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CAT

(Critical Appraisal of the Topics)


Jurnal ini memiliki beberapa kelebihan dan
kekurangan yang menyebabkan validitas dan
relevansinya baik.

Kelebihan :

 Sebagian peneliti jurnal ini tidak dipengaruhi oleh sponsor


organisasi tertentu
 Jika informasi yang terdapat pada jurnal ini benar maka
akan dapat menambah pengetahuan kita sebagai ahli
bedah untuk mempercepat waktu pemulihan pada pasien
anak yg menjalani anastomosis
 Penelitian bersifat prospektif
Kekurangan :

• Penelitian dilakukan hanya di 1 tempat ( single centre )


• Keterbatasan jumlah pada objek studi.
Determine the Intent of the Article
• Tujuan dari penelitian ini :
Menyelidiki efektifitas pemberian early oral feeding
pada pasien abak ygmenjalani prosedur anastomosis.
• Kategori klinis : therapi
• Penelitian ini :
Bersifat prospektif ,penelitian ini dilakukan dengan
studi prospektif pada 31 pasien yg berumur < 16
tahun selama periode 14 bulan (September 2011 –
Oktober 2012). Penelitian dilakukan di Bangalore
Hospital, India.
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 related


Cohort or case-control
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*) of SR (with homogeneity*) of SR (with homogeneity*) of


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

1b Individual RCT (with narrow Individual inception cohort Validating** cohort study with
Confidence Interval‡) study with > 80% good††† reference
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* ) of SR (with homogeneity*) SR (with homogeneity*) of
cohort studies of either retrospective Level >2 diagnostic studies
cohort studies or
untreated control groups
in RCTs
2b Individual cohort study Retrospective cohort Exploratory** cohort study
(including low quality RCT; study or follow-up of with good” “ “ reference
e.g., <80% follow-up) untreated control standards; CDR “ after
patients in an RCT; derivation, or validated only
Derivation of CDR† or on split-sample or databases
validated on split-
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*) of SR (with homogeneity*) 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
bench research or "first physiology, bench research or "first principles"
principles" research or "first
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
Terimakasih

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