism grade from tsh_miu_l (0.01-150 mIU/L) and three caller-assigned flags. First-match: grade 3 if severe_or_life_threatening or unable_to_perform_adl (paper G3-4 as grade 3); else 2 if moderate_symptoms or TSH >= 10; else 1 if TSH < 10. Returns icpi_action continue (grade 1) or hold_until_baseline (grade 2 or 3). Not hyperthyroidism (Table 4.1.2). magent does not assay TSH/FT4. Not a medical device, not a diagnosis, not a levothyroxine dose.","url":"https://api.magentlab.com/api/calc/irae_hypothyroidism","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":["tsh_miu_l","moderate_symptoms","severe_or_life_threatening","unable_to_perform_adl"],"properties":{"tsh_miu_l":{"type":"number","description":"TSH in mIU/L (0.01-150; Brahmer 2018 Table 4.1.1 primary hypothyroidism). Persistently TSH >10 mIU/L is grade 2 unless a grade 3 flag is true; TSH 10 is this band. TSH <10 mIU/L with no moderate or severe flags is grade 1. magent does not assay TSH."},"moderate_symptoms":{"type":"boolean","description":"Moderate symptoms with ability to perform ADL as assigned by the caller (Brahmer 2018 Table 4.1.1 grade 2). true or false. When true and no grade 3 flag is true, grade is 2. magent does not examine the patient."},"unable_to_perform_adl":{"type":"boolean","description":"Unable to perform ADL as assigned by the caller (Brahmer 2018 Table 4.1.1 grade 3-4, returned as grade 3). true or false. When true, grade is 3. magent does not assess ADL."},"severe_or_life_threatening":{"type":"boolean","description":"Severe symptoms, medically significant or life-threatening consequences as assigned by the caller (Brahmer 2018 Table 4.1.1 grade 3-4, returned as grade 3). true or false. When true, grade is 3. magent does not examine the patient."}}}},"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_AejiH4QgYYQjSWH-UO1nl","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":"Grades immune checkpoint inhibitor-related adverse event (irAE) primary hypothyroidism (grade 1–3) per Brahmer 2018 ASCO Table 4.1.1 using TSH level and three clinical flags, returning a grade and icpi_action.","exampleAgentPrompt":"My patient on immunotherapy has a TSH of 14.5 mIU/L, has moderate symptoms but can still perform ADLs, and no severe or life-threatening findings — can you grade the irAE hypothyroidism using the Brahmer 2018 Table 4.1.1 criteria and tell me whether to continue or hold the checkpoint inhibitor?","exampleUseCases":[{"title":"Routine ICI thyroid toxicity triage","prompt":"My oncology patient on pembrolizumab has a TSH of 7.2 mIU/L with no moderate symptoms, no severe symptoms, and is able to perform ADLs — run the Brahmer 2018 irAE hypothyroidism grading and tell me the icpi_action."},{"title":"Grade 2 hypothyroidism hold decision","prompt":"A checkpoint inhibitor patient has a TSH of 12 mIU/L and moderate symptoms but can still do daily activities and has no life-threatening features — use the Brahmer 2018 Table 4.1.1 grader to classify hypothyroidism severity and whether to hold immunotherapy."},{"title":"Severe irAE hypothyroidism escalation","prompt":"Patient on nivolumab has a TSH of 45 mIU/L and is unable to perform activities of daily living — apply the Brahmer 2018 irAE hypothyroidism grading to get the toxicity grade and recommended immunotherapy action."}],"resultDescription":"Returns the Brahmer 2018 irAE hypothyroidism grade (1, 2, or 3) based on first-match logic from the TSH value and three Boolean clinical flags, plus an icpi_action of 'continue' (grade 1) or 'hold_until_baseline' (grade 2 or 3). Does not diagnose, assay TSH/FT4, or recommend levothyroxine dosing.","failureModes":["TSH value outside 0.01–150 mIU/L range may produce unexpected results or errors","Missing required Boolean flags (moderate_symptoms, severe_or_life_threatening, unable_to_perform_adl) cause request failure","Endpoint does not handle hyperthyroidism — wrong table if TSH is suppressed in a hyperthyroid context","Payment not included or insufficient USDC triggers 402 error","Caller-assigned flags are subjective; garbage-in produces clinically meaningless grades"],"whenToPreferThis":"Use this endpoint when you need to programmatically apply the Brahmer 2018 ASCO irAE grading criteria specifically for primary hypothyroidism (Table 4.1.1) during checkpoint inhibitor therapy and need a structured grade plus icpi_action. Do not use for hyperthyroidism (Table 4.1.2), thyroiditis, or any condition outside the Brahmer 2018 primary hypothyroidism rubric. Prefer this over manual lookup when embedding irAE grading into automated oncology workflows or clinical decision pipelines.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-14T07:19:54.645Z","isFirstParty":false}