# FOUR Score Calculator (Wijdicks 2005)

> FOUR Score Calculator (Wijdicks 2005) is a paid API for AI agents from api.magentlab.com, paid per call via x402, $0.005/call, status unknown (last checked 2026-09-15).

Computes the Full Outline of UnResponsiveness (FOUR) score by summing four caller-assigned integer components: eye, motor, brainstem, and respiration (max 16).

## Facts

- Endpoint: GET https://api.magentlab.com/api/calc/four_score
- Price: $0.005/call
- Payment: x402
- Status: unknown
- Last checked: 2026-09-15
- Activations on Zero: 0
- Tags: x402
- Canonical page: https://www.zero.xyz/c/four-score-calculator-wijdicks-2005-f0b2dec5
- Structured record (JSON): https://api.zero.xyz/v1/capabilities/cap_EdbtPmWHZkwRmdj9ZwpRl

Status and success rate cover calls made through Zero and Zero's own probes. Third-party monitors may report differently.

## How to call it through Zero

Zero handles the 402 payment challenge and records the run. With the Zero CLI installed (`npm i -g @zeroxyz/cli`):

```sh
zero fetch --capability four-score-calculator-wijdicks-2005-f0b2dec5
```

Example prompt: Calculate the FOUR score for my ICU patient: eye is 2 (opens to voice), motor is 3 (localizing), brainstem is 4 (pupil and corneal present), and respiration is 1 (breathes above ventilator).

## When to prefer this

Use when you have already clinically assessed and assigned the four FOUR score components per Wijdicks 2005 criteria and need a reliable, auditable sum. Do not use to derive component scores from narrative text or to convert GCS to FOUR. Prefer this over manual arithmetic when embedding neurological scoring into an automated clinical workflow or documentation pipeline.

## Known failure modes

- Integer out of range (0-4) for any component returns an error
- Missing required query parameter (eye, motor, brainstem, or respiration) returns a validation error
- Non-integer values (e.g. decimals or strings) rejected
- Payment failure via x402 protocol returns 402

## How this service works

FOUR score (Wijdicks 2005) from caller-assigned eye, motor, brainstem, and respiration integers 0-4; magent sums only (max 16) and does not pick a component from a narrative. Eye 4 tracking/blink to command to 0 closed to pain; motor 4 thumbs-up/fist/peace to 0 none or myoclonus status; brainstem 4 pupil and corneal present to 0 pupil, corneal, and cough absent; respiration 4 not intubated regular to 0 ventilator rate or apnea. Not a diagnosis and not a GCS conversion.

## Output

Returns the summed FOUR score integer (0–16) derived from the four caller-supplied component scores (eye + motor + brainstem + respiration). Does not interpret clinical meaning, suggest a diagnosis, or convert to or from GCS.

## Request schema (JSON Schema)

```json
{
 "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": [
      "eye",
      "motor",
      "brainstem",
      "respiration"
     ],
     "properties": {
      "eye": {
       "type": "integer",
       "description": "Caller-assigned Wijdicks 2005 eye points (integer 0-4). magent does not pick the component from a narrative. 4 tracking or blink to command; 3 open not tracking; 2 open to voice; 1 open to pain; 0 closed to pain."
      },
      "motor": {
       "type": "integer",
       "description": "Caller-assigned Wijdicks 2005 motor points (integer 0-4). magent does not pick the component from a narrative. 4 thumbs-up, fist, or peace to command; 3 localizing; 2 flexion; 1 extension; 0 none or myoclonus status."
      },
      "brainstem": {
       "type": "integer",
       "description": "Caller-assigned Wijdicks 2005 brainstem points (integer 0-4). magent does not pick the component from a narrative. 4 pupil and corneal present; 3 one pupil wide and fixed; 2 pupil or corneal absent; 1 pupil and corneal absent; 0 pupil, corneal, and cough absent."
      },
      "respiration": {
       "type": "integer",
       "description": "Caller-assigned Wijdicks 2005 respiration points (integer 0-4). magent does not pick the component from a narrative. 4 not intubated regular; 3 Cheyne-Stokes; 2 irregular; 1 breathes above ventilator; 0 ventilator rate or apnea."
      }
     }
    }
   },
   "additionalProperties": false
  },
  "output": {
   "type": "object",
   "required": [
    "type"
   ],
   "properties": {
    "type": {
     "type": "string"
    },
    "example": {
     "type": "object"
    }
   }
  }
 }
}
```

## Response schema (JSON Schema)

```json
{
 "type": "json",
 "example": {
  "path": "/api/calc/four_score",
  "count": 2,
  "items": [
   {
    "score": 16,
    "formula": "four_score",
    "citation": {
     "id": "wijdicks-2005",
     "doi": "10.1002/ana.20611",
     "pmid": "16178024",
     "title": "Validation of a new coma scale: The FOUR score",
     "source": "Ann Neurol. 2005;58(4):585-593",
     "authors": "Wijdicks EFM, Bamlet WR, Maramattom BV, Manno EM, McClelland RL"
    },
    "max_score": 16,
    "components": [
     {
      "value": 4,
      "factor": "eye",
      "points": 4,
      "present": true
     },
     {
      "value": 4,
      "factor": "motor",
      "points": 4,
      "present": true
     },
     {
      "value": 4,
      "factor": "brainstem",
      "points": 4,
      "present": true
     },
     {
      "value": 4,
      "factor": "respiration",
      "points": 4,
      "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.",
    "formula_expression": "FOUR = eye + motor + brainstem + respiration; each caller-assigned integer 0-4; max 16"
   },
   {
    "score": 16,
    "formula": "four_score",
    "citation": {
     "id": "wijdicks-2005",
     "doi": "10.1002/ana.20611",
     "pmid": "16178024",
     "title": "Validation of a new coma scale: The FOUR score",
     "source": "Ann Neurol. 2005;58(4):585-593",
     "authors": "Wijdicks EFM, Bamlet WR, Maramattom BV, Manno EM, McClelland RL"
    },
    "max_score": 16,
    "components": [
     {
      "value": 4,
      "factor": "eye",
      "points": 4,
      "present": true
     },
     {
      "value": 4,
      "factor": "motor",
      "points": 4,
      "present": true
     },
     {
      "value": 4,
      "factor": "brainstem",
      "points": 4,
      "present": true
     },
     {
      "value": 4,
      "factor": "respiration",
      "points": 4,
      "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.",
    "formula_expression": "FOUR = eye + motor + brainstem + respiration; each caller-assigned integer 0-4; max 16"
   }
  ]
 }
}
```

## More

- Live health (JSON, refreshed every minute): https://www.zero.xyz/c/four-score-calculator-wijdicks-2005-f0b2dec5/health.json
- [Zero catalog index](https://www.zero.xyz/llms.txt)
- [Other services from api.magentlab.com](https://www.zero.xyz/host/api.magentlab.com/llms.txt)