Our cardiovascular risk calculator is now available for download (german version)
Principle features
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- calculates vascular (biological) age of your patient based on TPA
- risk calculations for Framingham Cox Proportional Hazards Model
- soft coronary events (Framingham 2008)
- hard coronary heart disease (CHD)
- stroke
- simulations of possible risk reduction for smoking cessation, blood pressure, diabetes, lipids
- calibration factors for different populations
- incorporation of total plaque area (TPA) carotid posttest risk calculations by default (average TPA by age and sex)
- posttest risk calculator of measured TPA
- direct comparison of the results in your patient for FRAMINGHAM, REYNOLDS, SCORE
- PROCAM and AGLA2014 are NOT available, because the algorithm is kept secret and has a low diagnostic accuracy (data on file)
- convenient generation of a report for your patient with one click to the printer of your choice
- possibility to enter up to 500 patients
- Feed back: the calculator is made freely available and we would be happy to receive your recommendations for further improvement
Improvement for the 2016 calculator
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- JAN 2015: new formula for ESC with HDL for men and women for low risk countries (Ref: O. Descamps, et al. Atheroslerosis, 2012, 222. 2 (564-566) A simple multiplier to calculate the impact of HDL cholesterol on cardiovascular risk estimation using SCORE, Table 1)
- NOV 2015: upgraded to 500 entries and removed obsolete risk calculators, which are no longer in use in order to reduce the size of this file
- DEC 2015: update ESC HDL calculation and smoothed out the SENS&SPEC formulas in order to improve posttest calculations (See graph: new and old posttest probabilities with smoothed SENS/SPEC)
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- F-SENS ” = – 0.268*LN(TPA) + 1.1551 “
- F-SPEC ” = 0.144*LN(TPA) + 0.4142 “
- M-SENS ” = – 0.222*LN(TPA) + 1.0187 “
- M-SPEC ” = 0.1652*LN(TPA) + 0.2931 “
- JAN 2016:
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- As you can see from the graph, if we keep pretest constant and use Tromso TPA to calculate posttest risk, with higher TPA values posttest risk may decrease (red squares). This has to do with the non uniform occurence of events in the Tromso cohort.
- By applying a smooth function as outlined above, we get a smoothed posttest risk (blue squares).
- In order to validate the smoothed SENS&SPEC, we performed an internal and external validation for the Tromso and the London Cohort. All calculations and results are available online.
- Internal validation using ROC Curves
- Women:
- original SENS&SPEC: 0.713
- smoothed SENS&SPEC: 0.717 (p NS)
- Men
- original SENS&SPEC: 0.618
- smoothed SENS&SPEC: 0.632 (p NS)
- External validation using ROC curves:
- London Cohort
- original SENS&SPEC: 0.743
- smoothed SENS&SPEC: 0.753 (p NS)
- Summary: smoothed SENS&SPEC produce better posttest risk calculations with some minor improvements (p NS) in ROC analysis. However, at the individual level, the counterintuitive reduction of risk with higher TPA values could be eliminated completely.
Future directions:
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- webbased program
- android app calculator
- youtube demonstration on how to operate the calculator
- youtube demonstration on how to acquire TPA images
Download
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