Estimation of contribution of changes in coronary care to improving survival, event rates and coronary heart disease mortality across the WHO MONICA Project populations: appendix to a paper published in the Lancet
Markku Mähönen1, Hugh Tunstall-Pedoe2, Anna-Maija Rajakangas1, Zygimantas Cepaitis1, Kari Kuulasmaa1, Annette Dobson 3 and Ulrich Keil4 for the WHO MONICA Project5
1 Department of Epidemiology and Health Promotion (MONICA Data
Centre), National Public Health Institute, KTL, Helsinki, Finland
2Cardiovascular Epidemiology Unit, (MONICA Quality Control Centre for Event Registration), University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, U.K.
3 Department of Statistics, University of Newcastle, New South Wales, Australia
4Department of Epidemiology and Social Medicine, University of Münster, Münster, Germany
5 Annex: Sites and key personnel of the WHO MONICA Project
Correspondence to: email@example.com
The purpose of this paper is to document the details of the definitions of case fatality that were used in WHO MONICA Project's publications on population versus clinical view of case fatality from acute coronary heart disease  and estimation of contribution of changes in coronary care to improving survival, event rates and coronary heart disease mortality .
The terms SURVIV (survival status), DIACAT (diagnostic category), DONSET (date of onset), DBIRTH (date of birth), PREMI (previous histoty of myogardial infarction), MANAGE (management) and ESTST (estimated survival time) are names of MONICA data items, and have been defined in the Core data transfer format - coronary events in the MONICA Manual .
Case fatality in age group 35-64 years was standardized for age using weights 1, 3 and 7 for the 10-year age groups 35-44 years, 45-54 years and 55-64 years respectively. The weights 1, 3 and 7 are approximately proportional to the numbers of coronary events in the 10-year age groups in the MONICA populations.
95% confidence intervals were calculated in the conventional manner using the normal approximation of binomial distribution.
The MONICA Centres are funded predominantly by regional and national governments, research councils, and research charities. Coordination is the responsibility of the World Health Organization (WHO), assisted by local fund raising for congresses and workshops. WHO also supports the MONICA Data Centre (MDC) in Helsinki. Not covered by this general description is the ongoing generous support of the MDC by the National Public Health Institute of Finland, and a contribution to WHO from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA for support of the MDC and the Quality Control Centre for Event Registration in Dundee. The completion of the MONICA Project is generously assisted through a Concerted Action Grant from the European Community. Likewise appreciated are grants from ASTRA Hässle AB, Sweden, Hoechst AG, Germany, Hoffmann-La Roche AG, Switzerland, the Institut de Recherches Internationales Servier (IRIS), France, and Merck & Co. Inc., New Jersey, USA, to support data analysis and preparation of publications.