Lembar Jawaban

Nama
NIM
No. Soal
LEMBAR JAWABAN
OSCE EBM
: Annisa Khaira Ningrum
:04011181320058
: 38
I.An 18 year old male with no significant past medical history is brought to emergeny
department.
I.1. Tabel PICO
Person/Problem
Laki-laki berusia 18 tahun mengalami kecelakaan sepeda

motor. Mengalami beberapa luka berat, fraktur multiple, dan
Intervention
Comparison
Outcome
trauma kepala.
Dexamethason
Steroid
Pengaruh pemberian dexamethasone terhadap kejadian
edema serebral
I.2. Clinical question

1. Apakah pemberian dexamethasone dapat mengurangi kejadian edema
serebral?
2. Bagaimana pengaruh dexamethasone dalam mengurangi edema serebral?
3. Apa efek samping pemberian dexamethasone dalam mengurangi edema
serebral?
4. Apakah ada alternatif lain dalam mengobati edema serebral?
I.3. (Edema OR eodema) AND (Brain OR Cerebral) AND (Dexamethason) AND

(Steroid)
I.4. Lakukan searching
I.5. Pastekan Abstract Artikel yang didapat pada lembar jawaban
Abstract
PURPOSE:
To compare the safety and efficacy of corticorelin acetate (CrA) and placebo in patients with
malignant brain tumors requiring chronic administration of dexamethasone (DEX) to control
the signs and symptoms of peritumoral brain edema (PBE).
PATIENTS AND METHODS:
Prospective, randomized, double-blind study of 200 patients with PBE on a stable dose of
DEX. Initially, DEX dose was decreased by 50% over a 2-week period and then held at this
level for 3 weeks. The primary end point was the proportion of patients who responded to
treatment-patients who achieved a 50% DEX reduction from baseline and achieved stable
or improved neurologic examination score and Karnofsky performance score at week 2, and
then continued to respond at week 5.
RESULTS:
One hundred patients received subcutaneous injections of 1 mg twice per day of CrA and 100
patients received placebo for the duration of the study period. Although results did not attain
statistical significance (at the P < .05 level), a clinically important difference in the proportion
of responders between the CrA group (57.0%) and the placebo group (46.0%; P = .12) was
observed. In addition, the maximum percent reduction in DEX dose achieved during the
double-blind 12-week study was significantly greater in the CrA group (62.7%) than in
placebo group (51.4%; P < .001). Patients receiving CrA demonstrated an improvement in
myopathy and were less likely to develop signs of Cushing syndrome.
CONCLUSION:
CrA enables a reduction in steroid requirement for patients with PBE and is associated with a
reduction in the incidence and severity of common steroid adverse effects, including
myopathy.
TRIAL REGISTRATION:
ClinicalTrials.gov NCT00088166.
I.6. Lakukan kritikal Appraisal dari Artikel dengan critical appraisal worksheet
II.
Suatu penelitian Randomized Controlled Trial yang dilakukan pada penderita Ischemic
Stroke dengan memakai regimen pengobatan baru sebagai experimental group dan
pengobatan sebagai control group.
Dead
Alive
Experimental
14% (28)
86% (172)
Control
25% (50)
75% (150)
Jumlah kelompok masing-masing (n) = 200
II.1.
Experimental event rate = 28/200 = 0.14
II.2.
Control event rate = 50/200 = 0.25
II.3.
Absolute risk reduction = EER CER = 0.11
II.4.
Relative reduction risk = ARR/CER = 0.44
II.5.
Relative risk = CER/EER = 0.56
II.6.
Number Needed to Treat = 1/ARR = 1/0.11=9.09
II.7.
Alternative menghitung RRR = 1-RR
II.8.
Kesimpulan
Dari perhitungan diatas didapatlan kelompok experimental efektif dalam mencegah
stroke sebesar 44%
III.
Suatu penelitian efektitas pengobatan MCI dengan experimental group

Alive
Dead
Stent + CAD
24% (48)
76% (152)
ASA + Atorvastatin
18% (36)
82% (164)
N= 200
III.1. EER = 0.24
III.2. CER = 0.18
III.3. ABI = 0.06
III.4. RBI = (EER-CER)/CER = 0.06/0,18 = 0.3
III.5. RR = EER/CER = 1.3
III.6. NNT = 1/ABI = 16.6
III.7. Alterbative RBI = 1-RR
III.8. Kesimpulan = Stent+CAD dapat mencegah kejadian MCI sebesar 30%
IV.
Beda NNT pada trial effectiveness dengan NNT pada trial adverse effect
NNT effectiveness= jumlah sampel yang dibutuhkan untuk menilai efektifitas
suatu experiment
NNT = adverse effect = jumlah sampel yang dibutuhkan untuk menilai efek
samping experiment
5.1. buatlah grafik potong LDL 8
Classification: PJK
100
90
80
70
60
50
40
30
20
10
0
0
50
100
150
LDL8
200
250
300
Secara visual didapatkan hasil LDL 8 antara 100-150
LDL8
100
Sensitivity
80
60
40
20
0
0
20
40
60
80
100-Specificity
100
ROC curve
Variable
LDL8
Classification variable
PJK
Sample size
300
Positive group :
PJK = 1
85
Negative group :
PJK = 0
215
Disease prevalence (%)
unknown
Area under the ROC curve (AUC)

Area under the ROC curve (AUC)
Standard Errora
95% Confidence intervalb
0.502
0.0355
0.444 to 0.560
z statistic
0.0563
Significance level P (Area=0.5)
0.9551
a
b
DeLong et al., 1988

Binomial exact
Youden index
Youden index J
0.1185
Associated criterion
69.02
Sensitivity
1.18
Specificity
86.98
Criterion values and coordinates of the ROC curve [Hide]

Criterion
Sensitivity
95% CI
Specificity
95% CI
+LR
-LR
<27.61
0.00
0.0 - 4.2
100.00
98.3 - 100.0
27.61
0.00
0.0 - 4.2
99.07
96.7 - 99.9
0.00
1.01
42.158
1.18
0.03 - 6.4
99.07
96.7 - 99.9
1.26
1.00
69.02
1.18
0.03 - 6.4
86.98
81.7 - 91.2
0.090
1.14
71.156
3.53
0.7 - 10.0
86.98
81.7 - 91.2
0.27
1.11
71.964
3.53
0.7 - 10.0
84.65
79.1 - 89.2
0.23
1.14
72.484
8.24
3.4 - 16.2
84.65
79.1 - 89.2
0.54
1.08
73.1
8.24
3.4 - 16.2
83.72
78.1 - 88.4
0.51
1.10
76.299
11.76
5.8 - 20.6
83.72
78.1 - 88.4
0.72
1.05
77.75
11.76
5.8 - 20.6
80.93
75.0 - 86.0
0.62
1.09
79.007
15.29
8.4 - 24.7
80.93
75.0 - 86.0
0.80
1.05
81.349
15.29
8.4 - 24.7
79.07
73.0 - 84.3
0.73
1.07
81.779
16.47
9.3 - 26.1
79.07
73.0 - 84.3
0.79
1.06
83.163
16.47
9.3 - 26.1
76.74
70.5 - 82.2
0.71
1.09
85.174
17.65
10.2 - 27.4
76.74
70.5 - 82.2
0.76
1.07
87.985
17.65
10.2 - 27.4
73.02
66.6 - 78.8
0.65
1.13
89.815
28.24
19.0 - 39.0
73.02
66.6 - 78.8
1.05
0.98
90.091
28.24
19.0 - 39.0
72.09
65.6 - 78.0
1.01
1.00
90.162
30.59
21.0 - 41.5
72.09
65.6 - 78.0
1.10
0.96
94.763
30.59
21.0 - 41.5
66.05
59.3 - 72.3
0.90
1.05
95.43
31.76
22.1 - 42.8
66.05
59.3 - 72.3
0.94
1.03
96.341
31.76
22.1 - 42.8
62.79
56.0 - 69.3
0.85
1.09
1.00
96.774
32.94
23.1 - 44.0
62.79
56.0 - 69.3
0.89
1.07
98.007
32.94
23.1 - 44.0
60.47
53.6 - 67.0
0.83
1.11
99.177
38.82
28.4 - 50.0
60.47
53.6 - 67.0
0.98
1.01
100.283
38.82
28.4 - 50.0
57.67
50.8 - 64.4
0.92
1.06
100.382
40.00
29.5 - 51.2
57.67
50.8 - 64.4
0.95
1.04
102.458
40.00
29.5 - 51.2
54.88
48.0 - 61.7
0.89
1.09
102.73
43.53
32.8 - 54.7
54.88
48.0 - 61.7
0.96
1.03
105.24
43.53
32.8 - 54.7
52.09
45.2 - 58.9
0.91
1.08
106.262
52.94
41.8 - 63.9
52.09
45.2 - 58.9
1.11
0.90
106.437
52.94
41.8 - 63.9
50.70
43.8 - 57.6
1.07
0.93
108.57
56.47
45.3 - 67.2
50.70
43.8 - 57.6
1.15
0.86
114.499
56.47
45.3 - 67.2
48.84
42.0 - 55.7
1.10
0.89
114.94
58.82
47.6 - 69.4
48.84
42.0 - 55.7
1.15
0.84
115.226
58.82
47.6 - 69.4
46.98
40.2 - 53.9
1.11
0.88
115.608
62.35
51.2 - 72.6
46.98
40.2 - 53.9
1.18
0.80
117.797
62.35
51.2 - 72.6
42.79
36.1 - 49.7
1.09
0.88
118.39
68.24
57.2 - 77.9
42.79
36.1 - 49.7
1.19
0.74
122.17
68.24
57.2 - 77.9
37.67
31.2 - 44.5
1.09
0.84
123.559
72.94
62.2 - 82.0
37.67
31.2 - 44.5
1.17
0.72
130.946
72.94
62.2 - 82.0
32.56
26.3 - 39.3
1.08
0.83
131.969
74.12
63.5 - 83.0
32.56
26.3 - 39.3
1.10
0.79
132.605
74.12
63.5 - 83.0
32.09
25.9 - 38.8
1.09
0.81
132.94
77.65
67.3 - 86.0
32.09
25.9 - 38.8
1.14
0.70
137.637
77.65
67.3 - 86.0
28.37
22.5 - 34.9
1.08
0.79
138.759
82.35
72.6 - 89.8
28.37
22.5 - 34.9
1.15
0.62
146.117
82.35
72.6 - 89.8
20.47
15.3 - 26.5
1.04
0.86
148.952
87.06
78.0 - 93.4
20.47
15.3 - 26.5
1.09
0.63
160.91
87.06
78.0 - 93.4
9.77
6.1 - 14.5
0.96
1.32
163.001
91.76
83.8 - 96.6
9.77
6.1 - 14.5
1.02
0.84
172.7
91.76
83.8 - 96.6
3.72
1.6 - 7.2
0.95
2.21
186.34
92.94
85.3 - 97.4
3.72
1.6 - 7.2
0.97
1.90
190.11
92.94
85.3 - 97.4
2.33
0.8 - 5.3
0.95
3.04
191.86
95.29
88.4 - 98.7
2.33
0.8 - 5.3
0.98
2.02
210.378
95.29
88.4 - 98.7
1.86
0.5 - 4.7
0.97
2.53
215.919
98.82
93.6 - 100.0
1.86
0.5 - 4.7
1.01
0.63
253.499
98.82
93.6 - 100.0
1.40
0.3 - 4.0
1.00
0.84
260.729
100.00
95.8 - 100.0
1.40
0.3 - 4.0
1.01
0.00
264.217
100.00
95.8 - 100.0
0.00
0.0 - 1.7
1.00
Sensitifitas 1.18
Spesifisitas = 86.98
PPV
NPV
LR + =
LR
LR test
AUC
Pretest odd
Pst test od
Kesimpulan

Lembar Jawaban

Uploaded by

Copyright:

Available Formats

Lembar Jawaban

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Lembar Jawaban

Uploaded by

Copyright:

Available Formats

Nama

Laki-laki berusia 18 tahun mengalami kecelakaan sepeda

I.2. Clinical question

I.3. (Edema OR eodema) AND (Brain OR Cerebral) AND (Dexamethason) AND

Suatu penelitian efektitas pengobatan MCI dengan experimental group

5.1. buatlah grafik potong LDL 8

Secara visual didapatkan hasil LDL 8 antara 100-150

Disease prevalence (%)

Area under the ROC curve (AUC)

Significance level P (Area=0.5)

DeLong et al., 1988

Criterion values and coordinates of the ROC curve [Hide]

You might also like