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                          "description": "Caller-assigned Bush 1996 mutism (item 3; integer 0-3). magent does not examine the patient.",
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                      "factor": "verbigeration",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "rigidity",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "negativism",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "waxy_flexibility",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "withdrawal",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "impulsivity",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "automatic_obedience",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "mitgehen",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "gegenhalten",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "ambitendency",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "grasp_reflex",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "perseveration",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "combativeness",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "autonomic_abnormality",
                      "points": 0,
                      "present": true,
                      "value": 0
                    }
                  ],
                  "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": "bush_francis",
                  "formula_expression": "Bush-Francis CRS = excitement + immobility_stupor + mutism + staring + posturing_catalepsy + grimacing + echopraxia_echolalia + stereotypy + mannerisms + verbigeration + rigidity + negativism + waxy_flexibility + withdrawal + impulsivity + automatic_obedience + mitgehen + gegenhalten + ambitendency + grasp_reflex + perseveration + combativeness + autonomic_abnormality; Bush 1996 23-item catatonia rating scale; items 1-16 and 22-23 integers 0-3; items 17-21 (mitgehen, gegenhalten, ambitendency, grasp_reflex, perseveration) 0 or 3 only; severity score = sum of items 1-23; screening instrument = first 14 items; screen_positive iff count of items 1-14 with score > 0 is >= 2; max 69; not a diagnosis",
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                  "score": 2,
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                    "authors": "Bush G, Fink M, Petrides G, Dowling F, Francis A",
                    "doi": "10.1111/j.1600-0447.1996.tb09814.x",
                    "id": "bush-1996",
                    "pmid": "8686483",
                    "source": "Acta Psychiatr Scand. 1996;93(2):129-136",
                    "title": "Catatonia. I. Rating scale and standardized examination"
                  },
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                      "points": 1,
                      "present": true,
                      "value": 1
                    },
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                    },
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                      "factor": "rigidity",
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                      "present": true,
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                    },
                    {
                      "factor": "negativism",
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                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "waxy_flexibility",
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                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "withdrawal",
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                      "present": true,
                      "value": 0
                    },
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                      "factor": "impulsivity",
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                      "present": true,
                      "value": 0
                    },
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                      "factor": "automatic_obedience",
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                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "mitgehen",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "gegenhalten",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "ambitendency",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "grasp_reflex",
                      "points": 0,
                      "present": true,
                      "value": 0
                    },
                    {
                      "factor": "perseveration",
                      "points": 0,
                      "present": true,
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                    },
                    {
                      "factor": "autonomic_abnormality",
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                    }
                  ],
                  "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": "bush_francis",
                  "formula_expression": "Bush-Francis CRS = excitement + immobility_stupor + mutism + staring + posturing_catalepsy + grimacing + echopraxia_echolalia + stereotypy + mannerisms + verbigeration + rigidity + negativism + waxy_flexibility + withdrawal + impulsivity + automatic_obedience + mitgehen + gegenhalten + ambitendency + grasp_reflex + perseveration + combativeness + autonomic_abnormality; Bush 1996 23-item catatonia rating scale; items 1-16 and 22-23 integers 0-3; items 17-21 (mitgehen, gegenhalten, ambitendency, grasp_reflex, perseveration) 0 or 3 only; severity score = sum of items 1-23; screening instrument = first 14 items; screen_positive iff count of items 1-14 with score > 0 is >= 2; max 69; not a diagnosis",
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                  "score": 2,
                  "screen_positive": true,
                  "screen_signs_met": 2
                }
              ],
              "path": "/api/calc/bush_francis"
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                            "description": "Caller-assigned Bush 1996 ambitendency (item 19; 0 absent or 3 present only). magent does not examine the patient.",
                            "enum": [
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                              3
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                          "automatic_obedience": {
                            "description": "Caller-assigned Bush 1996 automatic obedience (item 16; integer 0-3). magent does not examine the patient.",
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                              1,
                              2,
                              3
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                            "description": "Caller-assigned Bush 1996 autonomic abnormality (item 23; integer 0-3). magent does not examine the patient.",
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                              1,
                              2,
                              3
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                            "description": "Caller-assigned Bush 1996 combativeness (item 22; integer 0-3). magent does not examine the patient.",
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                              1,
                              2,
                              3
                            ],
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                            "description": "Caller-assigned Bush 1996 echopraxia/echolalia (item 7; integer 0-3). magent does not examine the patient.",
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                              1,
                              2,
                              3
                            ],
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                            "description": "Caller-assigned Bush 1996 excitement (item 1; integer 0-3). magent does not examine the patient.",
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                              1,
                              2,
                              3
                            ],
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                            "description": "Caller-assigned Bush 1996 gegenhalten (item 18; 0 absent or 3 present only). magent does not examine the patient.",
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                              3
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                            "description": "Caller-assigned Bush 1996 grasp reflex (item 20; 0 absent or 3 present only). magent does not examine the patient.",
                            "enum": [
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                              3
                            ],
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                          },
                          "grimacing": {
                            "description": "Caller-assigned Bush 1996 grimacing (item 6; integer 0-3). magent does not examine the patient.",
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                              0,
                              1,
                              2,
                              3
                            ],
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                            "description": "Caller-assigned Bush 1996 immobility/stupor (item 2; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "impulsivity": {
                            "description": "Caller-assigned Bush 1996 impulsivity (item 15; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "mannerisms": {
                            "description": "Caller-assigned Bush 1996 mannerisms (item 9; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "mitgehen": {
                            "description": "Caller-assigned Bush 1996 mitgehen (item 17; 0 absent or 3 present only). magent does not examine the patient.",
                            "enum": [
                              0,
                              3
                            ],
                            "type": "integer"
                          },
                          "mutism": {
                            "description": "Caller-assigned Bush 1996 mutism (item 3; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "negativism": {
                            "description": "Caller-assigned Bush 1996 negativism (item 12; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "perseveration": {
                            "description": "Caller-assigned Bush 1996 perseveration (item 21; 0 absent or 3 present only). magent does not examine the patient.",
                            "enum": [
                              0,
                              3
                            ],
                            "type": "integer"
                          },
                          "posturing_catalepsy": {
                            "description": "Caller-assigned Bush 1996 posturing/catalepsy (item 5; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "rigidity": {
                            "description": "Caller-assigned Bush 1996 rigidity (item 11; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "staring": {
                            "description": "Caller-assigned Bush 1996 staring (item 4; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "stereotypy": {
                            "description": "Caller-assigned Bush 1996 stereotypy (item 8; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "verbigeration": {
                            "description": "Caller-assigned Bush 1996 verbigeration (item 10; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "waxy_flexibility": {
                            "description": "Caller-assigned Bush 1996 waxy flexibility (item 13; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
                          },
                          "withdrawal": {
                            "description": "Caller-assigned Bush 1996 withdrawal (item 14; integer 0-3). magent does not examine the patient.",
                            "enum": [
                              0,
                              1,
                              2,
                              3
                            ],
                            "type": "integer"
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                          "impulsivity",
                          "automatic_obedience",
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                          "gegenhalten",
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                  "const": "POST",
                  "type": "string"
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                  "const": "http",
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              },
              "required": [
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              "type": "object"
            },
            "output": {
              "properties": {
                "example": {
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              "type": "object"
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          "required": [
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    "submitted_at": "2026-10-14T01:15:01.050Z"
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