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EVIDENCE

BASED
MEDICINE
IWAN SUMANTRI 1102012134
JELSA MEIDA
1102012137
FAKULTAS KEDOKTERAN UNIVERSITAS YARSI

SKENARIO
Ibu, 30 tahun membawa anaknya ke dokter untuk
berkonsultasi tentang perkembangan kognitif anaknya.
Anaknya sangat suka menonton televisi. Kebiasaan ini
sudah dilakukan selama setahun. Dia sering menonton untuk
waktu yang lama dalam sehari. Bila dihentikan
kebiasaannya, dia akan mengamuk dan menangis. Tapi
anaknya sangat aktif dan gesit dibandingkan teman-teman
sekolahnya di paud. Dan anaknya juga sangat suka bertanya
dan berbicara kepada ibu atau gurunya. Ibunya menanyakan
adakah hubungan perkembangan kognitif anaknya dengan
kebiasaan menonton televisi.

Pertanyaan (foreground question)


Apakah ada hubungan perkembangan kognitif anak
dengan kebiasaan menonton televisi ?

PICO
Population : Andi yang suka menonton tv
Intervention : Kebiasaan menonton TV dan waktu
menonton TV
Comparison : Teman Andi di paud
Outcomes : Perkembangan kognitif anak

PENCARIAN BUKTI
ILMIAH
Alamat website:http://www.ncbi.nlm.nih.gov/pubmed
Keyword :television watching time AND cognitive
AND playgroup
Limitasi : Januari 2009 Desember 2014
Hasil Pencarian:4

DIPILIH ARTIKEL BERJUDUL

Television watching time and cognitive development in


young children
I Gusti Ayu Trisna Windiani, Djauhar Ismail
2012 Jan 52;19(29):4799-807. doi:
10.3748/wjg.v19.i29.4799.

VALIDITY
1.

Apakah terdapat sampel pasien yang


representatif, dan didefinisikan secara
jelas pada titik yang sama (similar point) ,
dalam perjalanan penyakit (course of the
disease) ?

We conducted a cross-sectional study from April


to may 2011. Subject were children agend 34 52
months, attendig pre kindergarten in Denpasar, Bali.
The inclusion criteria were residence in as well as parents
providing proxy consent and able to read, write, and tell
time. We excluded children with history of head injuries,
birth complications, major congenital abnormalities
or illness at the time of the study. The calculated
minimum number of required study subjects was 135.

2. Apakah follow-up lengkap dan cukup


lama (sufficiently long and complete) ?

There were 135 subjects in our study, with ages ranging from 34
to 52 months. Subjects were allocated to one of three groups
depending on the amount of time spent watching television, i.e.,
< 1 hour daily, 1 2 hours daily, or > 2 hours daily. The mean
age of children who watched television < 1 hour daily was 45.08
months, 1- 2 hours daily was 40.93 months, and >2 hours daily
was 44.29 months. The mean duration of watching television in
this study for all subjects was 2.48 hours per day. Baseline
characteristics for each group are shown in Table 1.

3. Apakah digunakan kriteria outcome yang


objektif dan tersamar/tidak berbias?

Television watching by children has been


shown to increase their vocabulary, especially
for words that are rarely used by children in
daily life. Other studies concluded that
television can develop cognitive function
through looking at the pictures and hearing
words.

The cognitive development in children attending


playgroup who watched television 1 2 hours per
day was higher than in those who watched television
for less than 1 hour or more than 2 hours per day. In
conclusion, television watching time was statistically
associated with cognitive development of children
wwho attended playgroup.

4. Apakah diidentifikasi kelompok


dengan prognosis yang berbeda dan
dilakukan penyesuaian /adjustment
terhadap factor prognostic yang
penting?

IMPORTANCE

5. BAGAIMANA GAMBARAN OUTCOME


DARI WAKTU KE WAKTU?

An overseas study assessed cognitive development


with the Peabody Individual Achievement Test
Reading Recognition Scale and found positive effects
of television watching in children aged 3 to 5 years.
They reported that each hour of television watched
was associated with an increase of 0.51 points in the
reading recognition scale score, but not significantly
associated with memory capabilities. Reading skills
assessed includeed the ability t pronounce words and
enrich the vocabulary.

We used the Mullen scale to assess cognitive


development in children who attended playgroup, and
we observed results different from other studies that
used other criteria and cognitive assessment tools.
However , we had similar results to a studyby
Lineberger, who found that watching childrens
television programs (Dora the explorer, Blues clues,
Arthur, Clifford or Dragon Tales ) increased the value of
expressive languange and vocabulary in children who
watched at the age of 30 months.

6. seberapa tepat perkiraan prognosis?

APPLICABILITY

7. APAKAH PASIEN DALAM PENELITIAN


INI SERUPA DENGAN PASIEN KITA?
YA

8. Apakah simpulan hasil study bermanfaat


apabila disampaikan kepada pasien dalam
tatalaksan secara keseluruhan?