CRITICAL APPRAISAL

Septantri Handayani 13711133

 Kasus 4: ODHA yang dikucilkan
Seorang pasien AIDS dalam keadaan kritis
diantar oleh 2 orang warga ke Puskemas
Sanden. Setelah diterima oleh petugas
TI
kesehatan, warga meninggalkan pasien tersebut
tanpa ada seorang pun yang menunggui,
sehingga dokter Wenny harus mengurusnya
sampai ke rumah sakit. Selama ini, pasien
tersebut memang dikucilkan oleh warga karena
dianggap memiliki penyakit menular berbahaya
yang disebabkan karena memiliki perilaku yang
buruk. Istri dari pasien sudah lama
meninggalkannya karena tidak tahan dengan
gunjingan warga.
 Rumusan PICO
Question Part Question Term
Patient HIV, AIDS
Intervention TI
Support, Family Support, Social
Support
Comparison No Support
Outcome Quality of Life
 Judul Jurnal
Searching keywords : HIV patients AND Support
AND Quality Of Life

TI
 A. Are the results of the trial valid?
1. Did the trial address a clearly
focused issue?
Consider: An issue can be
‘focused’ in terms of TI
• The population studied
• The intervention given
• The comparator given
• The outcomes considered
 A. Are the results of the trial valid?
2. Was the assignment of patients to treatments
randomised?
Consider:
• How was this carried out, some methods may produce
broken allocation concealment
TI
• Was the allocation concealed from researchers?
 A. Are the results of the trial valid?
3. Were patients, health workers and study personnel
blinded?
Consider:
• Health workers could be; clinicians, nurses etc
TI
• Study personnel – especially outcome assessors
 A. Are the results of the trial valid?
4. Were the groups similar at the start of the trial?
Consider: Look at
• Other factors that might affect the outcome such as
age, sex, social class, these may be called baseline
characteristics TI
 A. Are the results of the trial valid?
5. Aside from the experimental intervention, were the
groups treated equally?

TI
 A. Are the results of the trial valid?
6. Were all of the patients who entered the trial properly accounted
for at its conclusion?
Consider:
• Was the trial stopped early?
• Were patients analysed in the groups to which they were
randomised? TI
 B. What are the results?

7. How large was the treatment effect?

• What outcomes were measured?
• Is the primary outcome clearly specified?
TI
• What results were found for each outcome?
• Is there evidence of selective reporting of outcomes?
8. How precise was the estimate of the treatment effect?
Consider:
• What are the confidence limits?
• Were they statistically significant?
TI
 C. Will the results help locally?
9. Can the results be applied in your context? (or to the local
population?)
Consider:
TI
• Do you have reason to believe that your population of interest is
different to that in the trial
• If so, in what way?
 C. Will the results help locally?
10. Were all clinically important outcomes considered?
Consider:
• Is there other information you would like to have seen?
TI
• Was the need for this trial clearly described?
 C. Will the results help locally?
11. Are the benefit worth the harms and costs?
Consider:
Even if this not addressed by the trial, what do you think?
TI