CRITICAL APPRAISAL WORKSHEET AN META ANALYSIS JOURNAL Authors Journal : Qonitatun Nahdliyyah, Nieko Caesar A. M.

: Risk of Placenta Previa in Second Birth After First Birth Cesarian

Section: A Population-Based Study and Meta-analysis Journal/Year/Vol./Page: BMC Pregnancy and Childbirth/ 2011/ 11/1-10

A. ARE THE STUDY RESULTS VALID? 1. Did address the a overview Yes focused

clinical question? 2. Were the criteria used to select articles for inclusion appropriate? Yes

3. Is it unlikely that important relevant studies were missed? Sampel terpenuhi?

Yes

4. Was the validity of the included studies appraised?

Yes

5. Were assesments of studies reproducible? 6. Were the results similar from study to study?

Yes

Yes

B. WHAT WERE THE RESULTS? 1. What are the overall results of the review?

2. How precise were the results?

C. CAN THE RESULTS BE APPLIED TO YOUR PATIEN(S)? 1. Can the results be applied to my patient (care)? Yes

2. Were all clinically important outcomes considered?

Yes

3. Are the benefits worth the harms and costs? Manfaat cukup baik

Yes

CONCLUSIONS The results or recommendation are valid (from A) The results are clinically important (from B) The results are relevant to my practice (from C) Yes Yes Yes

Critical Appraisal Worksheet Harm/Etiology

Student: Qonitatun Nahdliyyah, Nieko Caesar A.M.

Date: 09-01-2013

Complete Article Citation (APA format): Risk of Placenta Previa in Second Birth After First Birth Cesarian Section: A Population-Based Study and Meta-analysis

Appraisal (be sure to provide your comments - simple yes/no answers normally are not acceptable)

Are the Results Valid?* Questions Comments

Were there clearly defined Yes groups of subjects, similar in all important ways other than exposure to the treatment or other cause? Were treatment exposures and clinical outcomes measured the same ways in both groups (e.g., was the assessment of outcomes either objective (e.g., death) or blinded to exposure)? Yes

Was the follow-up sufficiently long and complete? Do the results satisfy the common tests for causation (e.g., temporal, dose-response, biological plausibility)? What are the Results?* Questions How strong is the association between exposure & outcome? How precise is the estimate of the risk?

Yes

Cant tell Sejauh ini kami belum menemukan penelitian yang menjelaskan hubungan sebab akibat yg terjadi antara riwayat SC sebelumnya dengan kejadian plasenta previa pada kehamilan sekarang.

Comments P<0,001 95% CI (1,71-2,07)

Adverse Outcome Present Exposed to treatment CS Delivery Vaginal Delivery RR = ((a/(a+b))/(c/(c+d))=(8,7/1000)/(4,4/1000)=1,98 8,7 4,4 Absent 991,6 995,6

How Can the Results Apply to Patient Care?* Questions Were the study patients and their management similar to mine? What is the magnitude of the risk/should I stop exposure? Untuk mengurangi angka kejadian plasenta previa maka kejadian SC pd kehamilan sebelumnya juga harus dikurangi yaitu dengan melaksanakan periksa Comments -

kehamilan (ANC) secara teratur sehingga penyulit

kehamilan dapat terdeteksi dini Do the results of this study fit with other available evidence? Yes Jurnal ini juga merupakan penelitian metaanalisis yang mengkaji beberapa publikasi dengan tujuan penelitian yang sama. Hasil penelitian ini dengan uji metaanalisis yang dilakukan sesuai.

*Question format derived from the following sources:

Guyatt, G., & Rennie, D. (2002). Users' guides to the medical literature: Essentials of evidence-based clinical practice. Chicago: AMA Press. Heneghan, C. & Badenoch, D. (2006). Evidence-based medicine toolkit. 2nd ed. Malden, MA: Blackwell Publishing. McGibbon A, Eady A, & Marks S. (1999). PDQ Evidence-based principles and practices. Hamilton, OT: B.C. Decker. Sackett DL, Straus S, Richardson S, Rosenberg W, & Haynes RB. (2000). Evidence-based medicine: How to practice and teach EBM, 2nd ed. London: Churchill Livingstone