Getting it into your agent
One page per mod, every tool's command on it. A separate URL per tool would split the same page into five that compete with each other.
npx skills add hannesill/m4 --skill meld-scoregit clone --depth 1 https://github.com/hannesill/m4Wrote this? Show the measurements
A badge with what this costs and how it scanned, read live from this page, so it follows the numbers instead of freezing them. Markdown for a README, HTML for a documentation site or a project page.
[](https://agentmods.dev/skills/hannesill/m4/meld-score)<a href="https://agentmods.dev/skills/hannesill/m4/meld-score"><img src="https://agentmods.dev/badge/skills/hannesill/m4/meld-score/github.svg" alt="Measured on agentmods" height="20"></a>Or the 80×15 button, for a site that already has a row of RSS and ATOM ones. Only the verdict fits; the numbers stay here.
<a href="https://agentmods.dev/skills/hannesill/m4/meld-score"><img src="https://agentmods.dev/badge/skills/hannesill/m4/meld-score.svg" alt="Reviewed on agentmods" width="80" height="20"></a>What it costs to keep this loaded
Counted locally with the o200k_base tokenizer, which is exact for GPT models; Claude uses its own tokenizer and its counts differ. Treat this as one consistent yardstick across the catalogue rather than a bill. Prices are per million input tokens.
| Model | Per session | Once invoked |
|---|---|---|
| Fable 5.1 | $0.00036 | $0.01119 |
| Opus 5 | $0.00018 | $0.00560 |
| Sonnet 5 | $0.00007 | $0.00224 |
| Haiku 4.5 | $0.00004 | $0.00112 |
Grade A, and why
meld-score scanned grade A with 0 findings against 26 rules in 11 categories — prompt injection, anti-refusal, data exfiltration, privilege escalation, supply chain, agent snooping, system-prompt leakage, SSRF and excessive agency — measured 9d ago.
A static scan of the body, not an audit. Every finding is printed with the line that produced it so you can judge whether it matters here. A mod is markdown that instructs an agent; that is exactly why what it instructs is worth reading.
Nothing flagged
None of the 26 patterns this scan looks for appear in this file: no shell pipes, no recursive deletes, no credential paths, no hidden text, no instruction-override or anti-refusal phrasing, no agent-config snooping. That is not a guarantee, it is the absence of the things that are checkable.
How it starts
The opening of the file, as written. The whole thing — 74 lines — stays where its author put it; the contents beside it link to each section on GitHub.
MELD Score Calculation
The Model for End-Stage Liver Disease (MELD) score predicts 3-month mortality in patients with liver disease. Originally developed for TIPS procedure prognostication, it is now the primary organ allocation criterion for liver transplantation in the US. The MELD-Na variant incorporates serum sodium for improved prediction.
M4Bench Use
In M4Bench, target concept tables listed in the task configuration are removed or unavailable in the agent database. Use this skill as procedural guidance and derive the requested output from available source or intermediate tables; do not rely on a precomputed target table or bundled SQL script.
When to Use This Skill
- Liver disease severity assessment
- Transplant prioritization research
- Hepatology outcome studies
- Cirrhosis prognosis evaluation
Score Components
MELD uses 4 laboratory values with logarithmic transformations:
| Component | Variable | Formula Weight | Floor | Ceiling |
|---|---|---|---|---|
| Creatinine | Serum creatinine (mg/dL) | 0.957 × ln(Cr) | 1.0 | 4.0 (or if RRT) |
| Bilirubin | Total bilirubin (mg/dL) | 0.378 × ln(Bili) | 1.0 | — |
| INR | International Normalized Ratio | 1.120 × ln(INR) + 0.643 | 1.0 | — |
| Sodium | Serum sodium (mEq/L) | 137 - Na | 125 | 137 |
Calculation Steps
-
Component scores (all values floored at 1.0 for logarithm):
- Creatinine:
0.957 × ln(max(Cr, 1))— capped at Cr=4 if RRT or Cr > 4 - Bilirubin:
0.378 × ln(max(Bili, 1)) - INR:
1.120 × ln(max(INR, 1)) + 0.643
- Creatinine:
-
MELD Initial:
round(Cr_score + Bili_score + INR_score, 1) × 10- Capped at 40 if sum > 4
-
Sodium adjustment (MELD-Na, only if MELD Initial > 11):
- Sodium score:
137 - max(min(Na, 137), 125) MELD = MELD_Initial + 1.32 × Na_score - 0.033 × MELD_Initial × Na_score- If MELD Initial ≤ 11: MELD = MELD Initial (no sodium adjustment)
- Sodium score:
Critical Implementation Notes
- Creatinine Cap: Patients on renal replacement therapy (RRT/dialysis) OR with creatinine > 4.0 are scored as creatinine = 4.0. This prevents extreme renal failure from dominating the score.
What this file has done since we first saw it
Hashed on every crawl. A supply-chain change to an agent config is a question of when, not whether, so the history is kept rather than the latest state alone.
- 9d ago First seen · 74 lines · 36 tokens per session scan A 2373c9aadb9c
meld-score is a skill published in the GitHub repository hannesill/m4 (43 stars, last pushed 1mo ago), licensed MIT. It adds 36 tokens to every session and 1,119 once invoked, about $0.0002 per session on Opus 5. A static security scan graded it A with 0 findings. No closer match exists in the catalogue, so it is treated as the original; first seen 2026-08-30.
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