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Annisa Farida Muti, S.Farm., M.Sc., Apt.

Pharmacy Department, Faculty of Health Science


University of Muhammadiyah Malang

EVALUASI LITERATUR

Introduction
Praktek medis dan farmasi dinamis.
Ilmu waktu sekolah tdk bisa
dipertahankan utk future practice.
Perubahan: obat baru, dosage
formulations, penggunaan yg disetujui
FDA, info keamanan obat yg ditinjau
kembali (mis. efek samping, interaksi
obat), dan updated disease guideline.
Harus mengikuti perkembangan spy
kompeten dan dapat dipercaya.

1. Tertiary Literature
ADVANTAGES

Provide a fairly complete


and concise overview of
information available on a
specific topic.
Convenient, easy to use,
and familiar to most
practitioners.
Most of the information
needed by a practitioner
can be found in these
sources excellent firstline resources.

DISADVANTAGES

The lag time associated with


publication, resulting in less
current information.
Information in a tertiary text
may be incomplete due either
to space limitations of the
book or incomplete literature
searches by the author.
Errors in transcription, human
bias, incorrect interpretation
of information, or a lack of
expertise by authors
quality of tertiary references.

Petunjuk Evaluasi
Literatur Tersier
1.
2.

3.
4.
5.

6.
7.

Siapakah pengarangnya dan apakah


kredibilitasnya?
Tahun dan bulan berapa referensi tersebut
diterbitkan? Waktu yang hilang 2-3 tahun untuk
buku dan 1-2 tahun untuk review articles.
Edisi ke- berapa? Apakah yang terkini?
Apakah ada daftar pustaka dan apakah dari
literatur primer terkini?
Apakah pernyataan, fakta, data dsb yang penting
diberi catatan dibawah dan/ atau diberi
referensi?
Informasi apa yang tersedia dari referensi ini?
Apakah peer-reviewed (review article)?
4

2. Secondary Literature
ADVANTAGES

Digunakan untuk
akses ke literatur
primer (berupa index
atau abstrak) dan tdk
digunakan utk
menjawab pertanyaan
Kebanyakan dalam
format elektronik

DISADVANTAGES

Referensi sekunder

dg

sistem index hanya


mencakupi jumlah
jurnal yg terbatas
Semua referensi
sekunder cenderung
mempunyai time lag
Harus mahir
searching electronic
database

The operator AND will combine two terms, returning only citations
containing both of those concepts or terms.
The operator OR will have an equal or greater number of returns
since it will include any citation where either term is used.
Use of the term NOT will always decrease the number of
responses, since it eliminates any references having the term that
follows that operator; therefore it should be used with caution,
since it may eliminate articles that may be appropriate, simply
because the term being eliminated happens to appear
somewhere in the article.

Example
Is clonidine effective in the treatment of
attention deficit hyperactivity disorder
(ADHD) in adolescents

3. Primary Literature
ADVANTAGES

Access to detailed
information about a
topic.
The ability to
personally
assess the
Primary
Literature
utility and
~ validity of
study results.
Research
Papers/
Journals

DISADVANTAGES
Misleading
conclusions based on
only one trial without
the context of other
researches.
The need to have
good skills in medial
literature evaluation.
The time needed to
evaluate the large
volume of literature
available.

Alasan research papers/ journals perlu dievaluasi :


Utk mengerti hasil penelitian.
Mengidentifikasi kekuatan dan kelemahannya.
Meyakinkan pasien mendapat pengobatan berdasarkan bukti

paling baik yg tersedia.

Kenapa byk artikel ditolak?


Isu ilmiah dlm studi tdk penting
Studi tdk original
Studi tdk menguji author hypothesis
Sample size terlalu kecil
Studi tdk ada/ tdk cukup kontrol
Penulisan jelek
Analisa statistik tdk betul, dll

Critical Appraisal

USEFUL OF
INFORMATION

Relevance x Validity
Time to locate and interpret.

10

hierarchy of major study designs

systematic review of
RCTs
RCT
interventional
cohort

observational

case control
validity
11

MK : Sistem Informasi Obat 2012

12

Format Isi Research Papers/


Journals
Section

Type of information

Abstract

Brief overview of the research project

Introduction

Research background
Clinical trial objective

Methodology

Study design
Patient inclusion and exclusion criteria
Randomization
Blinding
Endpoints
Follow-up procedure
Sample size calculations/power analysis
Statistical analysis

Results

Subject characteristics
Subjects dropouts/compliance
Endpoints quantified
Safety assessments

Discussion

Result interpretations
Other study results compared
Limitations

Acknowledgments

Other contributors
Funding source
Peer review dates

References/
Bibliography

Citations for information included from other sources (e.g trials


and report)

4. Internet Source
Information
A

starting point for questions about :

unusual diseases
marketed over-the-counter products
combination dietary supplements.

Additionally,

Internet searches may be


useful for topics that have recently been
in the news, where information is
changing more rapidly than standard
paper resources can be updated.

How to evaluate internet


source information?
To

carefully evaluate the quality of all


information provided.
There are literally millions of websites and there are

no true quality assurance measures in place to


evaluate the reliability of information available.
In order to assess the quality of online information,
several standards and programs now exist. These
include organizations such as the Health on the Net
(HON code, http://www.hon.ch), which clearly define
rules to evaluate the quality of information
available via a website.

How to evaluate internet


source information?
The

following criteria should be used when


determining quality of online material:
Is the source credible, without a vested interest in

promoting one particular treatment or product?


Is the information accurate and current?
Does the site link to other nonaffiliated sites that
provide good information consistently?
Is the information appropriately detailed and
referenced?
Is it possible to identify the author of the site to
contact with additional questions or comments?

Questions
1.

2.

3.

4.

5.

6.

A new mother has been breastfeeding her child for 3 months.


The mother has recently been prescribed levofloxacin for
treatment of an infection. Is it safe for her to continue
breastfeeding during this therapy?
A patient is receiving amiodarone in a bag of normal saline. The
nurse wants to know if the amiodarone therapy is compatible
with metronidazole.
A patient is given a prescription for promethazine 25 mg orally
every 6 hours to treat nausea and vomiting. The patient is
currently taking sertraline 50 mg daily and Ortho Tri Cyclen Lo .
Are there any interactions between the patient's medications?
A pharmacist received a prescription for dexamethasone to help
reduce a tumor. The pharmacist wants to know what dose is
appropriate for this use.
A prescriber needs to give diazepam to a 7-year-old child who is
not able to swallow pills or capsules. By what other routes can
this drug be given and what dose is appropriate for this patient?
A pharmacist wants to know what current investigational drugs