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Critical Appraisal of
Observational Study
in Epidemiology
dr. YUDHI WIBOWO, M.PH
OUTLINE PENDAHULUAN
SIKLUS EBM & KOMPONEN TELAAH jURNAL
MEMAHAMI LAPORAN JURNAL
OBSERVATIONAL STUDY in EPIDEMIOLOGY
STROBE
CA JURNAL OBSERVATIONAL STUDY IN
EPIDEMIOLOGY
KESIMPULAN
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PENDAHULUAN
Bailey et al. (2005) Introduction to Epidemiology.
London:McGraw-Hill
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PENDAHULUAN
Much biomedical research (9 of 10) is observational.
The reporting of such research is often inadequate,
Which hampers the assessment of its strengths and weaknesses and
of a studys generalizability.
However, in published observational research important
information is often missing or unclear.
(Erik et al., 2007)
An analysis of epidemiological studies published in general
medical and specialist journals found that the rationale behind the
choice of potential confounding variables
was often not reported (Pockok et al., 2004).
Only few reports of case-control studies in psychiatry explained
the methods used to identify cases and controls (Lee et al.,
2007).
In a survey of longitudinal studies in stroke research, 17 of 49
articles (35%) did not specify the eligibility criteria (Tooth et
al., 2005).
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SIKLUS EBM
Menjawab Pertanyaan
Telaah Jurnal
Menemukan Kasus
Mengembangkan
Pertanyaan
Mencari Rujukan
MEMAHAMI LAPORAN JURNAL OBSERVATIONAL
STUDY in EPIDEMIOLOGY STROBE
The Strengthening the Reporting of
Observational Studies in Epidemiology
(STROBE).
What should be included in an accurate
and complete report of an observational
study.
Covered three main study designs:
cohort, case-control and cross-sectional
studies
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A checklist of 22 items (the STROBE
Statement) that relate to the title,
abstract, introduction, methods, results
and discussion sections of articles.
Eighteen items are common to all three
study designs and four are specific for
cohort, case-control, or cross-sectional
studies.
To improve the quality of reporting of
observational studies
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Introduction
1. Background/rationale:
besar masalah: prevalensi/insidensi/jumlah, dibandingkan dengan
sebelumnya, di tempat lain, target program & dampak
Elaborasi: substansi & metodologis
Kesenjangan: substansi, metodologis, konfirmasi penelitian
sebelumnya
2. Tujuan Utama penelitian (primary outcome): paling diminati
peneliti, desain dirancang utk menjawab pertanyaan, sbg dasar
perhitungan besar sampel
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KOMPONEN TELAAH JURNAL (VIA)
V
V
Interna
non-kausal
V
Interna kausal
V
Eksternal
Transportability
Kodisi pasien
Kemampuan pelayanan
Ekonomi
Sosial budaya
Agama
Kepeentingan hasil
penelitian secara klinis
V eksterna 1
V eksterna 2
Temporality
Degree of association
Dose response
Consistency
Coherency
Specivicity
Biological plausibility
V Seleksi
V informaasi
V perancu
V analisis
A
I
CA OBSERVATIONAL STUDY IN EPIDEMIOLOGY
1. DESKRIPSI UMUM
Desain
Populasi target, populasi terjangkau, sampel
Teknik sampling
Variabel bebas, tergantung
Hasil utama (primary outcome)
2. Validitas interna, hubungan non-kausal
Pengaruh bias
Pengaruh perancu
Pengaruh peluang
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3. Validitas interna, hubungan kausal
Temporabilitas
Asosiasi kuat
Dosis respon
Konsistensi
Spesifik
Koherensi
Biologically plausible
4. Validitas eksterna
Apakah hasil dapat diterapkan pada subyek terpilih
Apakah hasil dapat diterapkan pada populasi terjangkau
Apakah hasil dapat diterapkan pada populasi luas
Kriteria Kausasi
Machin, D. & Campbell, M.J. (2005) The Design of Studies for
Medical Research.
England: John Wiley & Sons Ltd.
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CA MASIH DIPERLUKAN KOMPONEN:
1. IMPORTANCY : kepentingan hasil penelitian
secara klinis (effect size)
2. APPLICABILITY : transportability, kondisi
pasien, kemampuan pelayanan, ekonomi,
sosial budaya, agama.
Kesimpulan
Dokter harus mampu melakukan telaah jurnal
dengan baik.
Observational Study in Epidemiology
STROBE
CA ada 3 komponen (VIA):
Validitasvaliditas interna non-kausal, validitas
interna kausal (eksternaBradfold-Hill criteria),
validitas.
Importancy
Applicability
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Reference Erik von Elm,a Douglas G Altman,b Matthias Egger,a,c
Stuart J
Pocock,d Peter C Gtzsche e & Jan P Vandenbrouckef for the
STROBE Initiative. The Strengthening the Reporting of Observational
Studies in Epidemiology (STROBE) Statement: guidelines for
reporting observational studies. Bulletin of the World Health
Organization 2007;85:867872.
Pocock SJ, Collier TJ, Dandreo KJ, de Stavola BL, Goldman MB,
Kalish LA, et al. Issues in the reporting of epidemiological
studies: a survey of recent practice. BMJ 2004;329:883
Lee W, Bindman J, Ford T, Glozier N, Moran P, Stewart R, et al.
Bias in psychiatric case-control studies: literature survey. Br J
Psychiatry 2007;190:204-9.
Tooth L, Ware R, Bain C, Purdie DM, Dobson A. Quality of
reporting of observational longitudinal research. Am J
Epidemiol2005;161:280-8.
Bonita, R., Beaglehole, R. & Kjellstrom, T. (2006) Basic
pidemiology Ed.2.WHO.
Dahlan, M.S. (2010) Membaca dan menelaah
jurnal uji klinis. Jakarta:Salemba Medika.
Sastroasmoro, S. & Ismael, S. (2010) Dasar-
dasar Meodologi Penelitian Klinis
Ed.3.Jakarta:Sagung Seto.
Machin, D. & Campbell, M.J. (2005) The
Design of Studies for Medical Research.
England: John Wiley & Sons Ltd
