Three calculators to estimate the ten year risk of CHD and CVD with algorithms on risk factors originating from the SCORE project, FRAMINGHAM study and PROCAM study (PROCAM algorithm for men only) and regional adjustment factors of prevalence according to the MONICA project. A comparison of cardiovascular riskengines designed by Romanens and Ackermann , Dec 9th 2004 , version RA1. Primary Care Risk Calculator        SCORE   Algorithm Weibull (mortality) FRAMING Algorithm Weibull (events) PROCAM Algorithm Cox (events) Male  ;   Female Premenopause                                          Menopause Age (years) Total Cholesterol (mmol/l) HDL-C (mmol/l) LDL-C (mmol/l) TGL (mmol/l) BP systolic (mm Hg) Smoker ? no/yes no/yes no , yes Diabetes mellitus (FBG > 6.66 mmol/l) ? no/yes no , yes Premature CAD in family (1st°) ? no , yes LV-Hypertrophy by ECG ? no , yes Prevalence adjustment factor according to the selected MONICA region on the right Results 10 Yr Risk [%] of hard CHD (AMI) FRAMINGHAM,PROCAM: fatal & non-fatal SCORE: fatal only  LRP :  HRP: MONICA: PROCAM: SCORE: 10 Yr Risk [%] of fatal non-CHD CVD in LowRisk- & HigRisk-Populations  LRP :  HRP: SCORE: 10 Yr Risk [%] of fatal CVD in LowRisk- & HigRisk-Populations  LRP :  HRP:                                       Select Units you like to use mmol/l   mg/dl   For LDL-Calc use Formula 1. Select Region Australia Newcastle Australia Perth Belgium Charleroi Belgium Ghent Canada Halifax Country China Beijing Czech Republic Denmark Glostrup Finland Kuopio Province Finland North Karelia Finland Turku/Loimaa France Lille France Strasbourg France Toulouse Germany AUGSBURG Germany Bremen Germany East Germany Iceland Italy Area Brianza Italy Friuli Lithuania Kaunas New Zealand Auckland Poland Tarnobrzeg Voivodship Poland Warsaw Russia Moscow-Control Russia Moscow-Intervention Russia Novosibirsk-Control Russia Novosibirsk-Intervention Spain Catalonia Sweden Gotheburg Sweden Northern Sweden Switzerland Ticino Switzerland Vaud/Fribourg Switzerland AGLA 2003 UK Belfast UK Glasgow USA Stanford Yugoslavia Novi Sad data from PROCAM pocket guide 2. Press Button "region"       Regional adjustment factors for    MONICA PV men   MONICA PV women   Sources   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 PROCAM-algorithm 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 35-65 years within 10 years. As typical for Cox-algorithms, 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 PROCAM-algorithm for men, in this calculator MRAF's are used to correct the pretest-probability (prevalence, PV) and not to correct directly the posttest-probability as recommended in the Procam-pocket-guide. Finaly the calculation of the posttest-probability 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 MRAF-corrected PROCAM PV in a FAGAN-calculation (computed in hazard odds). In the MONICA output field you receive a regional adjusted posttest-10 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 PROCAM-PV, namely 0.25 * MRAF for women * PROCAM-PV for men. Zur korrekten Rechnerfunktion muss die Option JavaScript in Ihrem Browser aktiviert sein FREEWARE für Interessierte zu deren freien Verfügung. Dieses Programm unterliegt KEINEM COPYRIGHT Dr. med. Franz Paul Ackermann-Ball Spezialarzt FMH für Innere Medizin Ziegelfeldstr. 30 , CH-4600 OLTEN TN +41 (0)62 212 15 77 Dez 12th 2004 Last revision May 26th 2006 MONICA-PROCAM3_RA1.html , Version 2.1 (Java-Script.js integriert) Special Edition Dr. med. M. Romanens FMH Kardiologie , Olten .F.A.