critical appraisal of epidemiological study

8/13/2019 Critical Appraisal of Epidemiological Study

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Critical Appraisal ofObservational Study

in Epidemiology

dr. YUDHI WIBOWO, M.PH


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OUTLINE BACKGROUND

MEMAHAMI LAPORAN JURNAL

OBSERVATIONAL STUDY in EPIDEMIOLOGY

STROBE

CA JURNAL OBSERVATIONAL STUDY IN

EPIDEMIOLOGY

KESIMPULAN


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Bailey et al. (2005) Introduction to Epidemiology. London:McGraw-Hill


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Background

Much biomedical research (9 of 10) isobservational.

The reporting of such research is often

inadequate, Which hampersthe assessment of its

strengths and weaknesses and of a studysgeneralizability.

However, in published observationalresearch important information is oftenmissing or unclear.

(Erik et al., 2007)


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An analysis of epidemiological studiespublished in general medical and specialist

journals found that the rationale behind thechoice of potential confounding variableswas often not reported(Pockok et al., 2004).

Only fewreports of case-control studies inpsychiatry explained the methods used toidentify cases and controls(Lee et al., 2007).

In a survey of longitudinal studies in stroke

research, 17 of 49 articles (35%) did notspecify the eligibility criteria(Tooth et al.,2005).


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STROBE

The Strengthening the Reporting ofObservational Studies in Epidemiology

(STROBE).

What should be included in an accurate

and complete report of an observational

study.

Covered three main study designs:

cohort, case-control and cross-sectional

studies


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A checklist of 22 items(the STROBE

Statement) that relate to the title,

abstract, introduction, methods, results

and discussionsections of articles.

Eighteen items are common to all threestudy designs andfour are specific for

cohort, case-control, or cross-sectional

studies. To improve the qualityof reporting of

observational studies


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Introduction

1. Background/rationale: besar masalah: prevalensi/insidensi/jumlah,

dibandingkan dengan sebelumnya, di tempatlain, target program & dampak

Elaborasi: substansi & metodologis

Kesenjangan: substansi, metodologis, konfirmasipenelitian sebelumnya

2. Tujuan Utama penelitian (primary outcome):paling diminati peneliti, desain dirancang utkmenjawab pertanyaan, sbg dasarperhitungan besar sampel


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CA OBSERVATIONAL STUDY IN EPIDEMIOLOGY

1. DESKRIPSI UMUM

Desain

Populasi target, populasi terjangkau,sampel

Teknik sampling Variabel bebas, tergantung

Hasil utama (primary outcome)

2. Validitas interna, hubungan non-kausal Pengaruh bias

Pengaruh perancu

Pengaruh peluang


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3. Vaiditas interna, hubungan kausal

Temporabilitas

Asosiasi kuat

Dosis respon

Konsistensi

Spesifik

Koherensi

Biologically plausible

4. Validitas eksterna

Apakah hasil dapat diterapkan pada subyek terpilih

Apakah hasil dapat diterapkan pada populasi terjangkau

Apakah hasil dapat diterapkan pada populasi luas


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Kriteria Kausasi

Machin, D. & Campbell, M.J. (2005) The Design of Studies for Medical Research.England: John Wiley & Sons Ltd.


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CA MASIH DIPERLUKAN KOMPONEN:

1. IMPORTANCY : kepentingan hasil penelitian

secara klinis (effect size)

2. APPLICABILITY : transportability, kondisi

pasien, kemampuan pelayanan, ekonomi,

sosial budaya, agama.


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Kesimpulan

Dokter harus mampu melakukan telaah jurnaldengan baik.

Observational Study in Epidemiology

STROBE CA ada 3 komponen (VIA):

Validitasvaliditas interna non-kausal, validitas

interna kausal (eksternaBradfold-Hill criteria),

validitas.

Importancy

Applicability


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Reference

Erik von Elm,a Douglas G Altman,b Matthias Egger,a,c Stuart JPocock,d Peter C Gtzsche e & Jan P Vandenbrouckef for theSTROBE Initiative. The Strengthening the Reporting ofObservational Studies in Epidemiology (STROBE) Statement:guidelines for reporting observational studies. Bulletin of the WorldHealth Organization2007;85:867872.

Pocock SJ, Collier TJ, Dandreo KJ, de Stavola BL, Goldman MB, KalishLA, et al. Issues in the reporting of epidemiological studies: a surveyof recent practice. BMJ2004;329:883

Lee W, Bindman J, Ford T, Glozier N, Moran P, Stewart R, et al. Biasin psychiatric case-control studies: literature survey. Br J Psychiatry

2007;190:204-9. Tooth L, Ware R, Bain C, Purdie DM, Dobson A. Quality of reporting

of observational longitudinal research.Am J Epidemiol2005;161:280-8.

Bonita, R., Beaglehole, R. & Kjellstrom, T. (2006) Basic pidemiology

Ed.2.WHO.


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Dahlan, M.S. (2010) Membaca dan menelaah

jurnal uji klinis. Jakarta:Salemba Medika.

Sastroasmoro, S. & Ismael, S. (2010) Dasar-

dasar Meodologi Penelitian Klinis

Ed.3.Jakarta:Sagung Seto.

Machin, D. & Campbell, M.J. (2005) The

Design of Studies for Medical Research.

England: John Wiley & Sons Ltd

critical appraisal of epidemiological study

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