 

Remarks about the principles of calculating and how to use the PROCAM option in this CHD / CVD riskcalculator.
1.) In the PROCAM calculation option you are computing with the PROCAMalgorithm for men statistically based on the Cox proportional hazards model in the PROCAM cohort with 325 ACE (fatal and non fatal) in 4818 men aged 3565 years within 10 years. As typical for Coxalgorithms, you reach always a 100 % 10 year risk, if you compute with "full power" (meaning all risk factors as high as possible).
2.) In the PROCAM output field you receive as result the original, regional non adapted PROCAM posttest probability (P %) using the algorithm for men, if sex selection is male. If sex selection is female (premonopausal or menopausal) you get strictly a P % of men corrected by a reduction factor of 0.25 (if there is no Diabetes), according the recommendation of PROCAM.
3.) In the MONICA output field you receive a P % result epidemiological corrected by regional adjustment factors for men or women described in the procam pocket guide. You may define these factors (MRAF's) either by selection out of the regionlist or by manual input in the fields MONICA PV for men / women. On purpose not to falsify the original Bayes kernel (likelihoodratio, LR) of the PROCAMalgorithm for men, in this calculator MRAF's are used to correct the pretestprobability (prevalence, PV) and not to correct directly the posttestprobability as recommended in the Procampocketguide. Finaly the calculation of the posttestprobability is fulfilled in two steps: first by computing the specific LR out of the algorithm for men (using the PROCAM PV 325/4818), second by using this LR upon the MRAFcorrected PROCAM PV in a FAGANcalculation (computed in hazard odds).
In the MONICA output field you receive a regional adjusted posttest10 year probability P % according the chosen MRAF's described above, either using MRAF for men if sex selection is "male" or using MRAF for women if sex selection is "women postmenopausal". Warning: by using sex selection "women premenopausal", you may perhaps receive an overcorrected result based on an overcorrected PROCAMPV, namely 0.25 * MRAF for women * PROCAMPV for men.
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Dr. med. Franz Paul AckermannBall
Spezialarzt FMH für Innere Medizin
Ziegelfeldstr. 30 , CH4600 OLTEN
TN +41 (0)62 212 15 77
Dez 12^{th} 2004
Last revision May 26^{th} 2006
MONICAPROCAM3_RA1.html , Version 2.1 (JavaScript.js integriert)
Special Edition Dr. med. M. Romanens FMH Kardiologie , Olten
.F.A.
 
