Genesys Office of Research Page 1 7/2/2014

Latihan Analisis EBD :

Steps in Conducting a Critical Appraisal of a Research Article
1. Determine the type of article you have accoring to its stuy esign. !f you
are not sure" see the Director of Research for help #Office of Research"
$uite 2442" Phone %0%&7722'
2. Rea the corresponing Guielines for the type of article you have.
(. Print off an fill out the corresponing )or*sheet for that type of article.
Worksheet for Using an Article about Prognosis
ARE !E RESULS "# !E SUD$ %AL&D'
1 1. +as there a representative an )ell&efine sample of patients at a similar
2 point in the course of the isease,
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1 4 !nclusion an e5clusion criteria,
2 4 $election 6iases,
( 4 $tage of isease,
1 2. +as follo)&up sufficiently long an complete,
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1 4 Reasons for incomplete follo)&up,
2 4 Prognostic factors similar for patients lost& an not lost&to&follo)&up,
1 (. +ere o67ective an un6iase outcome criteria use,
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1 4 Outcomes efine at start of stuy,
2 4 !nvestigaotors 26lin to prognostic factors,
1
2 4. +as there a7ustment for important prognostic factors,
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1 8. Overall" are the results of the stuy vali,
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W!A WERE !E RESULS'
1 1. 9o) large is the li*elihoo of the outcome event#s' in a specifie perio of
2 time,
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1 4 $urvival curves,
1 2. 9o) precise )as the estimate of the treatment effect,
1 4 1onfience intervals,
Worksheet for Using an Article About herap( or Pre)ention
ARE !E RESULS "# !E SUD$ %AL&D'
1 1. +as the assignment of patients to treatment ranomi:e,
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1 2. +ere all patients )ho entere the trial properly accounte for an attri6ute at
its conclusion,
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1 4 )as follo)&up complete,
2 4 )ere patients analy:e in the groups to )hich they )ere ranomi:e
#intention to treat analysis',
1 (. +ere patients" their clinicians" an stuy personnel 26lin2 to treatment,
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1 4. +ere the groups similar at the start of the trial,
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1 4 ;aseline prognostic factors #emographics" co&moritity" isease severity"
other *no)n confouners' 6alance,
2 4 !f ifferent" )ere these a7uste for,
1
2 8. <sie from the e5perimental intervention" )ere the groups treate e=ually,
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1 4 1o&intervention,
Genesys Office of Research Page ( 7/2/2014
2 4 1ontamination,
( 4 1ompliance,
W!A WERE !E RESULS'
1 1. 9o) large )as the treatment effect,
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1 4 <6solute ris* reuction,
2 4 Relative ris* reuction,
1 2. 9o) precise )as the estimate of the treatment effect,
1 4 1onfience intervals,
W&LL !E RESULS !ELP *E &+ CAR&+, #"R *$ PA&E+S'
1 1. 1an the results 6e applie to my patient care,
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1 4 Patients similar for emographics" severity" co&mor6iity an other prognostic
factors,
2 4 1ompelling reason )hy the results shoul not 6e applie,
1 2. +ere all clinically important outcomes consiere,
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1 4 <re su6stitute enpoints vali,
1 (. <re the li*ely treatment 6enefits )orth the potential harms an costs,
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1 4 003 for ifferent outcomes,
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Worksheet for Using an Article About
Assessing Diagnostic ests
ARE !E RESULS "# !E SUD$ %AL&D'
1 1. +as there an inepenent" 6lin comparison )ith a reference stanar,
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1 4 !s reference stanar use accepta6le,
2 4 +ere 6oth reference stanar an test applie to all patients,
1 2. Di the patient sample inclue an appropriate spectrum of patients to )hom the
2 iagnostic test )ill 6e applie in clinical practice,
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1 (. Di the results of the test 6eing evaluate influence the ecision to perform the
2 reference stanar,
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1 4 >?erification> or >)or*&up> 6ias,
1 4. +ere the methos for performing the test escri6e in sufficient etail to
2 permit replication,
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1 4 Preparation of patient,
2 4 Performance of test,
1 4 <nalysis an interpretation of results,
1 8. Overall" are the results of the stuy vali,
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W!A WERE !E RESULS'
1 1. <re li*elihoo ratios for the test results presente or ata necessary for their
2 calculation provie,
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1 4 9o) 6ig or small is this @R,
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W&LL !E RESULS !ELP *E &+ CAR&+, #"R *$ PA&E+S'
1 1. +ill the reprouci6ility of the test result an its interpretation 6e satisfactory in
2 my setting,
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1
2
( 2. <re the results applica6le to my patient,
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1 4 $imilar istri6ution of isease severity,
2 4 $imilar istri6ution of competing iseases,
1 4 1ompelling reasons )hy the results shoul not 6e applie,
1 (. +ill the results change my management,
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1 4 3est an treatment threshols,
1 4 9igh or lo) @R2s,
1 4. +ill patients 6e 6etter off as a result of the test,
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1 4 !s target isorer angerous if left uniagnose,
1 4 !s test ris* accepta6le,
1 4 Does effective treatment e5ist,
1 4 !nformation from test )ill lea to change of Aanagement 6eneficial to patient,
Genesys Office of Research Page % 7/2/2014
W&LL !E RESULS !ELP *E &+ CAR&+, #"R *$ PA&E+S'
1 1. +ere the stuy patients similar to my o)n,
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1 4 Patients similar for emographics" severity" co&mor6iity an other prognostic
factors,
2 4 1ompelling reason )hy the results shoul not 6e applie,
1 2. +ill the results lea irectly to selecting or avoiing therapy,
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1 (. <re the results useful for reassuring or counselling patients,
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Worksheet for Using an Article About Causation of !ar-
ARE !E RESULS "# !E SUD$ %AL&D'
1 1. +ere there clearly ientifie comparison groups that )ere similar )ith respect
to important eterminants of outcome" other than the one of interest,
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1 4 R13" cohort" case&control,
2 4 Other *no)n prognosis factors similar or a7uste for,
1 2. +ere the outcomes an e5posures measure in the same )ay in the groups
6eing compare,
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1 4 Recall 6ias, !ntervie)er 6ias,
2 4 B5posure opportunity similar,
1 (. +as follo)&up sufficiently long an complete,
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1 4 Reasons for incomplete follo)&up,
2 4 Ris* factors similar in those lost an not lost to follo)&up,
1
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2 4. !s the temporal relationship correct,
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1 4 B5posure precee outcome,
1 8. !s there a ose&response graient,
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1 4 Ris* of outcome increases )ith =uantity or uration of e5posure,
W!A WERE !E RESULS'
1 1. 9o) strong is the association 6et)een e5posure an outcome,
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1 4 RR2s or OR2s,
1
2 2. 9o) precise is the estimate of ris*,
1 4 1onfience intervals,
W&LL !E RESULS !ELP *E &+ CAR&+, #"R *$ PA&E+S'
1 1. <re the results applica6le to my practice,
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1 4 Patients similar for emographics" mor6iity an other prognostic factors,
2 4 <re treatments an e5posures similar,
1 2. +hat is the magnitue of the ris*,
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1 4 <6solute ris* increase #an its reciprocal',
1 (. $houl ! attempt to stop the e5posure,
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1 4 $trength of evience,
2 4 Aagnitue of ris*,
( 4 <verse effects of reucing e5posure,