JOURNAL READING

Pembimbing : dr. Bambang sugeng, Sp.

B

Presented By :
Endah Inti Wening (012106146)
Journal Identity
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a OBJECTIVE
Untuk menentukan hasil diagnostik dengan
d menggunakan USG pada non palpasi testis di pasien
I Kriptokirdismus .
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J METHODS
o DESIGN : Prospective questionnaire based diagnostic accuracy
u study.
r SETTING : :Secondary care surgical assessment unit at a
n district general hospital in the UK.
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SAMPLE : 101 patients aged 17-76 years who are on the waiting list
L for the surgical team assessment of possible appendicitis .

R EXCLUTION CRITERIA :
- No data available histology
e - Patients treated with antibiotics
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d THE PRIMARY OUTCOME MEASURE :
Sensitivity , specificity , positive and negative predictive values , and
I positive and negative likelihood ratios for pain passing speed bumps in
n diagnosing appendicitis , with a histological diagnosis of appendicitis
g as the reference standard

TIME : February August 2012

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OUTCOME
r MEASURED :
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R Sensitivity , specificity , positive and

e negative predictive values , and positive
a and negative likelihood ratios , with 95 %
d confidence intervals , for the diagnosis of
appendicitis
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Diagnosis of acute appendicitis

" speed bumps positive " if you have pain that worsens rather
than initially when passing speed bumps

" speed bumps negative if they feel the pain remains the
same , if they do not feel confident , or if they improved pain
when passing speed bumps .

RESEARCH INSTRUMENTS
Questionnaire
RESULTS
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Of the 54 patients who complain of pain when passing
speed bums , 33 were positively diagnosed with appendicitis
The results of the comparison diagnosis of
appendicitis by speed bums and other
clinical diagnosis : Sensitivity diagnosis with
speed bumps is the highest The positive
predictive value of a diagnosis of
tenderness just below the loose , with a
positive likelihood ratio were similar
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Strengths and limitations of the study
 Comparison with the results of
other studies

The accuracy of the diagnosis of appendicitis in this study is similar to

studies Anderson and Golledge et al . (1996) that the diagnosis of
appendicitis with bums speed is superior to other clinical variables in
our study
Conclusions and implications

High sensitivity over a pain when passing speed

bumps be a useful tool for use in diagnosing
appendicitis and other important abdominal complaints.

Specifications are low , indicating that many patients

with pain when passing speed bumps do not
necessarily have appendicitis.
Questions about the speed bumps can be used
as a routine part of the assessment of patients with
possible appendicitis .

Unanswered questions include speed or manner

of driving which is an approximation of the impact of
the diagnostic power of speed bumps.
CRITICAL APPRAISAL JOURNAL
 TITLE
Pain over speed bumps in
diagnosis of acute appendicitis:
diagnostic accuracy study

The title is in conformity with the contents of

the study
Writing the title suit = 12 words
Shows the independent variables and the
dependent variable
ABSTRACT
 PICO analysis

Patient Intervention Comparison Outcome

101 patients aged Assignment to Comparing The diagnosis of

17-76 years who research Sensitivity , appendicitis is
were waiting for participants to fill specificity , positive through pain
and negative
the diagnosis of out questionnaires predictive values , when passing
appendicitis about pain , and and positive and speed bumps are
symptoms negative likelihood better when
experienced , also ratios of pain compared with
about the journey assessment as it other features
that has been passes through the commonly used in
done whether or speed bumps with the clinical
other histological
not passing diagnosis of assessment of
speeds bumps appendicitis as the appendicitis
Examination to reference standard
diagnose for diagnosing
apendisitis or not appendicitis
 THE VALIDITY OF THE DIAGNOSTIC
TEST

Pertanyaan Jawaban
* Apakah penelitian uji diagnostik ya
dilakukan secara tersamar dengan baku
emas yang benar?
* Apakah uji diagnostik dilakukan ya
terhadap pasien dengan spektrum
penyakit atau kelainan yang memadai
seingga dapat diterapkan dalam praktek
sehari-hari?
* Apakah pemeriksaan dengan baku emas ya, selain digunakan
dilakukan tanpa memandang hasil dengan speed bums,
pemeriksaan dengan uji diagnostik? penelitian juga
melibatkan hasil
diagnostik lain

THE RESULTS OF THE STUDY VALID

Rating the importance of diagnostic
test
IMPORTANT RESEARCH RESULTS
THE APPLICABILITY OF DIAGNOSTIC TEST

Pertanyaan Jawab

Apakah uji diagnostik tersebut tersedia, Ya

terjangkau dan akurat?

Apakah kita dapat memperkiakan pretest ya

probability penyakit pada pasien kita?

Apakah post-test probability yang dihitung akan tidak

mengubah tata laksana pasien?

Apakah secara keseluruhan uji diagnostik ya

tersebut bermanfaat bagi pasien kita?

THE RESULTS OF THE STUDY CAN BE APPLIED