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CRITICAL APPRAISAL CHECKLIST FOR

A SYSTEMATIC REVIEW.

Study Design: Systematic Review, with or without Meta-analysis

Adapted from:

Critical Appraisal Skills Programme (CASP), Public Health Resource Unit,


Institute of Health Science, Oxford.

Oxman AD, Cook DJ, Guyatt GH. Users’ guides to the medical literature. VI.
How to use an overview. JAMA 1994; 272:1367-1371.

Dept. of General Practice


University of Glasgow.
DOES THIS REVIEW ADDRESS A CLEAR QUESTION?

1. Did the review address a clearly focussed issue? Yes Can’t tell No

Was there enough information on:

 The population studied


 The intervention given
 The outcomes considered

2. Did the authors look for the appropriate sort of


papers?

The ‘best sort of studies’ would

 Address the review’s question


Have an appropriate study design

1. Did the review address a clearly focussed issue?


a. The population studied
No. Pada jurnal hanya dijabarkan mengenai kriteria sampel yang diambil yakni orang
dewasa atau berusia > 18 tahun. Akan tetapi tidak dijabarkan mengenai berapa jumlah
keseluruhan sampel yang digunakan. Pada jurnal sistematik review ini juga tidak
menjabarkan kriteria eksklusi yang digunakan.
b. The intervention given
No. 15 jurnal yang digunakan menggunakan metode cross sectional (n=13), deskriptif
murni (n=1), deskriptif komparatif (n=1) dan prospektif kohort (n=1) dan tidak dijelaskan
intervensi yang digunakan terutama pada penelitian prospektif kohort.
c. The outcomes considered
Ya. Faktor-faktor yang mempengaruhi kualitas hidup pasien penyakit ginjal kronik yang
menjalani hemodialisis adalah faktor sosial demografi seperti jenis kelamin, usia, tingkat
pendidikan, status pernikahan, status pekerjaan atau status ekonomi. Faktor lainnya
depresi, beratnya/stage penyakit ginjal, adanya penyakit penyerta, lamanya menjalani
hemodialisis, tidak patuh terhadap pengobatan, indeks masa tubuh yang tinggi, dukungan
sosial, adekuasi hemodialisis, dan interdialityc weight gain (IDWG), urine output, dan nilai
hemoglobin.

2. Did the authors look for the appropriate sort of papers?


a. Address the review’s question
No. Pada jurnal tidak dituliskan mengenai pertanyaan ulasan.
b. Have an appropriate study design
Ya. Pada metode studi dijelaskan secara bertahap mengenai langkah pengambilan
jurnal yang akan direview

Dept. of General Practice


University of Glasgow.
ARE THE RESULTS OF THIS REVIEW VALID?

3. Do you think the important, relevant studies were Yes Can’t tell No
included?

Look for

Which bibliographic databases were used


Follow up from reference lists
Personal contact with experts
Search for unpublished as well as published studies
Search for non-English language studies

4. Did the review’s authors do enough to assess the


quality of the included studies?

The authors need to consider the rigour of the studies


they have identified. Lack of rigour may affect the studies
results.

5. If the results of the review have been combined, was it


reasonable to do so?

Consider whether

 The results were similar from study to study


 The results of all the included studies are clearly
displayed
 The results of the different studies are similar
 The reasons for any variations are discussed

3. Do you think the important, relevant studies were included?


Can’t tell. Karena salah satu referensi yang digunakan adalah berita online yang bersumber
dari http://health.okezone.com sehingga kredibilitasnya kurang bisa dipertangggungjawabkan.
Dan juga tidak diketahui apakah penulis melakukan tindak lanjut dari daftar referensi, kontak
personal dengan ahli, dan mencari studi yang tidak diterbitkan
4. Did the review’s authors do enough to assess the quality of the included studies?
Tidak. Karena pada pembahasan penulis tidak menyinggung mengenai perhitungan OR atas
faktor-faktor yang diteliti pada jurnal sehingga tidak diketahui alasan pemilihan faktor-faktor
tersebut.
5. If the results of the review have been combined, was it reasonable to do so?
Can’t tell. Karena pada pembahasan tidak dibahas mengenai alasan untuk berbagai variasi
didiskusikan dan tidak ditampilkan OR tiap faktor.

Dept. of General Practice


University of Glasgow.
WHAT ARE THE RESULTS?

6. What is the overall result of the review?

Consider

 If you are clear about the reviews ‘bottom line’ results


What these are (numerically if appropriate)
How were the results expressed (NNT, odds ratio,
etc)

7. How precise are the results?

Are the results presented with confidence intervals?

6. What is the overall result of the review?


Faktor-faktor yang mempengaruhi kualitas hidup pasien penyakit ginjal kronik yang menjalani
hemodialisis adalah faktor sosial demografi seperti jenis kelamin, usia, tingkat pendidikan,
status pernikahan, status pekerjaan atau status ekonomi. Faktor lainnya depresi, beratnya/stage
penyakit ginjal, adanya penyakit penyerta, lamanya menjalani hemodialisis, tidak patuh
terhadap pengobatan, indeks masa tubuh yang tinggi, dukungan sosial, adekuasi hemodialisis,
dan interdialityc weight gain (IDWG), urine output, dan nilai hemoglobin. Kesimpulan,
penilaian kualitas hidup sangat penting dilakukan, dan pemilihan instrumen yang tepat akan
mempengaruhi hasil penilaian kualitas hidup yang lebih objektif. Perlunya pendekatan
kolaborasi tim untuk meningkat kualitas hidup pasien penyakit ginjal kronik yang menjalani
hemodialisis.
7. How precise are the results?
Tidak presisi. Karena tidak menyertakan confidence interval (CI) nya.

WILL THE RESULTS HELP LOCALLY?

8. Can the results be applied to the local population? Yes Can’t tell No

Consider whether

The patients covered by the review could be sufficiently


different from your population to cause concern
Your local setting is likely to differ much from that of the
review

9. Were all important outcomes considered?

10. Are the benefits worth the harms and costs?

Even if this is not addressed by the review, what do you


think?

Dept. of General Practice


University of Glasgow.
8. Can the results be applied to the local population?
Yes. Karena Indonesia termasuk negara dengan tingkat penderita penyakit ginjal kronik yang
cukup tinggi dan berbagai penelitian ini menggunakan instrumen yang berbeda-beda sehingga
dapat dilakukan pemilihan instrumen yang paling objektif sesuai dengan kondisi setempat.
9. Were all important outcomes considered?
Can’t tell. Karena tidak dipaparkan OR maupun CI dari faktor-faktor yang mempengaruhi
sehingga sulit dilakukan pertimbangan mana yang paling penting.
10. Are the benefits worth the harms and costs?
Yes. Karena penilaian kualitas hidup dan pendekatan kolaborasi tim sangat penting dilakukan
untuk meningkat kualitas hidup pasien penyakit ginjal kronik yang menjalani hemodialisis.

Dept. of General Practice


University of Glasgow.
JARGON BUSTER.

Systematic review A review in which evidence on a topic or research question has been
systematically identified, appraised and summarised according to
predetermined criteria. Systematic reviews may incorporate meta-
analysis, but don’t have to.

Meta-analysis A statistical technique. Summarises the results of several studies into


a single estimate, giving more weight to larger studies.

Publication bias When only studies with positive results are published, not the neutral
or negative studies. If only published studies are included in a
systematic review, it may overestimate the effect of the treatment or
intervention.

Number Needed to Treat The number of patients who needed to be treated to prevent the
(NNT) occurrence of one adverse event (e.g. complication, death) or
promote the occurrence of one beneficial event (e.g. cessation of
smoking).

Odds A ratio. It is the odds (or chance) of an event occurring.

Odds ratio The ratio of two odds. Used as measure of a treatment’s


effectiveness. If OR = 1.0, then the effect of the experimental
treatment is no different from that of the control treatment. If the OR is
>1.0 (or <1.0), then the experimental treatment effect is greater than
(or less than) the control treatment.
N.B. The effect being measured may be good (e.g. stopping smoking)
or bad (death).

Dept. of General Practice


University of Glasgow.