NIM: C185202002

NAMA MPPDS: Rasi Sallang

Departemen: Pulmonologi dan kedokteran respirasi
JUDUL ARTIKEL: Metformin Use and Lung Cancer Risk in Diabetic Patients : A Systematic Review and Meta-Analysis
DOI ARTIKEL: https://doi.org/10.1155/2019/6230162
PRISMA CHECKLIST
Section/topic # Checklist item Reported on page # Comments/description

TITLE

Title 1 Identify the report as a systematic review, meta-analysis, or both. 1 Terdapat pada bagian judul
ABSTRACT
Structured summary 2 Provide a structured summary including, as applicable: 1 Jurnal ini menjelaskan secara
background; objectives; data sources; study eligibility criteria,
participants, and interventions; study appraisal and synthesis kuantitatif hubungan antara
methods; results; limitations; conclusions and implications of key kejadian kanker paru dan
findings; systematic review registration number. metformin pada pasien
diabetes dalam meta-analisis
ini. Metode. Yang dilakukan
pencarian di PubMed,
Embase, ISI Web of Science,
dan Cochrane Library hingga
20 September 2017. Rasio
odds (OR), risiko relatif (RR)
atau rasio bahaya (HR), dan
interval kepercayaan 95%
(95% CI) diperkirakan
menggunakan model efek
acak. Skala Newcastle-
Ottawa (NOS) digunakan
untuk menilai kualitas
penelitian. Hasil. Sebanyak 13
studi (10 studi kohort dan 3
studi kasus-kontrol)
dimasukkan dalam meta-
analisis. Dibandingkan
dengan pengguna
nonmetformin,
I2 = 66%, P = 0 0004). Analisis
subkelompok menunjukkan
bahwa studi kohort (RR = 0
91; 95% CI, 0,85-0,98; P = 0
008), lokasi di
Eropa (RR = 0 90; 95% CI,
0,86-0,94; P <0 0001), obat
kontrol dari kelompok
sulfonylurea (RR = 0 91; 95%
CI, 0,86-0,96;
P. = 0 001), dan
penyesuaian untuk merokok
(RR = 0 86; 95% CI, 0,75-
1,00; P = 0 05) mungkin
terkait dengan risiko kanker
paru-paru yang lebih
rendah. Tidak ada bias
publikasi yang signifikan
terdeteksi menggunakan
plot corong.
Kesimpulan. Penggunaan
metformin terkait dengan
risiko kanker paru-paru
yang lebih rendah pada
pasien diabetes
dibandingkan dengan
nonpengguna, tetapi hasil
ini diambil dari studi
observasi dan temuan kami
 membutuhkan RCT yang
dirancang lebih baik untuk
memastikan hubungan
tersebut.

INTRODUCTION

Rationale 3 Describe the rationale for the review in the context of what is 2 Studi yang mengevaluasi
already known. hubungan antara risiko
kanker paru-paru dan
penggunaan metformin di
antara pasien diabetes
menghasilkan hasil yang
tidak konsisten.

Objectives 4 Provide an explicit statement of questions being addressed with 2 Jurnal ini meneliti hubungan
reference to participants, interventions, comparisons, outcomes,
and study design (PICOS).
antara kejadian kanker paru
dan metformin pada pasien
diabetes menggunakan
sistematik review dan meta
analisis
METHODS
Protocol and registration 5 Indicate if a review protocol exists, if and where it can be accessed 2 PRISMA 2009 checklist.doc,
(e.g., Web address), and, if available, provide registration
information including registration number.
ini dijelaskan sebagai Item
Pelaporan Pilihan untuk
Tinjauan Sistematis dan
Analisis Meta (PRISMA)
daftar periksa yang 27 item
daftar periksa berkaitan
dengan konten tinjauan
sistematis dan meta-analisis,
yang meliputi judul, abstrak,
metode, hasil, pembahasan,

Eligibility criteria 6 Specify study characteristics (e.g., PICOS, length of follow-up) and
Information sources 7 Describe all information sources (e.g., databases with dates of
Search 8 Present full electronic search strategy for at least one database,
Study selection 9 State the process for selecting studies (i.e., screening, eligibility,
Data collection process 10
dan pendanaan.
2 Artikel direview setidaknya 2
report characteristics (e.g., years considered, language,
publication status) used as criteria for eligibility, giving rationale.
orang dari 7 penulis. Artikel
di katakana layak jika
mengandung informasi
kejadian kanker paru dan
metformin pada pasien
diabetes Tidak ada Batasan
dalam Bahasa artikel.
2-3 Data diesktraksi oleh 2
coverage, contact with study authors to identify additional studies)
in the search and date last searched.
reviewed independent dan
dicek setidaknya 2 dari 4
penulis. Terdapat 2 studi
yang tidak sesuai dan
dilakukan kontak via email
kepada penulis namun tidak
mendapat balasan.
2 Pada bulan agustus 2017,
including any limits used, such that it could be repeated.
dilakukan pencarian artikel
dari 117database elektronik
(PubMed dan Information
Science Institute)
2 Dilakukan skrining oleh 2 dari
included in systematic review, and, if applicable, included in the
meta-analysis).
7 penulis. Studi dikatakan
memenuhi syarat jika
menganduk informasi DBD
dengan status gizi. Tidak ada
Batasan dalam desain studi
Describe method of data extraction from reports (e.g., piloted 2-3 Data diekstrakasi oleh 2
forms, independently, in duplicate) and any processes for
obtaining and confirming data from investigators.
reviewer independent. 13
studi dari 15 data yang
diekstraksi dimasukkan
 pertama kali. 2 studi yang
tidak sesuai dilakukan kontak
kepada penulis yang
bersangkutan via email
namun tidak ada balasan.
Data items 11 List and define all variables for which data were sought (e.g., 2 Dijelaskan variable inklusi,
PICOS, funding sources) and any assumptions and simplifications
made.
eksklusi, interpretasi factor
pendukung dan desikripsi
diagnose DBD
Risk of bias in individual 12 Describe methods used for assessing risk of bias of individual 3 Menggunakan
studies studies (including specification of whether this was done at the
study or outcome level), and how this information is to be used in
Comprehensive Meta-
any data synthesis. Analysis software version 2
Summary measures 13 State the principal summary measures (e.g., risk ratio, difference -
in means).
Synthesis of results 14 Describe the methods of handling data and combining results of 3 Studi direview oleh 2 orang
studies, if done, including measures of consistency (e.g., I2) for
each meta-analysis.
reviewer dan di cek oleh 2
dari 4 penulis. Apabila ada
perbedaan diselesaikan
dengan diskusi dan
consensus.
Risk of bias across 15 Specify any assessment of risk of bias that may affect the -
studies cumulative evidence (e.g., publication bias, selective
reporting within studies).
Additional analyses 16 Describe methods of additional analyses (e.g., sensitivity or 3 Menggunakan
subgroup analyses, meta-regression), if done, indicating Comprehensive Meta-
which were pre-specified.
Analysis software version 2
RESULTS

Study selection
Study characteristics
17 Give numbers of studies screened, assessed for eligibility, 3 Fig 1. Flow diagram of the
and included in the review, with reasons for exclusions at article screening process
each stage, ideally with a flow diagram.
from electronic database
18 For each study, present characteristics for which data were 2 A total of 892 studies were
 extracted (e.g., study size, PICOS, follow-up period) and obtained using the above
provide the citations. search strategy, and 17
studies were identified
through initial research. Of
these studies, Hall et al. [21],
Bodmer et al. [22], and
Smiechowski et al. [16]
assessed the same
population from the U.K.
General Practice Research
database, and the
populations in Ferrara et al.’s
study [23] and Sakoda et al.’s
study [17] were both from
the Kaiser Permanente
Northern California (KPNC)
Diabetes Registry. After
excluding these articles, 13
studies fulfilled the inclusion
criteria and were pooled in
our meta-analysis
Risk of bias within studies 19 Present data on risk of bias of each study and, if available, 7 Tidak terdapat bias pada studi ini
any outcome level assessment (see item 12).
Results of individual 20 For all outcomes considered (benefits or harms), present, 5-7 Fig 2, Fig 3, Fig 4, Fig 5
studies for each study: (a) simple summary data for each
intervention group (b) effect estimates and confidence
intervals, ideally with a forest plot.
Synthesis of results 21 Present results of each meta-analysis done, including 5 Tabel 1, figure 3, figure 4, figure
confidence intervals and measures of consistency. 5

Risk of bias across 22 Present results of any assessment of risk of bias across
studies studies (see Item 15).
Additional analysis 23 Give results of additional analyses, if done (e.g., sensitivity 8-9 Dilakukan studi tambahan
or subgroup analyses, meta-regression [see Item 16]). oleh penulis dimana
 membandingkan antara
kanker paru terhadap
perokok dan bukan perokok.
Hasilnya perokok
berhubungan dengan
keparahan kanker paru
DISCUSSION
Summary of evidence 24 Summarize the main findings including the strength of 7 Penulis berhipotesis bahwa
evidence for each main outcome; consider their relevance gizi buruk memiliki factor
to key groups (e.g., healthcare providers, users, and policy
proteksi terhadap DSS
makers).
dikarenakan disfungsi imun.
Namun studi yang direview
mengatakan bahwa tidak ada
hubungan antara gizi buruk
dan DSS.
Limitations 25 Discuss limitations at study and outcome level (e.g., risk of 7 Keterbatasan dari meta
bias), and at review-level (e.g., incomplete retrieval of analisis ini kriteria inklusi,
identified research, reporting bias).
semua studi yang
dimasukkan adalah studi
observasional
Conclusions 26 Provide a general interpretation of the results in the context 7 Untuk menyimpulkan,
of other evidence, and implications for future research. penggunaan metformin
tampaknya menurunkan
kejadian kanker paru-paru
pada pasien diabetes
menurut meta-analisis ini.
Karena heterogenitas yang
signifikan dan kemungkinan
bias, lebih banyak
penyelidikan, terutama uji
coba terkontrol acak yang
dirancang dengan baik,
 diperlukan untuk
memvalidasi hubungan
FUNDING
Funding 27 Describe sources of funding for the systematic review and 7 didukung oleh dana dari
other support (e.g., supply of data); role of funders for the Yayasan Ilmu Pengetahuan
systematic review.
Alam dari Lembaga
Pendidikan Tinggi Anhui
China (KJ2016A358) dan
Penelitian Ilmiah BSKY
(XJ201726) dari Universitas
Kedokteran Anhui
Adapted From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA
Statement. PLoS Med 6(7): e1000097. doi:10.1371/journal.pmed1000097. For more information, visit: www.prisma-statement.org.