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Presentasi

Penugasan Journal Reading

Muthia Tsabita Rahmi


14711056
KASUS
Berdasarkan hasil survey mawas diri di Desa Kuring masih banyak masyarakat

desa yang belum memiliki rumah dengan kriteria sehat. Sebagian besar juga

memiliki kandang ternak / unggas di dalam / samping rumah. Adanya kandang

ternak yang berdekatan dengan rumah menjadi sumber penularan penyakit.

Salah satunya flu burung dengan case fatality rate > 80 %. Pada tahun 2010 di

Desa Kuring pernah ada 1 warga yang meninggal akibat terinfeksi avian

influenza. Adanya outbreak flu burung beberapa tahun yang lalu tidak membuat

masyarakat menjadi berhati-hati. Dr Irma ingin mengetahui bagaimana respon

masyarakat terhadap outbreak flu burung / avian influenza di Indonesia?

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PICO ANALYSIS

P I
PATIENT Intervention
-Question Term: -Question Term:
Dokter Outbreak avian
-Synonyms: Klinisi “Bagaimanakah influenza
respon dokter dalam -Synonyms: Outbreak
mencegah outbreak flu burung, Outbreak
H5N1
Comparison flu burung / avian Outcome
-Question Term: - influenza di -Question Term:

C O
-Synonyms: - Indonesia?” Peningkatan respon
pencegahan di
masyarakat
-Synonyms: Pengetahuan,
Sikap, Praktek
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SEARCHING KEYWORDS

• (physician OR doctor OR clinician) AND (outbreak


avian influenza OR outbreak H5N1 OR outbreak bird
flu) AND (respon* prevention OR knowledge OR
practice OR attitude) AND (Indonesia*)
• Lalu mengatur tools tahun menjadi 2012-2018.
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JOURNAL
CRITICAL
APPRAISAL
WITH CEBM TOOLS
1. Did the study
address a clearly
focused question /
issue?
WITH CEBM TOOLS
“The study population was comprised of outpatient and
inpatient based physicians providing medical care for

YES
adult and/or pediatric patients at government or private

&
sector health facilities in Bogor (peri- urban and rural
communities) and East Jakarta (primarily urban)
districts. We utilized a list of all registered physicians
from the District Health Offices in the two districts and
randomly sampled general primary care clinicians and
subspecialists from the list for recruitment”

“Of 1 725 registered physicians, 1 130 (66%) physicians


were approached in the two districts and of those 554
(49%) were enrolled in the survey”
1. Did the study
address a clearly
focused question /
issue?
WITH CEBM TOOLS
&
“A standardized data collection instrument was
developed with 119 questions about influenza KAP.”

YES
“Following verbal informed consent from clinician
participants, face to face interviews were conducted in
Bahasa Indonesia, the Indonesian language, during
March to June 2012”

“We collected demographic information and data on


participants’ clinical practice setting, knowledge of
influenza signs, symptoms, and complications,
outpatient and inpatient influenza diagnosis, testing,
treatment, and preventive measures for seasonal
influenza, pandemic influenza, and HPAI H5N1,including
the H5N1 suspect case definition used in Indonesia.”
2. Is the research “We conducted a cross- sectional survey

method (study design) of practicing clinicians in western Java,


Indonesia”
appropriate for
“ A standardized data collection
answering the
instrument was developed with 119
WITH CEBM TOOLS
research question? questions about influenza KAP”

YES
“Descriptive statistic were calculated to
analyze the results using SPSS”
3. Is the method of
selection of the
“Of 1725 registered physician, 1130
subjects (employees, (66%) physicians were approached in two
districts and those 554 (49%) were
teams, divisions, enrolled in the survey (Table 1). The 595
physicians who were not approached to
WITH CEBM TOOLS participate did not have a valid adress for
organizations) clearly contact or were no longer practicing
physicians”
described?

YES
4. Could the way the “.....1130 (66%) physicians were
approached in two districts and those
sample was obtained 554 (49%) were enrolled in the
introduce survey”.
(selection) bias?
WITH CEBM TOOLS

YES
subjects
representative with
regard to the “Overall participation of eligible
population to which physicians from the two districts was
low (49%) of recruited physicians
the findings will be participated in the survey and 32% of
referred?
WITH CEBM TOOLS 1750 registered physicians).
Therefore, the findings may not be
representative or generalizable to all

NO
physicians practicing in East Jakarta
or Bogor districts, or in Indonesia”
6. Was the sample
Ukuran sampel tidak
size based on pre-
menggunakan kekuatan
study considerations statistik, tetapi hanya
of statistical power? menggunakan populasi sesuai
WITH CEBM TOOLS kriteria inklusi yang bersedia.

NO
“Overall participation of
7. Was a satisfactory eligible physicians from the
response rate two districts was low (49%
achieved? of recruited physicians
WITH CEBM TOOLS participated in the survey
and 32% of 1750 registered

NO
physicians).
8. Are the
measurements
(questionnaires) likely “A standardized data collection
instrument was developed with 119
to be valid and questions about influenza KAP”
reliable?
WITH CEBM TOOLS “We collected demographic
information and data on participants’
clinical practice setting, knowledge of

YES
influenza signs, symptoms, and
complications, outpatient and
inpatient influenza diagnosis, testing,
treatment, and preventive measures
for seasonal influenza, pandemic
influenza, and HPAI H5N1,including
the H5N1 suspect case definition
used in Indonesia.”
Penelitian ini menjelaskan
bahwa ia menggunakan
9. Was the statistical aplikasi IBM SPSS untuk
significance assessed? menganalisis hasil, tetapi
tidak disebutkan nilai
WITH CEBM TOOLS signifikansinya. Penelitian
menggunakan statistik

NO
deskriptif.
10. Are confidence Tidak disebutkan
intervals given for the confidence intervalnya.
main results?
WITH CEBM TOOLS

NO
11. Could there be
confounding factors Tidak disebutkan
that haven’t been comfounding factornya.
accounted for?
WITH CEBM TOOLS

Cant
tell
12. Can the results be
applied to your Penelitian ini menunjukan fakta
bahwa 98 % dokter pernah
organization? mendengar suspek flu burung tetapi
sedikit yang pernah menganamnesis
WITH CEBM TOOLS

YES
faktor risiko yang tepat, melakukan
pemeriksaan penunjang pada suspek
flu burung, memberi antivirus,
menyarankan rawat inap dan
melakukan tindakan pencegahan
penularan yang adekuat. Penemuan
fakta ini mensugestikan bahwa
dokter di indonesia perlu diberikan
edukasi lebih mengenai penyakit
tersebut.
12. Can the results be
applied to your
“Educational training of physicians, such
organization? as that conducted in Vietnam, and
continuing medical education modules,
WITH CEBM TOOLS could improve clinician knowledge of HPAI

YES
H5N1 risk factors and clinical
management of patients with suspected
HPAI H5N1 virus infection in Indonesia.”
“These findings suggest that Indonesian
physicians might benefit from more
education about how influenza viruses are
transmitted and of measures to prevent
and control influenza in healthcare
workers and healthcare settings as
recommended by the World Health
Organization.
12. Can the results be Sejak tahun 2005 dilaporkan
applied to your Indonesia memiliki kasus fatal
organization? yang tinggi yang disebabkan
H5 N1. Penelitian ini
WITH CEBM TOOLS menggunakan populasi dan

YES bertempat
karenanya
di
hasil
Indonesia,
penelitian
dapat digunakan di Indonesia