RIONA SANJAYA,S.ST.,M.

Keb

KONSEP DASAR EVIDENCE

BASED DALAM ASUHAN
KEBIDANAN
Evidence based ??
 Pengertian

Evidence Berdasarkan
based Bukti
 Medicine

Policy
Evidence
Based Midwifery

Report
This is congruent with the principles
of effective and high-quality care, in
which midwives, and all
practitioners, strive to provide the
very best care to each individual.

As Sackett et al (2000) emphasize,

EBP is more than just the best
evidence, it is the integration of best
evidence with high-quality clinical
skills, such as communication
and assessment, as well as the
application of evidence to the
particular belief systems, values and
context of the client’s life.
 Therapy / Prevention / Etiology / Harm

Levels of Diagnosis
Evidence
Prognosis
 Diagnosis is the first step in clinical
management
We need to make diagnosis before we can
DIAGNOSIS discuss prognosis and treatment with our
patient
Diagnosis is rare definitive
Making diagnosis means estimating the
probability of a disease or condition
PROGNOSTIC
BASIC PRINCIPLES FOR
DETERMINING BEST AVAILABLE EVIDENCE
Grade of Level of
Recommendation Evidence

A 1a Systematic Review (with homogeneity) of Randomized Controlled Trials

1b Individual Randomized Controlled Trial (with narrow confidence Interval)
1c All or none
2a Systematic Review (with homogeneity) of cohort studies

B 2b Individual cohort study (including low quality RCT; e.g. <80% follow-up)
2c “Outcomes” Research
3a Systematic Review (with homogeneity) of case-control studies
3b Individual Case-Control Study

C 4 Case-series (and poor quality cohort and case-control studies)

D 5 Expert opinion without explicit critical appraisal, or based on physiology,

bench research or “first principles”
 A
•Consistent, good-quality
patient-oriented evidence
Strength of B
Recommendation •Inconsistent or limited-quality
Taxonomy (SORT)
patient-oriented evidence
C
•Consensus, disease-oriented
evidence
FORMULATING A CLEAR
QUESTION BASED ON A
CLINICAL PROBLEM

LITERATURE REVIEW TO
SEARCH BEST AVAILABLE
EVIDENCE

ANALYSIS OF STRENGTHS
AND WEAKNESSES OF
EVIDENCES

USE OF BEST EVIDENCE IN

CLINICAL PRACTICE

EVALUATING THE EFFICACY

OF EMPERICAL EVIDENCES
Dalam Evidence-based practise, pemahaman mengenai desain
penelitian amat penting, oleh karena desain penelitian amat
menentukan validitas penelitian.

Pemilihan desain penelitian yang tidak sesuai dengan tujuan

penelitian menyebabkan hasil penelitian tidak atau kurang sahih,
sehingga tidak dapat diaplikasikan pada pasien yang kita kelola
KENAPA PENERAPAN EVIDENCE
BASED DALAM ASUHAN KEBIDANAN
DAN PRAKTIK KEBIDANAN PENTING
DILAKUKAN ??
 Keamanan bagi
nakes

Meningkatkan Memenuhi kepuasan

kompetensi pelanggan

Memenuhi tuntutan dan kewajiban

sebagai profesional
Correct application of the principles of
EBM help clinicians make better
diagnostic and management decisions

Physicians need to understand

the logic of and basis
for statistical procedures
Clinicians need to understand the way in
which results are expressed statistically before
they can apply findings to their clinical
practice.

The size of the effect and the precision of the

estimate of that efect are both important.

Elliott EJ, Kennedy K.

Evidence-based Pediatrics,
2004.
TERIMAKASIH