Jayanti Ayu Kusumastuti 11/317188/KU/14449

Practicing and teaching evidence-based health care in other clinical specialties 4. appendix: Critical appraisal worksheets DIAGNOSIS WORKSHEET Citation : Portable Exhaled Nitric Oxide Measurement* : Comparison with the Gold Standard Technique Daniel Menzies, Arun Nair and Brian J. Lipworth http://chestjournal.chestpubs.org/content/131/2/410.full.html

Are the results of this diagnostic study valid? Was there an independent, blind comparison with a reference (gold) standard of diagnosis? Yes. The data collected by some researchers who were blinded. But the data analysis was carried out in an unblinded fashion.

Was the diagnostic test evaluated in an appropriate spectrum of patients (like those in whom it would be used in the practice)?

Yes. The journal wasnt mention the exact age of the patient. It only showed the mean of age. The mean of asthmatic patients age is 48,5 y.o while the mean of healthy volunteers age is 35,6 y.o.

Was the reference standard applied regardless of the diagnostic test result?

Yes. This journal didnt say it explicitly, but I can say Yes from these points: To discriminate asthmatic and non asthmatic patient, we usually use the basic spirometry. In this journal, they used other diagnostic tool which wasnt similar to the basic spirometry to asthmatic and healthy patients. And the researchers were blinded, so the reference standard is applied regardless of the diagnostic test result.

Was the test (or cluster of test) validated in a second, independent group of patient?

No.

MY CALCULATION Target disorder (gold standard) present Absent 84 14 17 36 101 50 Totals 98 53 151

Diagnostic test result totals

Positive negative

a. sensitivity = b. specificity =

c. likelihood for positive test result = LR + = d. likelihood for negative test result = LR - = e. positive predictive value = +PR = f. negative predictive value = -PR =

g. pre-test probability (prevalence) = h. pre-test odds = i. post-test odds = pre test odds x LR =.. bila dikali LR + = 2,03 x 2,97 = 6,0291 bila dikali LR

= 2,03 x 0,23 = 0,4669 j. post-test probability = bila memakai post test odds dengan LR + = bila memakai post test odds dengan LR =