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7/25/2019 ppt EBM ayu

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CRITICAL APPRAISAL

DIAGNOSTICTYPHIDOT M AND DIAZO TEST VIS--VIS

BLOOD CULTURE AND WIDAL TEST IN THE

EARLY DIAGNOSIS OF TYPHOID FEVER IN

CHILDREN IN A RESOURCE POOR SETTING

Ayu Wijayanti

1102009049

dr. Aryenti, M. Sc


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SKENARIO

Seorang ere!"an #er"$%a &' (a)"n *a(ang *engan+e,")an *e!a! $e*a) +"rang ,e#%) $e!%ngg"- na.$"!a+an #er+"rang- *%are- "$%ng- !"a,- !"n(a)- #era(#a*an !en"r"n/ Se(e,a) *%,a+"+an e!er%+$aan 0$%+

*%(e!"+an TD 1'23'- na*% &''42!en%(- ,%*a) +o(or- $")"("#") 516C- +ea*aan "!"! ,e!a)/ Pa$%en !e!%,%+%+e#%a$aan 7a7an $e!#arangan *% $e+o,a) *an,%ng+"ngann8a/ D"gaan $e!en(ara *o+(er a*a,a) *e!a!(%.o%* (e(a% "n("+ !enega++an *%agno$%$ a$(%- *o+(er

!er"7"+ "n("+ !e,a+"+an e!er%+$aan "7% 9%*a,/Pe!er%+$aan (er$e#"( !e!#"(")+an 9a+(" 8ang ,a!a/Orang ("a a$%en #er(an8a aa+a) a*a e!er%+$aan ,a%n8ang (%*a+ !e!#"(")+an 9a+(" 8ang ,a!a agar ana+n8a

$egera *%(angan% $e$"a% *engan *%agno$%$ a$(%n8a/


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Pertanyaan (foreground question)

Aa+a) (er*aa( e!er%+$aan $e,a%ne!er%+$aan 9%*a, 8ang )a$%,n8a ,e#%):ea( +e,"ar *%#an*%ng+an *engan

e!er%+$aan 9%*a, 8ang !e!#"(")+an9a+(" 8ang ,a!a ;


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P I C O

Po",a(%on < Pere!"an *%*"ga !enga,a!% demamtifoid

In(er=en(%on< Me,a+"+an e!er%+$aan 9%*a, (e$( "n("+!enega++an *%agno$%$ a$(% 8ang !e!#"(")+an 9a+("

,e#%) ,a!a Co!ar%$on < Me,a+"+an e!er%+$aan T8)%*o( M a(a"

*engan e!er%+$aan *%a>o (e$( "n("+ !enega++an*%agno$%$ a$(% *engan !e!er,"+an 9a+(" 8g ,e#%) :ea(

O"(:o!e$ < Dengan !e,a+"+an e!er%+$aan T8)%*o(

M a(a" *engan e!er%+$aan *%a>o (e$(- *%agno$%$*e!a! (%.o%* *aa( *%(ega++an *engan 9a+(" 8ang ,e#%):ea(


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VALIDITY


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Menen("+an a*a a(a" (%*a+n8aer#an*%ngan 8ang *%,a+"+an $e:ara%n*een*en( *an #,%n* (er)a*a $"a("

$(an*ar r"7"+an ?go,* $(an*ar@;

Tidak, di jurnal ini tidak dijelaskan

tentang perbandingan yangdilakukan secara independent danblind terhadap suatu standarrujukan (gold standard)


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Menen("+an +e$e$"a%an an(ara $a!,ea$%en ene,%(%an *engan $e+(r"!en*er%(a a*a $e((%ng ra+(%+ +,%n%+ $aa(

"7% *%agno$(%+ (er$e#"( a+an*%a,%+a$%+an/

Ya, Terdapat kesesuaian antara

partisipan di jurnal dengan pasienpada setting klinik


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Menen("+an a*a a(a" (%*a+n8a r"7"+an$(an*ar *%,a+"+an (ana !e,%)a( )a$%, "7%*%agno$(%:

Ya- (er*aa( go,* $(an*ar 8ang*%(a!%,+an *a,a! 7"rna, %n% 8a%(" %$o,a$%#a+(er%


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IMPORTANCE


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Menen("+an $en$%(%=%(8- $e:%0:%(8- LR

iya, Sensitivitas dan spesiftasditampilkan dalam jurnal


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Tabel 1 Likelihood

ratio (!

Likelihood

ratio ("!

Widal test 1.33 0.67

Typhidot M

test

0 0.1

Diazo test 21.5 0.23

Tabel # Likelihood

ratio (!

Likelihood

ratio ("!

Widal test17.75 00.75

Typhidot M

test

0 0.11


Tabel 2 Likelihood ratio

(!

Likelihood ratio

("!

Blood Culture 0 0.72

Widal test 0 0.11

Typhidot M test 7.11 0.38

Diazo test 5.6 0.22

Tabel 4 Likelihood

ratio (!

Likelihood

ratio ("!

Blood Culture 0 0.6

Widal test 16.56 0.61

Typhidot M test 0 0.14



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APPLICABILIT


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Menen("+an +e!"ng+%nan eneraana*a a$%en ?a=a%,a#,e- aor*a#,e-a::"ra(e- re:%$e@

AVAILABLE :

Un("+ (8)%*o( (e$( (%*a+ (er$e*%a *%+,%n%+ / a,a( (er$e#"( !e!#"(")+an

(e+)n%+ *%,a#o,a(or%"! 8ang (er,%#a((e(a% 9a+(" 8ang *%#"(")+an "n("+*%agno$%$ (%*a+ ,a!a/


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Un("+ *%a>o (e$( !"ng+%n *aa(*%(era+an +arena !"*a) *%,a+"+an *an(%*a+ !e!#"(")+an 9a+(" 8ang ,a!a


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AFFORDABLE :

Ya/ Un("+ *%a>o (e$( +arena ,e#%) !"ra)*an (er7ang+a" "n("+ ra+8a( !enenga)

+e#a9a)


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TABEL 3

W%*a, (e$( '/T8)%*o( M = '/1D%a>o (e$( '/F

TABEL 4

B,oo* C",("re '/3W%*a, (e$( '/3

T8)%*o( M =

'/1D%a>o (e$( '/1

ACCURATE

TABEL 1

W%*a, (e$( '/3

T8)%*o( M '/1

D%a>o (e$( '/1

TABEL 2

B,oo* C",("re '/F

W%*a, (e$( '/

T8)%*o( M '/1

D%a>o (e$( '/


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PRECISE

Menen("+an er)%("ngan re(e$(ro#a#%,%(8 a$%en

P ! (A"C)#(A"B"C"$)Ta#e, & < '/& ?P5'2&F@

Ta#e, < '/3 ?P&&'2&F@

Ta#e, 5 < '/FF ?P'2&F@Ta#e, < '/ ?P12&F@


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TERIMAKASIH

WASSALAMUALAIKUM WR/ WB

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