# M4

> Use when working with the following block is the public reference SQL used to construct the

- Skill: `tomevault-io/m4` (Agent Skill, multi-file: 2 files)
- Install (CLI): `npx skillmds@latest add tomevault-io/m4`
- Raw SKILL.md: https://api.skillmd.com/api/skills/tomevault-io/m4/raw
- Safety review: pending (external: skill-scanner PASS, skillspector PASS)
- Works with: Claude Code, Claude.ai, OpenAI Codex
- Category: Data & Analytics
- Author: tomevault-io (https://skillmd.com/u/tomevault-io)
- Updated: 2026-09-17
- Page: https://skillmd.com/skills/tomevault-io/m4

---

# Reference SQL (matched-content control)

The following block is the public reference SQL used to construct the
ground truth for this task. It is provided verbatim, without procedural
prose, to test whether matched task-relevant content alone explains the
WITH-SKILL gain.

```sql
-- ------------------------------------------------------------------
-- Title: Norepinephrine-Equivalent Vasopressor Dose
-- Calculates a normalized vasopressor dose combining 5 agents using
-- standard equivalence factors. Enables comparison across different
-- vasopressor types.
-- ------------------------------------------------------------------

-- Reference:
--    Goradia S et al. "Vasopressor dose equivalence: A scoping review
--    and suggested formula." J Crit Care. 2020;61:233-240.

-- Adapted from mimic-code norepinephrine_equivalent_dose.sql
-- DEVIATION from mimic-code: vasoactive_agent can contain duplicate rows for
-- the same stay/start/end interval. The benchmark key is interval-level, so
-- duplicates are collapsed with MAX dose to provide one deterministic target
-- row per interval.

SELECT
  stay_id,
  starttime,
  endtime,
  MAX(ROUND(
    TRY_CAST(COALESCE(norepinephrine, 0) + COALESCE(epinephrine, 0) + COALESCE(phenylephrine / 10, 0) + COALESCE(dopamine / 100, 0) + COALESCE(vasopressin * 2.5 / 60, 0) AS DECIMAL),
    4
  )) AS norepinephrine_equivalent_dose
FROM mimiciv_derived.vasoactive_agent
WHERE
  NOT norepinephrine IS NULL
  OR NOT epinephrine IS NULL
  OR NOT phenylephrine IS NULL
  OR NOT dopamine IS NULL
  OR NOT vasopressin IS NULL
GROUP BY stay_id, starttime, endtime
```

---
> Source: [hannesill/m4](https://github.com/hannesill/m4) — distributed by [TomeVault](https://tomevault.io).
<!-- tomevault:4.0:skill_md:2026-06-27 -->