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    The document discusses managing evidence-based medicine for two clinical scenarios: 1) determining the most appropriate medicine to prevent preeclampsia and eclampsia in pregnant women, and 2) identifying the most appropriate program to increase community health problems. For the first scenario, the evidence suggests that astaxanthin may be effective at preventing preeclampsia by reducing blood pressure and proteinuria compared to antihypertensive drugs, but this needs confirmation in clinical trials using human models. For the second scenario, a community-based approach called GERMAS may be more effective at reducing morbidity and mortality than individual approaches, but community health outcomes in Indonesia still need improvement.

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    Managing Evidence-based Medicine

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    The document discusses managing evidence-based medicine for two clinical scenarios: 1) determining the most appropriate medicine to prevent preeclampsia and eclampsia in pregnant women, and 2) identifying the most appropriate program to increase community health problems. For the first scenario, the evidence suggests that astaxanthin may be effective at preventing preeclampsia by reducing blood pressure and proteinuria compared to antihypertensive drugs, but this needs confirmation in clinical trials using human models. For the second scenario, a community-based approach called GERMAS may be more effective at reducing morbidity and mortality than individual approaches, but community health outcomes in Indonesia still need improvement.

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    © All Rights Reserved
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    8 views11 pages

    Managing Evidence-Based Medicine

    Uploaded by

    Joshua Hariara
    The document discusses managing evidence-based medicine for two clinical scenarios: 1) determining the most appropriate medicine to prevent preeclampsia and eclampsia in pregnant women, and 2) identifying the most appropriate program to increase community health problems. For the first scenario, the evidence suggests that astaxanthin may be effective at preventing preeclampsia by reducing blood pressure and proteinuria compared to antihypertensive drugs, but this needs confirmation in clinical trials using human models. For the second scenario, a community-based approach called GERMAS may be more effective at reducing morbidity and mortality than individual approaches, but community health outcomes in Indonesia still need improvement.

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    of 11

    MANAGING EVIDENCE-BASED MEDICINE

    MORITA WIBOWO, MD-OG


    CLINICAL SCCENARIO

    1. What is the most appropriate medicine to prevent preeclampsia & emclampsia on pregnant woman?
    2. What is the most appropriate programme to Increase community health problem?
    PICO

    Patient or Problem Intervention Comparison Outcomes


    Medicine to prevent Astaxanthin Antihypertensives Blood Pressure, Proteinuria
    preeclampsia & eclampsia
    Community Health GERMAS (community Individual Approach Morbidity/Mortality
    Problems approach)
    THE EVIDENCE : SYSTEMS

    1. POGI/HKFM. 2016. PNPK Diagnosis dan Tatalaksana Pre-Eklamsia. Jakarta


    2. Kemenkes. 2015. RPJMN 2015-2019. Jakarta
    THE EVIDENCE : SUMMARIES

    1. Magee, Laura A., Von Dadelzen, Peter., Stones, William., Mathai, Matthews.. The FIGO Text Book of Pregnancy
    Hypertension. GLOWM, 2016.
    2. Kemenkes. 2015. Renstra Kemenkes 2015-2019. Jakarta
    THE EVIDENCE : SYNOPSIS

    1. Effects of astaxanthin on preeclampsia rat model. Yao Xue Xue Bao. 2014 Oct; 49 (10):1400-5
    2. Kemenkes. 2016. Permenkes no. 43 2016 SPM Bidang Kesehatan. Jakarta
    THE EVIDENCE : SUMMARIES

    1. Rumbold A., Duley L., Crowther CA., Haslam RR.. Antioxidants for preventing pre-eclampsia. 2008. cited from
    https://www.Cochrane.org/CD004227/PREG_antioxidants-for-preventing-pre-eclampsia
    2. Kemenkes. 2016. Profil Kesehatan Indonesia 2016. Jakarta
    THE EVIDENCE : STUDIES

    1. Astaxanthin blocks preeclampsia progression by suppressing oxidative stress and inflammation. Molecular
    Medicine Reports, 2016;14:2697-2704
    Sunur,Yeremias R. 2016. Thesis. Pemberian Astaxanthin Meningkatkan Kadar Glutathione Peroxidase dan
    Memperbaiki Kondisi Preeklampsia Ringan. Denpasar.
    2. Kemenkes. 2016. Profil Kesehatan Indonesia 2016. Jakarta
    STEP 3 : CRITICAL APPRAISAL

    No Validity Impact Applicability


    1 Lack of evidence on human model To be confirm in clinical random trial Yes
    2 Need Improvement MMR still high, IMR slightly decrease Yes
    STEP 4 : INTEGRATING EVIDENCE WITH CLINICAL EXPERTISE
    THANK YOU

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