LEMBAR JAWABAN

SKILL LAB EVIDENCE BASED MEDICINE

NAMA: IMANUEL SONI
NIM: 0401281621123

1. DATA ABNORMALITAS

Statistics
SGOT_SGPT Hemoglobin Trigliserid TotalKolestrol HDL LDL
N Valid 200 200 200 200 200 200
Missing 0 0 0 0 0 0
Mean 26,290 12,472 115,305 137,235 89,440 74,640
Std. Deviation 13,9232 ,3238 20,0475 32,4054 17,1193 13,6341

Parameter Rerata SD Rerata +- 2SD Nilai abnormalitas

SGOT/SGPT 26,29 13,9232 26,69+2(13,9232) = 54,5364 54,5364+0,05=54,5864
 > 54,5864
Hb 12,472 0,3238 12,472-2(0,3238)=11,8244 11,8244-0,05=11,8744
 < 11,8744
Trigliserid 115,305 20,0475 115,305+2(20,0475)=155,4 155,4+0,05=155,45
 > 155,45
Total 137,235 32,4054 137,235+2(32,4045)= 202,044 202,044+0,05=202,094
Kolesterol  > 202,094
HDL 89,440 17,1193 89,440-2(17,1193)= 55,2014 55,2014-0,05=55,1514
 < 55,1514
LDL 74,640 13,6341 74,640+2(13,6341)= 101,9082 101,9082+0,05=101,9582
 > 101,9582
2. EBM 1
2.1 Tabel PICO
P (Problem) Young Infant
I (Intervention) Tachypnea
C (Comparative Intervention) Oxymetry
O (Outcome) Hypoxia

2.2 Clinical Question

In young infant with rapid breathing, does tachypnea, compared with oxymetry, could
diagnose hypoxia?

2.3 Keyword
Tachypnea AND Oxymetry AND Hypoxia

2.4 Search the Keyword: PubMed

https://www.ncbi.nlm.nih.gov/pubmed/10630912

2.5 Abstract

Arch Dis Child. 2000 Jan;82(1):46-9.

Tachypnoea is a good predictor of hypoxia in acutely ill infants under 2 months.

Rajesh VT1, Singhi S, Kataria S.

Author information
1

Department of Pediatrics, Postgraduate Institute of Medical Education and Research,

Chandigarh 160012, India.

Abstract
OBJECTIVE:
To evaluate the respiratory rate as an indicator of hypoxia in infants < 2 months of age.

SETTING:
Pediatric emergency unit of an urban teaching hospital.

SUBJECTS:
200 infants < 2 months, with symptom(s) of any acute illness.

METHODS:
 Respiratory rate (by observation method), and oxygen saturation (SaO(2)) by means of a
pulse oximeter were recorded at admission. Infants were categorised by presence or
absence of hypoxia (SaO(2) </= 90%).

RESULTS:
The respiratory rate was >/= 50/min in 120 (60%), >/= 60/min in 101 (50. 5%), and >/=
70/min in 58 (29%) infants. Hypoxia (SaO(2) </= 90%) was seen in 77 (38.5%) infants.
Respiratory rate and SaO(2) showed a significant negative correlation (r = -0.39).
Respiratory rate >/= 60/min predicted hypoxia with 80% sensitivity and 68% specificity.

CONCLUSION:
These results indicates that a respiratory rate > 60/min is a good predictor of hypoxia in
infants under 2 months of age brought to the emergency service of an urban hospital for
any symptom(s) of acute illness.

2.6 Critical Appraisal

Citation:
Rajesh, V. T., Singhi, S., & Kataria, S. (2000). Tachypnoea is a good predictor of
hypoxia in acutely ill infants under 2 months. Archives of disease in childhood, 82(1),
46–49. doi:10.1136/adc.82.1.46

Are the results of this diagnostic study valid?

Was there an independent, blind The method was compared with pulse
comparison with a reference (“gold”) oximeter which is a reference standard
standard of diagnosis? of diagnosis.

Was the diagnostic test evaluated in an
appropriate spectrum of patients (like
those in whom it would be used in
practice)?
The diagnostic test has evaluated as an
indicator of hypoxia in infants less than 2
months of age attending a paediatric
emergency service. Two hundred infants
under 2 months of age who were
brought with symptom(s) of any acute
illness to the paediatric emergency
service of Nehru Hospital, Postgraduate
Institute of Medical Education and
Research, Chandigarh were included in
the study.
 Was the reference standard applied
regardless of the diagnostic test result?
Yes. Oxygen saturation (SaO2) was
measured at finger or toe with a pulse
oximeter using an appropriate sized
sensor. Hypoxia was defined as an
SaO2 < 90%. All the observations were
made and recorded by a single observer
(VTR) who was unaware of the patient’s
clinical findings and diagnosis.

Was the test (or cluster of tests) Validity test in independent group is
validated in a second, independent unclear
group of patients?

Are the valid results of this diagnostic study important?

YOUR CALCULATIONS
Hypoxia

Totals
Present Absent
≥60 a b a+b
Diagnostic 62 39 101
test result
<60 c d c+d
15
84 99

a+c b+d a+b+c+d

Totals
77 123 200

Sensitivity = a/(a+c) = 62/77 = 81%

Specificity = d/(b+d) = 84/123 = 68%
Likelihood ratio for a positive test result = LR+ = sens/(1-spec) = 81%/32% = 2,539
Likelihood ratio for a negative test result =LR - = (1-sens)/spec = 19%/68% = 0.285

Positive Predictive Value = a/(a+b) = 62/101 = 85%

Negative Predictive Value = d/(c+d) = 84/99 = 95%
Pre-test probability (prevalence) = (a+c)/(a+b+c+d) = 77/200 = 39%
Pre-test odds = prevalence/(1-prevalence) = 39%/61% = 0,64
Post-test odds = pre-test odds  LR = 0,64 x 2,539 = 1,624
Post-test probability = post-test odds/(post-test odds +1) = 1,624/(1,624+1)=62%
Can you apply this valid, important evidence about a diagnostic test in caring for your
patient?
Is the diagnostic test available, affordable,
accurate, and precise in your setting?
Can you generate a clinically sensible
estimate of your patient’s pre-test probability study is the same as the condition of
(from personal experience, prevalence
statistics, practice databases, or primary
studies)?
 Are the study patients similar to your
own?
 Is it unlikely that the disease possibilities
or probabilities have changed since the
evidence was gathered?
Will the resulting post-test probabilities
affect your management and help your
patient?
 Could it move you across a test-
treatment threshold?
 Would your patient be a willing partner
in carrying it out?
Would the consequences of the test help
your patient?
Yes, the diagnostic test is available,
affordable, accurate and precise with
my setting.
The condition of the patient in the
this patient.
The pre‐test probability is 39%. When
this child returns tachypneau, we can
estimate his post‐test probability as
about 62%. This child's chances of
having Hypoxia has increased from
39% to 62%. This may make the
pyshician decide to recommend using
breathing rate to diagnose hypoxia.
Yes, this test will help to make an
early diagnosis of hypoxia.
3. EBM 2
3.1 Tabel PICO
P (Patient) Child with fever and tachypnea
I (Intervention) 3 days amoxicillin
C (Comparative Intervention) 5 days amoxicillin
O (Outcome) Reduce non severe pneumonia

3.2 Clinical Question

In children with non severe peneumonia, is three days amoxicillin as effective as five days
amoxicillin to treat non severe pneumonia?

3.3 Keyword
Three days AND five days amoxicillin AND non severe pneumonia

3.4 Search the Keyword: PubMed

https://www.ncbi.nlm.nih.gov/pubmed/15070633

2.5 Abstract
Three day versus five day treatment with amoxicillin for non-severe pneumonia in
young children: a multicentre randomised controlled trial.
Agarwal G, Awasthi S, Kabra SK, Kaul A, Singhi S, Walter SD; ISCAP Study Group.
Erratum in BMJ. 2004 May 1;328(7447):1066.
Abstract
OBJECTIVE:
To assess the efficacy of three days versus five days of treatment with oral amoxicillin for
curing non-severe pneumonia in children.
DESIGN:
Randomised, double blind, placebo controlled multicentre trial.
SETTING:
Outpatient departments of seven referral hospitals in India.
PARTICIPANTS:
2188 children aged 2-59 months, 1095 given three days of treatment and 1093
given five days.
INTERVENTION:
 Oral amoxicillin 31-54 mg/kg/day in three divided doses.
MAIN OUTCOME MEASURES:
Treatment failure: defined as development of chest indrawing, convulsions, drowsiness,
or inability to drink at any time; respiratory rate above age specific cut points on day 3 or
later; or oxygen saturation by pulse oximetry < 90% on day 3.
RESULTS:
The clinical cure rates with three days and five days of treatment were 89.5% and 89.9%,
respectively (absolute difference 0.4 (95% confidence interval--2.1 to 3.0)). Adherence to
treatment regimen was 94% and 85% for three day and five day treatments, respectively.
Loss to follow up was 5.4% by day 5. There were no deaths, 41 hospitalisations, and 36
minor adverse reactions. There were 225 (10.3%) clinical failures and 106 (5.3%) relapses,
and rates were similar in both treatments. At enrollment, 513 (23.4%) children tested
positive for respiratory syncytial virus, and Streptococcus pneumoniae and Haemophilus
influenzae were isolated from the nasopharynx in 878 (40.4%) and 496 (22.8%) children,
respectively. Clinical failure was associated with isolation of respiratory syncytial virus
(adjusted odds ratio 1.95 (95% confidence interval 1.0 to 3.8)), excess respiratory rate of
> 10 breaths/minute (2.89 (1.83 to 4.55)), and non-adherence with treatment at day 5
(11.57 (7.4 to 18.0)).
CONCLUSIONS:
Treatment with oral amoxicillin for three days was as effective as for five days in children
with non-severe pneumonia.

2.6 Critical Appraisal

SCREENING
Does the study question match your - Yes, it does.
question? - Yes, the study did a double-blind,
Was the study design appropriate? randomised, placebo-controlled trial.

VALIDITY
F: Patient Follow-Up
 Were all patients who entered the trial - Yes, they were properly accounted.
properly accounted for at its The study personnel assessed patients
conclusion? Losses to follow-up should who did not come for follow-up at the
be less than 20% and reasons for drop- specified date the next day at the
out given. child’s home. If the child was not
 Was follow-up long enough? available on that day, one more
attempt was made to contact them

R: Randomization
 Were the recruited patients
representative of the target population?
 Was the allocation (assignment) of
patients to treatment randomized and
concealed?
I: Intention to Treat Analysis
 Were patients analyzed in the groups
to which they were randomized?
 Were all randomized patient data
analyzed? If not, was a sensitivity or
“worst case scenario” analysis done?
S: Similar Baseline Characteristics of
Patients
Were groups similar at the start of the trial?
B: Blinding
 Were patients, health workers, and
study personnel “blind” to
treatment?
 If blinding was impossible, were
blinded raters and/or objective
outcome measures used?
E: Equal Treatment
 Aside from the experimental
intervention, were the groups treated
equally?
Conflict of Interest
 Are the sources of support and other
potential conflicts of interest
acknowledged and addressed?
Summary of Article’s Validity
 Notable study strengths or
weaknesses or concerns?
 How serious are the threats to validity
and in what direction could they bias
the study outcomes?
before they were judged lost to
follow-up. The losses to follow up
were less than 20%.
- Yes, it was long enough. The study
physician assessed every child 3 days,
5 days, and 14 days after enrolment.
- Yes, the sample was randomised and
representated the target population.
- Yes, it was randomized and concealed.
- Yes, they were analyzed in each group.
- Yes, all randomized patient data were
analyzed.
Yes, the baseline characteristics from both
groups were similar.
- Yes, two of them were ‘blind’ to
treatment (double-blind).
- No, the blinding was possible.
Yes, they were treated equally aside from
the experimental intervention.
Yes, they are addressed in the last
paragraph before references.
- The weaknesses from the study are:
the overall failure rate was high in
both groups , the study did not have a
definitive aetiological diagnosis and
did not obtain clinical data on chest
examination by stethoscope, and the
study results are restricted to children
in less developed countries.

CLINICAL IMPORTANCE
Succes
3-days amoxicillin 791
5-days amoxicillin 798
CER (Control event rate)=c/(c+d)
EER (experimenal event rate) =a/(a+b)
RR (Relative Risik)=(a+b)/(c+d)
RRR (relative Risi reduction)/RBI (relative
Benefit Increase)=(CER-EER)/CER
ARI (Atributable Riskk Reduction)/ABI
(Absolut Benefit Increase)-CER-EER
NNT (Number Needed to Treat) 1/RRR
Results OF IMPORTANCY
APPLICABILITY
Similar patient
1. Are your patients similar to those in the
study?
2. Are they so different that the results
can’t help you
Apakah tersedia obat, keahllian, fasilitas,
biaya yg diperlukkan?
3. How much of the study effect can you
expect for your patients
-The limitations of this study are: it was
a hospital based study,the causes of
infection were not investigated, follow
up was limited to only 15 days, and
children with history of asthma were
excluded. Potential threats are
minimal and would likely bias the
result of the study towards
underestimate of treatment effect.
Failure
209 1000
202 1000
0,798 79,8%
0,791 79,1%
0,99 1  tidak ada perbedaan risiko
antara dua kelompok berdasarkan lama
pemberian.
0,00877  tidak bermakna secara klinis.
0,798-0,791=0,007 0,7%  pemberian
amoksisilin selama 3 hari memiliki
keuntungan sebesar 0,7% terhadap
outcome dibanding pemberian selama 5
hari.
114,025
Tidak bermakna secara klinis
Nilai p>0,05  tidak bermakna secara
statistik
Yes, the study included children aged 2-59
months with non-severe pneumonia which
has similar characteristics with the patient
in the scenario.
- No, they don’t have much differences.
- Ya, tersedia.
- The research result showed that 3-
days’ treatment with amoxicillin for
WHO defined non-severe pneumonia
Apakah pasin dan keluarga dapat menerima
pemberian obat/pengobatan atas dasar
nilai nilai sosial, budaya dan agama?
Realistic Interventions
4. Is the intervention realistic in your
setting?
5. Does the comparison intervention reflect
your current practice?
6. What alternatives are available
Right Outcomes
7. Have all the right outcomes been
considered?
8. Are the outcomes appropriate to your
patient?
9. Does the intervention meet their values
and preferences?
Overall conclusion
is as effective as treatment for 5 days
as the presently recommended
duration of 5 days. This result could
help the doctor complies patient
wishes to take the medicine in short
time.
- Ya, bisa.
Yes, it is.
Yes, it does because it was the presently
recommended intervention.
Change the treatment allocation to 3 days
of amoxicillin or other simple antibiotics
such as chloramphenicole.
Yes, they have been considered.
Yes, they are appropriate to the patient.
Yes, it does.
The study is valid, important, and
applicable.
4. DATA DIAGNOSTIK
KREATININ KINASE

Area Under the Curve

Test Result Variable(s): KreatininKinase
Asymptotic 95% Confidence
Interval
a b
Area Std. Error Asymptotic Sig. Lower Bound Upper Bound
,973 .c . . .
The test result variable(s): KreatininKinase has at least one tie between the
positive actual state group and the negative actual state group. Statistics may be
biased.
a. Under the bi-negative exponential distribution assumption
b. Null hypothesis: true area = 0.5
c. Number of valid observations of the positive actual state group is not equal to
that of the negative actual state group. Therefore, under the bi-negative
exponential distribution assumption, Std. Error, Asymptotic Sig., and Asymptotic
Confidence Interval cannot be computed.
 Coordinates of the Curve
Test Result Variable(s): KreatininKinase
Positive if Less
Than or Equal
Toa Sensitivity 1 – Specificity
39,088600 ,000 ,000
41,161050 ,023 ,000
43,083850 ,046 ,000
44,230350 ,069 ,000
44,933400 ,092 ,000
45,666650 ,115 ,000
46,268400 ,138 ,000
46,627550 ,161 ,000
46,767250 ,184 ,000
48,195200 ,207 ,000
50,384450 ,230 ,000
51,317550 ,253 ,000
51,468800 ,276 ,000
51,551700 ,299 ,000
52,438550 ,322 ,000
53,365200 ,345 ,000
53,508750 ,368 ,000
53,607550 ,391 ,000
53,776900 ,414 ,000
54,348000 ,437 ,000
55,207250 ,460 ,000
56,025200 ,483 ,000
56,556400 ,506 ,000
56,734750 ,529 ,000
56,841900 ,552 ,000
57,167500 ,575 ,000
59,475150 ,598 ,000
61,600600 ,621 ,000
61,913100 ,644 ,000
62,752850 ,667 ,000
63,806850 ,690 ,000
64,809450 ,713 ,000
65,388350 ,736 ,000
65,523700 ,759 ,000
65,760700 ,782 ,000
66,496550 ,805 ,000
67,507500 ,828 ,000
68,161400 ,851 ,000
 68,738250 ,874 ,000
69,082200 ,897 ,000
69,636950 ,920 ,000
71,533950 ,931 ,077
73,076650 ,931 ,231
74,245100 ,943 ,308
75,877750 ,966 ,308
76,701000 ,977 ,385
77,172300 ,989 ,462
77,726200 ,989 ,615
78,178450 1,000 ,692
78,518500 1,000 ,846
79,675100 1,000 1,000
The test result variable(s): KreatininKinase has at
least one tie between the positive actual state
group and the negative actual state group.
a. The smallest cutoff value is the minimum
observed test value minus 1, and the largest
cutoff value is the maximum observed test value
plus 1. All the other cutoff values are the
averages of two consecutive ordered observed
test values.

grup kreatinin kinase * MCI1 Crosstabulation

Count
MCI1

positif MCI negatif MCI Total

grup kreatinin kinase >=71,53 12 6 18
<71,53 1 81 82
Total 13 87 100
4.1 cut off point 71,53
4.2 Nilai Diagnostik:
AUC 0,973; Sen 92%; spesific 0,98; LR+ 13,38; LR-0,08; PPV 67%; NPV 1,2%
4.3 Kesimpulan:
- Akurasi 0,973 (excellent, artinya pada cut off point kreatinin kinase 71,53, dapat
didiagnosis MCI sebesar 0,973)
- Validitas: valid  sen 92%, spec 98%

LDL
 Area Under the Curve
Test Result Variable(s): LDL
Asymptotic 95% Confidence
Interval
Area Std. Errora Asymptotic Sig.b Lower Bound Upper Bound
,402 .c . . .
a. Under the bi-negative exponential distribution assumption
b. Null hypothesis: true area = 0.5
c. Number of valid observations of the positive actual state group is not equal to
that of the negative actual state group. Therefore, under the bi-negative
exponential distribution assumption, Std. Error, Asymptotic Sig., and Asymptotic
Confidence Interval cannot be computed.

Coordinates of the Curve

Test Result Variable(s): LDL
Positive if Less
Than or Equal
Toa Sensitivity 1 - Specificity
95,3900 ,000 ,000
100,9950 ,011 ,000
107,9950 ,023 ,000
111,5750 ,023 ,077
113,0850 ,034 ,077
113,8750 ,046 ,077
114,6750 ,046 ,154
115,9450 ,057 ,154
117,5450 ,069 ,154
118,5200 ,080 ,154
118,8550 ,092 ,154
120,0250 ,103 ,154
121,7450 ,103 ,231
122,4800 ,115 ,231
123,0300 ,126 ,231
123,8750 ,138 ,231
124,3900 ,149 ,231
124,7150 ,161 ,231
125,1300 ,161 ,308
125,2950 ,172 ,308
126,6650 ,184 ,308
128,2250 ,195 ,308
128,4900 ,207 ,308
129,0850 ,218 ,308
129,8200 ,230 ,308
130,0500 ,241 ,308
130,3100 ,253 ,308
130,6550 ,264 ,308
131,4900 ,276 ,308
132,5450 ,287 ,308
132,9550 ,299 ,308
133,1450 ,310 ,308
133,3700 ,322 ,308
133,9450 ,333 ,308
134,8000 ,345 ,308
135,2550 ,356 ,308
135,4750 ,368 ,308
135,6700 ,379 ,308
135,7450 ,379 ,385
135,8600 ,391 ,385
136,1850 ,402 ,385
136,4800 ,414 ,385
136,7500 ,414 ,462
138,1850 ,414 ,538
139,8050 ,414 ,615
140,2750 ,414 ,692
140,5100 ,425 ,692
140,7050 ,437 ,692
140,8900 ,448 ,692
141,3150 ,460 ,692
141,6200 ,471 ,692
141,6700 ,483 ,692
141,7850 ,494 ,692
142,3100 ,506 ,692
142,7600 ,517 ,692
142,8500 ,517 ,769
142,9550 ,529 ,769
143,3300 ,529 ,846
143,7250 ,540 ,846
144,1900 ,552 ,846
144,7350 ,563 ,846
145,0850 ,575 ,846
145,4850 ,586 ,846
145,7350 ,598 ,846
145,9250 ,609 ,846
146,1800 ,621 ,846
146,5550 ,632 ,846
 148,0300 ,644 ,846
149,4850 ,655 ,846
150,0750 ,667 ,846
150,4600 ,678 ,846
150,8200 ,690 ,846
151,6900 ,701 ,846
152,3150 ,713 ,846
153,4850 ,724 ,846
154,5900 ,736 ,846
154,7850 ,747 ,846
155,0550 ,759 ,846
155,8250 ,770 ,846
156,6350 ,782 ,846
157,1050 ,793 ,846
157,5500 ,805 ,846
158,0350 ,816 ,846
158,6400 ,828 ,846
158,9400 ,828 ,923
159,4250 ,839 ,923
160,2350 ,851 ,923
160,7500 ,862 ,923
160,9750 ,874 ,923
161,2550 ,885 ,923
161,6750 ,897 ,923
162,4400 ,908 ,923
165,4650 ,920 ,923
168,4450 ,931 ,923
169,6500 ,943 ,923
174,6250 ,954 ,923
181,8150 ,966 ,923
184,9850 ,977 ,923
186,4450 ,989 ,923
189,9500 ,989 1,000
193,2200 1,000 1,000
a. The smallest cutoff value is the minimum
observed test value minus 1, and the largest
cutoff value is the maximum observed test value
plus 1. All the other cutoff values are the
averages of two consecutive ordered observed
test values.
 Grup LDL * MCI1 Crosstabulation
Count
MCI1
Positif Negatif Total
Grup LDL >=138,1850 6 51 57
<138,1850 7 36 43
Total 13 87 100

Chi-Square Tests
Asymp. Sig. (2- Exact Sig. (2- Exact Sig. (1-
Value df sided) sided) sided)
Pearson Chi-Square ,717a 1 ,397
b
Continuity Correction ,299 1 ,585
Likelihood Ratio ,710 1 ,400
Fisher's Exact Test ,550 ,290
Linear-by-Linear Association ,710 1 ,399
N of Valid Cases 100
a. 0 cells (0,0%) have expected count less than 5. The minimum expected count is 5,59.
b. Computed only for a 2x2 table

4.4 cut off point 138,1850

4.5 Nilai Diagnostik
AUC 40,2%; Sen 46%; spesific 41%; LR+ 0,787; LR- 1,301; PPV 10,53%; NPV 16,28%
4.6 Kesimpulan:
- Akurasi: AUC 0,402 (dibawah batas bawah nilai AUC, LDL dengan cut-off point
138,1850 tidak dapat mendiagnosis MCI—uji diagnostik tidak berguna)
- Validitas: tidak valid  sen 46%, spec 41%
5. DATA THERAPY BAD OUTCOME

KelompokPerlakuan * mci1 Crosstabulation

Count
mci1
dead Alive Total
KelompokPerlakuan ACE inhibitor 6 44 50
plasebo 13 37 50
Total 19 81 100

Chi-Square Tests
Asymp. Sig. (2- Exact Sig. (2- Exact Sig. (1-
Value df sided) sided) sided)
Pearson Chi-Square 3,184a 1 ,074
b
Continuity Correction 2,339 1 ,126
Likelihood Ratio 3,246 1 ,072
Fisher's Exact Test ,125 ,062
Linear-by-Linear Association 3,152 1 ,076
N of Valid Cases 100
a. 0 cells (0,0%) have expected count less than 5. The minimum expected count is 9,50.
b. Computed only for a 2x2 table
 Nilai Importancy
 Secara statistik: p value 0,126  tidak bermakna secara statistik
 Secara klinis:
 EER: 0,12  12%
 CER: 0,26  26%
 RR: 0,46 (artinya ACEi sebagai faktor proteksi terhadap kematian akibat MCI)
 ARR: 0,14  14% (artinya perbedaan kematian MCI santara ACEi dan plasebo
sebesar 14%)
 RRR: 0,59  59% (artinya ACEi dapat mencegah kematian MCI sebesar 59%
dibandingkan plasebo dalam pengobatan sekian tahun)
 NNT: 7,14 (artinya diperlukan pengobatan ACEi untuk mencegah kematian 1 orang)

Kesimpulan
Penggunaan ACE inhibitor penting dan sangat bermakna (karena RRR > 59%) secara klinis
namun tidak bermakna secara statistik.
6. NILAI IMPORTANCY EBM THERAPY: EFFECTIVE OUTCOME

Kelompok * MCI Crosstabulation

Count
MCI
sembuh tidak sembuh Total
Kelompok enalapril+ASA 26 24 50
Isosorbid
9 41 50
prodiprogel+diuretik
Total 35 65 100

Chi-Square Tests
Asymp. Sig. (2- Exact Sig. (2- Exact Sig. (1-
Value Df sided) sided) sided)
Pearson Chi-Square 12,703a 1 ,000
Continuity Correctionb 11,253 1 ,001
Likelihood Ratio 13,115 1 ,000
Fisher's Exact Test ,001 ,000
Linear-by-Linear Association 12,576 1 ,000
N of Valid Cases 100
a. 0 cells (0,0%) have expected count less than 5. The minimum expected count is 17,50.
b. Computed only for a 2x2 table
 Nilai Importancy
 Secara Statistik: chi square nilai p value = 0,001  bermakna secara statistik
 Secara Klinis
 EER: 0,18
 CER: 0,52
 RR: 2,89 (jika enalapril digunakan sebagai terapi, peluang kesembuhannya sebesar
2,89 kali dibandingkan isosorbid prodiprogel+diuretik)
 ABI: 34% (apabila enalapril dan ASA digunakan sebgai terapi, maka selisih insiden
kesembuhan antara enalapril+ASA dan isosorbi prodiprogel+diuretik sebesar 34%)
 RBI: 189% (pemberian enalapril dan ASA dapat meningkatkan kesembuhan sebesar
189% dibandingkan obat isosorbid prodiprogel+Diuretik (>50% sangat bermakna)
 NNT: 2,94 (membutuhkan terapi sebanyak 2-3 orang untuk mendapatkan 1
kesembuhan)

Kesimpulan
Terapi enalapril+ASA dalam kesembuhan MCI adalah sangat penting secara klinis maupun
secara statistik.