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Critical Appraisal of the Topics

* Validitas Awal and Relevansi

Dikeluarkan oleh tim yang mempunyai tim


peer review (Journal of Pakistan Medicine
Association)
Lokasi penelitian di Rumah Sakit Pendidikan
dan Penelitian Universitas Zonguldak
Karaelmas di Zonguldak Turki, berbeda
kondisi dengan negara kita namun di lakukan
di rumah sakit pendidikan dan penelitian
Studi ini tidak disponsori oleh organisasi
yang dapat berdampak pada desain dan
hasil studi
Jika informasi ini benar maka akan
merubah sikap kita terhadap cara kita
dalam melayani pasien namun tidak bisa
diterapkan keseluruhannya.
Terdapat kesamaan karakteristik pasien
dengan di Indonesia yaitu pasien cedera
kepala, memiliki kemiripan dan dapat
*Masalah yang diangkat pada jurnal ini :
efektivitas Kraniotomi Dekompresi pada SDH
akut serta menilai apakah prosedur bedah
memberikan angka kelangsungan hidup
jangka pendek maupun jangka panjang yang
menguntungkan yang dinyatakan dalam
Glasgow Outcome Scale (GOS). Kasus ini
banyak ditemukan dalam praktek sehari- hari
Clinical category Description Prefered Study Design

Therapy Tests the effectiveness of a treatment, such Randomized, double-blinded,


as a drug, surgical procedure, or other placebo- controlled trial
intervention

Diagnosis Measures the validity (is it dependable?) and Cross-sectional survey


reliability (will the same results be obtained (comparing the new test with
every time?) of a diagnostic test, or a reference standard)
evaluates the effectiveness of a test in
detecting disease at a presymptomatic stage
when applied to a large population

Causation Assesses whether a substance is related to Cohort or case-control


the development of an illness or condition

Prognosis Determines the outcome of a disease Longitudinal cohort study


Level of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm
1a SR (with homogeneity*) of RCTs SR (with homogeneity*) of inception SR (with homogeneity*) of Level 1
cohort studies; CDR validated diagnostic studies; CDR with
in different populations 1b studies from different
clinical centres

1b Individual RCT (with narrow Individual inception cohort study Validating** cohort study with
Confidence Interval) with > 80% follow-up; CDR good reference standards;
validated in a single or CDR tested within one
population clinical centre

1c All or none All or none case-series Absolute SpPins and SnNouts

2a SR (with homogeneity* ) of cohort SR (with homogeneity*) of either SR (with homogeneity*) of Level


studies retrospective cohort studies or >2 diagnostic studies
untreated control groups in RCTs

2b Individual cohort study (including Retrospective cohort study or Exploratory** cohort study with
low quality RCT; e.g., <80% follow- follow-up of untreated control goodreference standards; CDR
up) patients in an RCT; Derivation of after derivation, or validated only
CDR or validated on split- on split-sample or databases
sample only

2c Outcomes" Research; Ecological" Outcomes" Research"


studies
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm

3a SR (with homogeneity*) of case- SR (with homogeneity*) of 3b and


control studies better studies

3b Individual Case-Control Study Non-consecutive study; or without


consistently applied reference
standards

4 Case-series (and Case-series (and Case-control study, poor or non-


poor quality cohort and case-contr poor quality prognostic cohort independent reference standard
ol studies studies***
) )
5 Expert opinion without explicit Expert opinion without explicit Expert opinion without explicit
critical appraisal, or based on critical appraisal, or based on critical appraisal, or based on
physiology, bench research or physiology, bench research or physiology, bench research or "first
""first principles ""first principles "principles
* Grades of Recommendation
A consistent level 1 studies

B consistent level 2 or 3 studies or extrapolations


from level 1 studies

C level 4 studies or extrapolations from level 2 or


3 studies

D level 5 evidence or troublingly inconsistent or


inconclusive studies of any level
* TERIMA KASIH