Critical Thinking in Epidemiology-klp1

8/13/2019 Critical Thinking in Epidemiology-klp1

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STROBE Statement> Checklistang se$arusna "ila)or0an "ala2 )enelitian

"engan "esain 0asus 0ontrol (case-control studies)(

Ite2

No

Re!o22en"ation Re)orte"

on )age

=u"ul "an Abstra0 1 a. Studi desain yang digunakan

dicantumkan di abstrak atau judul.

Abstrak : Dicantumkan di

design studynya yaitu, Case-

control study comparing the

prevalence of diabetes

mellitus (fasting blood

glucose level >126 mg/dl)among newly diagnosed

pulmonary ! patients and

matched neighbourhood

controls"

!"!

b. #agian abstrak terdiri dari

ringkasan in$%rmati$ terhada& a&a

yang sudah dilakukan dan ditemukan

'(erda&at latar belakang, tujuan,

design studi, hasil, kesim&ulan)

!"!

Pen"a$uluan

*atar

#elakang+asi%nalisasi

- *atar belakang dari studi terda&at di

&aragra$ &ertama yaitu &ada kalimat :

#he $revalence of diabetes mellitus

is increasing worldwide% especially in

&sia% where tuberculosis (!) is

highly endemic" 'ost tetboos state

that diabetes is a ris factor for !%but little is nown about the nature

and strength of this relationship"

*riginal studies on this sub+ect were

mostly conducted more than , years

ago%""".

!"!

(ujuan (ujuan dari studi ini dicantumkan

&ada akhir kalimat &aragra$ &ertama,

yaitu :

#e therefore eamined to what !"!


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etent diabetes is associated with an

increased ris of ! in 0ndonesia".

Meto"e

Desain Penelitian / Desain studi yang dicantumkan &ada

bagian design terda&at &ada kalimat:

0Case-control study comparing the

prevalence of diabetes mellitus

(fasting blood glucose level >126

mg/dl) among newly diagnosed

pulmonary ! patients and matched

neighbourhood controls."

!"!

Setting 2ambaran dari :

*%kasi : 3ntuk !ase )enelitian

dilakukan 4akarta (engah dan

umah Sakit Hasan Sadikin

#andung, yang tercantum &ada

kalimat &ertama di bagian

'ethods .""" an out-patient !clinic in central aarta% and

3asan 4adiin 5eneral 3ospital%

!andung""". Sedangkan untuk

!ontrol )enelitian meru&akan

masyarakt 5nd%nesia yang berada

di lingku& (, se&erti yang

tercantum &ada kalimat :

#"""selected a control sub+ect of

the same se and age (17)

living within the same ruun

tetangga% the smallest residential

unit in 0ndonesia% which consistsof 189: households""".

!"! dan

!"6

Peri%de rekruitmen, e7&%sure,

$%ll%89u&, dan &engum&ulan data

terda&at &ada bagian ;esults &ada

kalimat, 0!etween 'arch 21

and 'arch 28% ,


4/15

diketahui &ada bagian yang sama

di kalimat, 0$atients presented

after a median of : months (range

1 wee to over 1 year) with cough

(=


5/15

3rine 2luc%se ;%ncentrati%n :

abn%rmal jika >? mg+dl

Plasma ;reatinine : abn%rmal jika

n%rmal Calue @"? mm%l+l '8anita)

dan @11? mm%l+l '&ria).

H5< : menggunakan indikat%r test

H5< ''Determine, Abb%tt

Diagn%stics, H%%$dd%r&, (he

Netherlands).

3mur : diklasi$ikasikan menjadi /

kel%m&%k umur yaitu E1" tahun,

-?9-" tahun, ?9" tahun, dan F/?

tahun.

Penda&atan : diklasi$ikasikan

menjadi kel%m&%k yaitu @1, 19-,

dan >- 3S G+ca&ita+day.

Ke&adatan hunian rumah :

dikateg%rikan &adat jika terda&at

>- indiCidu di setia& kamar.

i8ayat k%ntak (#

#%dy Mass 5nde7 : &enentuan

batas indikat%r berdasarkan

median untuk setia& case dan

c%ntr%l.

!"6

!"6

!"6

!"6

'(able 1)

!"6

'(able 1)

!"6

'(able 1)

!"6

'(able 1)

!"6

'(able 1)

Sumber Data+

Pengukuran

I a. Sumber Data

;ase : 0"""an out-patient ! clinic

in central aarta% and 3asan

4adiin 5eneral 3ospital%!andung% consecutive new $!

patients aged over 18 years of age

were included in the study"

?iagnosis was based on clinical

presentation and chest @-ray

eamination% confirmed by

microscopic detection of acid-fast

bacilli" reatment consisted of a

standard regimen%

23;AB/,3:;:"""'kalimat &ertama

!"!


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bagian'ethods)

;%ntr%l : #"""randomly selected a

control sub+ect of the same se

and age (17) living within the

same ruun tetangga% the smallest

residential unit in 0ndonesia%

which consists of 189:

households" irst-degree relatives

of patients were ecluded"

Control sub+ects with signs and

symptoms suggesting active ! or

a history of prior anti-tuberculosis treatment were also

ecluded. 'kalimat &ertama

&aragra$ &ertama)"

b. Pengukuran, baik untuk case dan

c%ntr%l menggunakan cara yang sama

Diabetes Mellitus: teknik

kuantitati$ dengan sebelumnya

&asien ber&uasa / jam terlebihdahulu , standar yang digunakan

adalah standar HB. K%nsentrasi

=#2 diukur sebelum dan sesudah

&eng%batan anti (#. Da&at dilihat

&ada kalimat berikut : 0o anti-

diabetic agents were taen within

,< h before blood sampling for

measurement of fasting blood

glucose (!5) concentrations"""

0n all patients% !5

concentrations were measured

before and after one month of

anti-tuberculosis treatment"".

2lyc%suria, teknik semi kuantitai$,

da&at dilihat &ada kalimat :

04emi-Duantitative measurement

of glycosuria was done using

urine dipstics".

3rine 2luc%se ;%ncentrati%n :

!"6

!"6

!"6


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teknik kuantitati$ dengan

mengukur k%nsentrasi urine

gluc%se.

Plasma ;reatinine : teknik

kuantitati$, dengan mengukur

&lasma creatine.

H5< : 0.""(30E) testing was

conducted using the dipstic

test"".

!"6

!"6

!"6

#ias " Adanya recall bias ketika

me8a8ancarai in$%rman, hal ini da&at

terlihat dari &ernyataan :0&d+ustment for the higher freDuency

of ! contacts among the cases did

not lower the ris estimates" his

difference may have been due to

recall bias. 'bagian ?iscussion

&aragra$ ketiga)"

!"

3kuran Studi 1? 3ntuk !ase )enelitian dilakukan

4akarta (engah dan umah Sakit

Hasan Sadikin #andung, yang

tercantum &ada kalimat &ertama di

bagian 'ethods .""" an out-patient! clinic in central aarta% and

3asan 4adiin 5eneral 3ospital%

!andung""". Sedangkan untuk

!ontrol )enelitian meru&akan

masyarakt 5nd%nesia yang berada di

lingku& (, se&erti yang tercantum

&ada kalimat : #"""selected a control

sub+ect of the same se and age(17) living within the same ruun

tetangga% the smallest residential unit

in 0ndonesia% which consists of 189:

households""".

!"! dan

!"6


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=#2 diukur sebelum dan sesudah

&eng%batan anti (#. Da&at dilihat

&ada kalimat berikut : 0o anti-

diabetic agents were taen within

,< h before blood sampling for

measurement of fasting blood

glucose (!5) concentrations"""

0n all patients% !5

concentrations were measured

before and after one month of

anti-tuberculosis treatment"".

3rine 2luc%se ;%ncentrati%n :teknik kuantitati$ dengan

mengukur k%nsentrasi urine

gluc%se.

Plasma ;reatinine : teknik

kuantitati$, dengan mengukur

&lasma creatine.

3mur : diklasi$ikasikan menjadi /

kel%m&%k umur yaitu E1" tahun,

-?9-" tahun, ?9" tahun, dan F/?tahun.

Penda&atan : diklasi$ikasikan

menjadi kel%m&%k yaitu @1, 19-,

dan >- 3S G+ca&ita+day.

Ke&adatan hunian rumah :

dikateg%rikan &adat jika terda&at

>- indiCidu di setia& kamar.

i8ayat k%ntak (# 'Ja dan

(idak)

#%dy Mass 5nde7 : &enentuan

batas indikat%r berdasarkan

median untuk setia& case dan

c%ntr%l.

!"6

!"6

!"6

'(able 1)

!"6

'(able 1)

!"6

'(able 1)

!"6

'(able 1)

!"6

'(able 1)

Met%de Statistik 1- a. Ditemukan &ada kalimat, 0Crude

and ad+usted odds ratios (*;s)

were calculated as estimates of

!"6


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the relative riss with

corresponding =87 confidence

intervals (C0) and a logistic

regression model" &d+usted *;s

reflect the ris of ! for people

with diabetes mellitus compared

to normal individuals after

ad+ustment for variables

including se% age% body mass

inde (!'0% calculated as g/m2)%

presence of ! contact in the

family or household% income andnumber of individuals per

household"

b. Ditemukan &ada kalimat,

#$ossible confounding of the

relationship between diabetes and

! was eamined using logistic

regression" 4e% income and

overcrowding did not alter the*; significantly" 3istory of !

contact was significantly more

common among cases than

controls (able 1)F however%

ad+ustment to this variable didnot

reduce the ris estimates" !

patients had a lower !'0 than

controls% but ad+ustment.

!"

c. (idak ditemukan dalam bagianmet%de dalam jurnal

9

d. (idak ditemukan dalam bagianmet%de dalam jurnal

9

e. (idak ditemukan dalam bagianmet%de dalam jurnal

9

Hasil

Partisi&an 1I a. 3ntuk !ase da&at dilihat &ada

kalimat berikut, 0""",


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analysis" wenty-seven were

ecluded because of a past history

of ! (nG 6) and incomplete data

(n G21)" le (able 1)" 'bagian

;esults&aragra$ &ertama).

Sedangkan untuk !ontrol da&at

dilihat dari, 04i hundred and

twenty-two sub+ects were

recruited as matched controls"

4ity-si were ecluded for further

analysis because of suspected !

(n G 22)% history of ! treatment

(n GH) or incomplete data (n

G:H) 'bagian ;esults &aragra$

kedua).

!"6

b. Penyebab &artisi&an dikeluarkandari &enelitian

;ase ditemukan &ada kalimat,0wenty-seven were ecluded

because of a past history of! (nG 6) and incomplete

data (n G21) 'bagian ;esults&aragra$ &ertama).

;%ntr%l ditemukan &adakalimat, 04ity-si wereecluded for further analysis

because of suspected ! (n G

22)% history of ! treatment (n

GH) or incomplete data (n

G:H). 'bagian ;esults

&aragra$ kedua).

!"6

!"6

c. (idak terda&at diagram alur dijurnal

9

Data Deskri&ti$ 1/I a. Karakteristik studi &artisi&an

Case% da&at dilihat &ada kalimat%

#$atients had a median age of

:" years (range 189H8)% and

2:< (82",7) were male" Cases

had a median !'0 of 1H"H g/m2

!"6

(able 1


11/15

(range 11"29:1",). 'bagian

;esults&aragra$ &ertama).

;%ntr%l, da&at dilihat &adakalimat, 0he remaining 886controls had a similar se

distribution% age (median :"

yearsF range 189H6) and socio-

economic bacground as the

patients (able 1)" Control

sub+ects had a higher body weight

than patients% while history of !

contact was less common (able

1). 'bagian ;esults &aragra$kedua).

!"6

(able 1

b. (idak ditemukan data yang hilang

'missing data) baik untuk case

mau&un c%ntr%l &ada jurnal.

9

Data Hasil 1I ;ase, da&at dilihat &ada kalimat,

0&ll were newly diagnosed with

$! confirmed by sputum

microscopy" 'ycobacterium

tuberculosis culture results wereavailable in :H: patients% and

were positive in :2< (


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higher body weight than patients%

while history of ! contact was

less common.'bagian ;esults

&aragra$ kedua).

Hasil 3tama 1! a. Da&at ditemukan &ada kalimat :

?iabetes mellitus was more

common in patients with ! than

in control sub+ects (igure)" 4ity

! patients (1:"27) had diabetes

compared with 1< (:"27) controls

(*; ,"H% =87C0 2"H9


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b. Ditemulan &ada kalimat, #$ossible

confounding of the relationship

between diabetes and ! was

eamined using logistic regression"

4e% income and overcrowding did

not alter the *; significantly" 3istory

of ! contact was significantly more

common among cases than controls

(able 1)F however% ad+ustment to this

variable didnot reduce the ris

estimates" ! patients had a lower

!'0 than controls% but ad+ustment.

!"

c. (idak ditemukan dalam jurnal

&enelitian ini.

9

Analisis *ainnya 16 (idak ditemukan dalam jurnal

&enelitian ini.

9

Dis0usi

Hasil+5n$%rmasi

Penting

1 Ditemukan &ada kalimat, 0e have

found a strong association of ! and

diabetes in two urban clinics in

0ndonesia" e believe this is the first

study to eamine this association in0ndonesia% where more than 17 of

the worldJs ! patients live%2 and one

of the first in 4outh-Bast &sia.

'bagian ?iscussion% &aragra$ &ertama

dan kalimat &ertama)"

!"

Keterbatasan 1" Ditemukan &ada kalimat, 0&s the

study sub+ects were very poor% with

limited access to regular health care%

the proportion with undiagnoseddiabetes may in fact have been

higher. '&aragra$ &ertama)"

!""

5nter&retasi -? Ditemukan &ada kalimat :

0mmunological studies support

the hypothesis that diabetes is a

ris factor for !" $roduction of

interferon-gamma% which is

crucial for host defence agains

!% has been found to be low in

diabetic mice infected with '"

!""


14/15

tuberculosis% and it has been

shown that alveolar macrophage

in ! patients with diabetes show

less activation"

Cohort studies performed in

Burope and th Knited 4tates in

the 1=:s also support this

hypothesis diabetics showed a

three- to four-fold increased ris

of developing !"

& recent case-control study of !

patients in 'eico reported ahigher ris estimate than ours

the prevalence of diabetes was

2="67% which was 6"


15/15

reduce the ris of developing active

!".

In?or2asi Lainnna=unding -- Ditemukan &ada kalimat, 0his study

is an indirect result of the pro+ect

M0mmunogenetic basis of

susceptibility to and disease

manifestations of mycobacterial

infectionsJ% conducted within the

M4cientific $rogramme 0ndonesia

etherlandsJ (4$0) and supported

by the ;oyal &cademy of &rts and4ciences (L&)""" 'bagian

&cnowledgements).

!""

I2iCe in$%rmati%n se&arately $%r cases and c%ntr%ls

Documents

Critical Thinking in Epidemiology-klp1