Critical Appraisal Predictive Value of Plasma HIV RNA Level on Rate of CD4 T-Cell Decline in Untreated HIV Infection

Arizal Robbi Nugraha 110170004 Kelompok 4

Telaah Kritis Jurnal

Sumber : JAMA, 2006 Judul Penelitian : Predictive Value of Plasma HIV RNA Level on Rate of CD4 T-Cell Decline in Untreated HIV Infection Judul tidak terlalu panjang, namun tidak mencakup keseluruhan 5WIH Menggambarkan isi utama penelitian Cukup menarik perhatian pembaca Terdapat singkatan

Variabel bebas : Value of Plasma HIV RNA Variabel tergantung : Value of CD4 Decline

Penulisan Nama Peneliti Nama penulis disertai dengan gelar akademik atau indikasi jabatan dan kepangkatan penulis. Alamat korespondesi penulis sudah tercantum dalam jurnal ini

Abstrak Abstrak tersusun dengan baik Namun belum mencakup secara keseluruhan komponen IMRAD (introduction, method, result, analysis, conclusion, comment ) Tanpa singkatan selain yang baku Abstrak dalam penilitian ini sudah cukup jelas menggambarkan secara keseluruhan dari jurnal Pada abstrak tidak terdapat tabel, grafik, rumus, gambar, dan acuan atau pengutipan pustaka hal ini telah sesuai dengan ketentuan penulisan abstrak Tidak mencantumkan keyword

Pendahuluan Latar belakang sudah dapat menggambarkan permasalahan yang dikaitkan dengan judul penelitian Masalah-masalah yang dipaparkan oleh peneliti ini telah meyakinkan pembaca akan pentingnya masalah penelitian yang dikaji dan tidak melebar sehingga fokus ke masalah penelitian

Tujuan Penelitian Peneliti memaparkan tujuan penulisnya adalah untuk memperkirakan proporsi variabilitas dalam memprediksi tingkat penurunan CD4 dengan memaparkan tingkat RNA HIV plasma pada pasien yang terinfeksi HIV yang tidak diobati

Metode Penelitian Penelitian ini menggunakan metode penelitian observasional dengan desain Prospektif (Study Cohort) Yang terdiri dari pengamatan dimulai pada tanggal 12 Mei 1984 dan berakhir pada tanggal 26 Agustus 2004. Analisis dilakukan antara Agustus 2004 dan Maret 2006 Pengukuran Alat yang digunakan untuk mengukur kadar RNA HIV Plasma adalah dengan Amplicor HIV-1 Monitior assay (Roche Diagnostics, In-dianapolis,Ind) DNA assay (Chiron Corp,Emeryville,Calif) untuk mengukur CD4 dengan sitometri

Hasil Disertakan tabel uji statistik hasil penelitian Dikedua kohort level RNA HIV Plasma yang lebih tinggi dihubungkan dengan penurunan T-Cell CD4 pada studi kohort, median estimasi model sel CD4 menurun diantara partisipan dengan RNA HIV level 500 atau kurang, 501-2000, 2001-10000, 10001 40000 dan lebih dari 40000 copy/ml adalah 20, 39, 48, 56, dan 78 sel/ml secara berurutan

12 Questions to Help You Make Sense of A Cohort Study

A.

Are the results of the study valid? Screening Questions 1. Did the study address a clearly focused issue? a. The Population Studied (Yes) b. The Risk Factors Studied (Yes) c. The Outcomes Considered (Yes) d. Is it clear whether the study tried to detect a beneficial or harmful effect? (Yes)

2. Did the authors use an appropriate method to answer their question? a. Is a cohort study a good way of answering the question under the circumstances? (Yes) Penelitian yang dapat memprediksi suatu penyakit Jarang dilakukan b. Did it address the study question? (Yes)

Detailed Questions 3. Was the cohort recruited in an acceptable way? a. Was the cohort representative of a defined population? (Yes) b. Was there something special about the cohort? (Yes) c. Was everybody included who should have been included? (Yes) 4. Was the exposure accurately measured to minimize bias? (Yes) a. Did they use subjective or objective measurements? (Yes) b. Do the measures truly reflect what you want them to (have they been validated)? (Yes) c. Were all the subjects classified into exposure groups using the same procedure? (Yes)

5. Was the outcome accurately measured to minimize bias? (Yes) a. Did they use subjective or objective measurements? b. Do the measures truly reflect what you want them to (have they been validated)? c. Has a reliable system been established for detecting all the cases (for measuring disease occurrence)? d. Were the measurement methods similar in the different groups? e. Were the subjects and/or the outcome assessor blinded to exposure (does this matter)?

6. a. Have the authors identified all important confounding factors? List the ones you think might be important, that the authors missed. (Yes) b. Have they taken account of the confounding factors in the design and/or analysis? (Yes) 7. a. Was the follow up of subjects complete enough? (Yes) b. Was the follow up of subjects long enough? (Yes) B. What are the results? 8. What are the results of this study? 9. How precise are the results? How precise is the estimate of the risk? 10. Do you believe the results?

(Yes) (Yes) (Yes) (Yes)

c. Will the results help me locally? (Yes) 11. Can the results be applied to the local population? (Yes) 12. Do the results of this study fit with other available evidence? (Yes)