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    Critical Appraisal: Artikel Diagnostik

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    nugrahawindy
    1) The document discusses the process of critically appraising research evidence before using it to inform clinical decisions. It involves systematically examining the validity, results, and relevance of evidence. 2) It provides an overview of quantitative research methods, including observational and experimental study designs. The ideal study design for evaluating a diagnostic test is described as a cross-sectional study. 3) Users of diagnostic research are advised to consider whether the study results are valid based on aspects like independent blinding and inclusion of an appropriate patient sample, as well as how well the test is described. Likelihood ratios provide more useful information than sensitivity and specificity alone.

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    Critical Appraisal: Artikel Diagnostik

    Uploaded by

    nugrahawindy
    17 views38 pages
    1) The document discusses the process of critically appraising research evidence before using it to inform clinical decisions. It involves systematically examining the validity, results, and relevance of evidence. 2) It provides an overview of quantitative research methods, including observational and experimental study designs. The ideal study design for evaluating a diagnostic test is described as a cross-sectional study. 3) Users of diagnostic research are advised to consider whether the study results are valid based on aspects like independent blinding and inclusion of an appropriate patient sample, as well as how well the test is described. Likelihood ratios provide more useful information than sensitivity and specificity alone.

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    Diagnostic (2)

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    1) The document discusses the process of critically appraising research evidence before using it to inform clinical decisions. It involves systematically examining the validity, results, and relevance of evidence. 2) It provides an overview of quantitative research methods, including observational and experimental study designs. The ideal study design for evaluating a diagnostic test is described as a cross-sectional study. 3) Users of diagnostic research are advised to consider whether the study results are valid based on aspects like independent blinding and inclusion of an appropriate patient sample, as well as how well the test is described. Likelihood ratios provide more useful information than sensitivity and specificity alone.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    17 views38 pages

    Critical Appraisal: Artikel Diagnostik

    Uploaded by

    nugrahawindy
    1) The document discusses the process of critically appraising research evidence before using it to inform clinical decisions. It involves systematically examining the validity, results, and relevance of evidence. 2) It provides an overview of quantitative research methods, including observational and experimental study designs. The ideal study design for evaluating a diagnostic test is described as a cross-sectional study. 3) Users of diagnostic research are advised to consider whether the study results are valid based on aspects like independent blinding and inclusion of an appropriate patient sample, as well as how well the test is described. Likelihood ratios provide more useful information than sensitivity and specificity alone.

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    Critical Appraisal

    Artikel Diagnostik

    Fakultas Kedokteran Universitas YARSI

    Practicing EBM: Five Steps


    Step 1: convert need for information in to an answerable question Step 2: track down the best evidence with which to answer that question

    Step 3: critically appraise the evidence for its validity, impact and applicability
    Step 4: integrate the critical appraisal with our clinical expertise and patients unique circumstances Step 5: evaluate our effectiveness and efficiency in steps 1-4 and seeking ways to improve
    2

    Critical Appraisal
    is the process of systematically examining research evidence to assess its validity, results and relevance before using it to inform a decision.

    QUANTITATIVE RESEARCH METHOD


    OBSERVATIONAL EXPERIMENTAL

    Descriptive

    Analytic

    Pure

    Semi

    Exposures & outcomes are measured at the same time

    Outcome

    Exposure

    RCT
    Quasi experimental

    Cause
    Case report Case series Cross-sectional Case Control Study

    Disease
    Cohort Study

    Kohort
    Paparan

    prospektif

    Outcome

    Paparan

    retrospektif

    Kasus Kontrol
    Outcome

    Paparan

    Potong lintang
    Outcome
    Saat sekarang

    Article About Diagnostic

    Article About Diagnostic


    Ideal Study Design:
    Cross-sectional study
    Cross-sectional study A study that examines the relationship between disease (or other health-related characteristics) and other variables of interest as they exist in a defined population at a single point in time.

    Skenario
    Suatu Rumah Sakit Khusus Anak mewajibkan pemeriksaan urine untuk mendeteksi bakteriuria yang menunjukkan adanya ISK.

    Pemeriksaan dilakukan pada setiap pasien-anak yang datang ke UGD Rumah Sakit tersebut.
    Untuk menghemat biaya, perawat UGD tidak memeriksa urine pasien yang tampak jernih dalam botol tampung, karena berdasarkan pengalaman mereka hasilnya akan negatif.

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    Focusing Answerable Questions


    Population Intervention or Exposure Alternative Intervention or Exposure Outcomes

    Pasien anak dengan spesimen urine tampung midstream atau kateter

    Urine jernih pada pengamatan langsung

    Kultur urine negatif

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    Article About Diagnostic

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    Article About Diagnostic

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    Article About Diagnostic

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    Users' Guides for an Article About Diagnostic


    I. Are the results of the study valid?

    II. What were the results?


    III. Will the results help me in caring for my patients?
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    Users' Guides for an Article About diagnostic


    I. Are the results in the study valid?
    Primary Guides
    Was there an independent, blind comparison with a reference standard? Did the patient sample include an appropriate spectrum of patients to whom the diagnostic test will be applied in clinical practice?

    Secondary Guides
    Did the results of the test being evaluated influence the decision to perform the reference standard? Were the methods for performing the test described in sufficient detail to permit replication?
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    Users' Guides for an Article About Diagnostic


    I. Are the results in the study valid?
    Primary Guides
    Was there an independent, blind comparison with a reference standard?

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    Users' Guides for an Article About Diagnostic


    I. Are the results in the study valid?
    Primary Guides
    Did the patient sample include an appropriate spectrum of patients to whom the diagnostic test will be applied in clinical practice?

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    Users' Guides for an Article About Diagnostic


    I. Are the results in the study valid?
    Secondary Guides
    Were the methods for performing the test described in sufficient detail to permit replication?

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    Users' Guides for an Article About Diagnostic


    II. What are the results? Are likelihood ratios for the test results presented or data necessary for their calculation provided?

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    Users' Guides for an Article About Diagnostic


    Jangan hanya melihat: Sensitivitas, atau Spesifisitas
    Perhatikan nilai: Likelihood Ratio, Pre-test probabilty Post-test probability
    27

    Users' Guides for an Article About Diagnostic


    Sensitivitas Spesifisitas Likelihood ratio
    Sensitivitas Spesifisitas Likelihood ratio

    80% 20% 1
    35% 65% 1

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    Likelihood ratio
    >10 atau < 0,1, menghasilkan perubahan yg besar dari pre dan post test probability sering konklusif 5-10 dan 0.1-0.2, perubahan sedang 2-5 daan 0,5-0,2, perubahan kecil (kadangkadang penting) 1-2 dan 0,5-1, mengubah probability kecil sekali (dan jarang penting)
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    Users' Guides for an Article About Diagnostic


    III. Will the results help me in caring for my patients? Will the reproducibility of the test result and its interpretation be satisfactory in my setting?

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    Users' Guides for an Article About Diagnostic


    III. Will the results help me in caring for my patients? Are the results applicable to my patient?

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    Users' Guides for an Article About Diagnostic


    III. Will the results help me in caring for my patients? Will the results change my management?

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    Users' Guides for an Article About Diagnostic


    III. Will the results help me in caring for my patients? Will patients be better off as a result of the test?

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    Terima Kasih

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