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CAT

(Critical Appraisal of The Topics)


Skrining Validitas Awal dan Relevansi
KELEBIHAN
 Peneliti jurnal ini tidak dipengaruhi oleh sponsor organisasi
tertentu
 Lokasi studi tidak sama, namun jika valid, dapat
berpengaruh pada praktek medis
 Jika informasi yang terdapat pada jurnal ini benar maka
akan dapat menambah modalitas kita sebagai ahli bedah
untuk menentukan rencana terapi pasien dan dapat
menjadi dasar pemikiran bagi kita untuk dilakukan
penelitian lanjutan.
KEKURANGAN
 Penelitian dilakukan di 1 tempat ( single centre )
 Retrospective study
Determine the Intent of the Article
 Tujuan dari penelitian ini untuk menentukan apakah
Dexamethasone dapat menurunkan angka kejadian
kekambuhan dini ( early recurrence ) dari intususepsi aut
pada pasien anak.
 Kategori klinis : Terapeutik

 Penelitian ini :
 Retrospektif, pasien anak dengan intususepsi
idiopatik dalam kurun waktu Januari 1999 sampai
dengan September 2014 yang dirawat di Assaf
Harofeh Medical Center.
Clinical category Description Prefered Study Design

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


such as a drug, surgical procedure, or blinded, placebo-
other intervention controlled trial
Diagnosis Measures the validity (is it dependable?) Cross-sectional survey
and reliability (will the same results be (comparing the new test
obtained every time?) of a diagnostic with a reference standard)
test, or 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
Cohort or case-control
related to the development of an illness
or condition
Prognosis
Determines the outcome of a disease Longitudinal cohort study
Level 1 of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm

1a SR (with homogeneity*) SR (with homogeneity*) SR (with homogeneity*) of


of RCTs of inception cohort Level 1 diagnostic studies;
studies; CDR† CDR† with 1b studies from
validated in different different clinical centres
populations

1b Individual RCT (with Individual inception Validating** cohort study


narrow Confidence cohort study with > with good††† reference
Interval‡) 80% follow-up; CDR† standards; or CDR† tested
validated in a single within one clinical centre
population

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


SnNouts††
Level 2 of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm
2a SR (with homogeneity* ) SR (with SR (with homogeneity*) of
of cohort studies homogeneity*) of Level >2 diagnostic studies
either retrospective
cohort studies or
untreated control
groups in RCTs
2b Individual cohort study Retrospective cohort Exploratory** cohort study
(including low quality study or follow-up of with good†††reference
RCT; e.g., <80% follow- untreated control standards; CDR† after
up) patients in an RCT; derivation, or validated only
Derivation of CDR† or on split-sample§§§ or
validated on split- databases
sample§§§ only
2c "Outcomes" Research; "Outcomes" Research
Ecological studies
Level 3, 4, 5 of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm
3a SR (with homogeneity*) SR (with homogeneity*) of
of case-control studies 3b and better studies
3b Individual Case-Control Non-consecutive study; or
Study without consistently applied
reference standards

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


quality cohort and case- quality prognostic non-independent reference
control studies§§ ) cohort studies***) standard
5 Expert opinion without Expert opinion without Expert opinion without
explicit critical appraisal, explicit critical explicit critical appraisal, or
or based on physiology, appraisal, or based on based on physiology,
bench research or "first physiology, bench bench research or "first
principles" research or "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
Kami simpulkan jurnal ini memiliki validitas
level 2b dengan grade of recommendation C