Professional Documents
Culture Documents
OVERVIEW
& CRITICAL APRAISAL
1. CLINICAL EXPERTISE
2. BEST RESEARCH EVIDENCE
3. PATIENTS VALUES & EXPECTATION
UGM
How to practice EBM
See
a patient
Monitor Appraise
Implementation
the change the evidence
UGM
1. A. CLINICAL QUESTION
Background question
Foreground question
P I C O
PATIENT/
INTERVENTION COMPARISON OUTCOMES
PROBLEM
KLINIS
ICT TB
KP BAKU EMAS AKURASI Dx
Pasien dws UGM
1. B. CLINICAL QUESTION
Background question
Foreground question
P I C O
PATIENT/
INTERVENTION COMPARISON OUTCOMES
PROBLEM
BATUK
TERAPI TANPA LAMA SAKIT/
AKUT
ANTIBIOTIKA ANTIBIOTIKA KEPARAHAN
Pasien anak UGM
1. C. CLINICAL QUESTION
Background question
Foreground question
P I C O
PATIENT/
INTERVENTION COMPARISON OUTCOMES
PROBLEM
TERAPI
ASMA TANPA
STEROID MOON FACE
Pasien anak STEROID
JK PANJANG UGM
2. SEARCH "evidence"
UGM
Level of Evidence
Level Evidence
Ia Meta-analisis (RCT)
Ib RCT
Clinical study with comparison,
IIa without randomisation
IIb Quasi-experimental study
UGM
Derajat Evidence
Derajat Jenis Evidence
Ia
Ib
IIa
IIb
III
IV
UGM
Derajat Evidence
Derajat Jenis Evidence
Ia
Ib
UGM
CRITICAL APPRAISAL
USERSGUIDE http://www.cche.net
UGM
Pedoman
standar publikasi
Uji diagnosis
STARD CHECKLIST
UGM
Are the result of the study valid?
Petunjuk primer :
A
Standar referensi
Uji diagnostik pembandingan
(gold standard)
Independen
Dibutakan
UGM
KAJIAN KRITIS ARTIKEL DIAGNOSIS
UGM
KAJIAN KRITIS ARTIKEL DIAGNOSIS
UGM
KAJIAN KRITIS ARTIKEL DIAGNOSIS
UGM
KAJIAN KRITIS ARTIKEL DIAGNOSIS
UGM
KAJIAN KRITIS ARTIKEL DIAGNOSIS
APA HASILNYA?
Gold standard
N3 N4 N
UGM
SIGNIFICANT ?
CLINICAL OR STATISTICAL ?
DIAGNOSTIC
Sensitivity
Spesivicity p value ; CI
Predictive value
Likelihood ratio
UGM
DIAGNOSIS WORKSHEET
CITATION :
UGM
ABSTRACT
DIAGNOSTIC TEST
UGM
Are the result of the study valid?
A Independent
Blind
Reference standard
Diagnostic test comparison
(gold standard)
UGM
Independent & Blind ?
METHOD
UGM
Are the result of the study
valid?
YES, .
On page was described
UGM
Are the result of the study valid?
UGM
Are the result of the study
valid?
YES,
All patients with dengue symtomps & signs were
included
UGM
Are the result of the study
valid?
METHOD ?
UGM
Details of
methods
UGM
What were the result?
UGM
GOLD
Result? STANDARD
162
38
UGM
result?
162
38
UGM
UGM
ACUTE I DENGUE INF ?
ELISA
(+) (-)
(+) 10 14 24
Rapid Dengue
Test
PanBio (-) 41 135 176
51 149 200
UGM
ACUTE II DENGUE INF ?
ELISA
(+) (-)
(+) 25 31 56
Rapid Dengue
Test
PanBio (-) 19 125 144
44 156 200
UGM
Dx Performance ?
Acute I Inf. Acute II Inf.
UGM
KAJIAN KRITIS ARTIKEL DIAGNOSIS
UGM
Nomogram
UGM
KAJIAN KRITIS ARTIKEL DIAGNOSIS
Likelihood ratio
Test-treatment tresholds
Do not Do not
test
Test, & treat on test
the basis of the
tests results
Do not Get on with
treat treatment
UGM
TO BE CONTINUE
43
UGM