LEMBAR JAWABAN

SKILLAB EVIDENCE BASED MEDICINE (EBM)

Nama : Anton Rama Yunianto

NIM : 04052721923007
Prodi : Obstetri dan Ginekologi

1. Dalam file excel tersedia DATA abnormalitas. Data abnormalitas terdiri dari variabel
SGOT/SGPT laki-laki, hemoglobin, trigliserid, total koleseterol, HDL dan LDL.
Hitunglah
Nilai abnormalitas dari data yang tersedia:
1.1 Hitung harga rerata
1.2 Hitung standar deviasi
1.3 Nilai abnormalitas adalah > rerata + 2x standar deviasi

Descriptive Statistics

N Minimum Maximum Mean Std. Deviation

Statistic Statistic Statistic Statistic Std. Error Statistic

SGOT/SGPT Laki-
200 1 49 26,29 ,985 13,923
laki
Hemoglobin 200 12,0 13,0 12,472 ,0229 ,3238
Trigliserid 200 81 148 115,30 1,418 20,047
Total Kolestrol 200 80 199 137,23 2,291 32,405
HDL 200 61 119 89,44 1,211 17,119
LDL 200 50 98 74,64 ,964 13,634
Valid N (listwise) 200

Parameter Rerata SD Rerata ± 2SD Nilai abnormalitas

1. SGOT/SGPT 26,29 13,92 26,29 + 2 (13,923)= 54,136 54,136 + 0,05 = 54,186
3 Abnormal bila > 54,136
2. Hemoglobin 12,472 0,323 12,472 – 2 (0,3238) = 11,824 – 0,05 = 11,774
8 11,824 Abnormal bila ≤ 11,774
3. Trigliserid 115,30 20,04 115,30 + 2 (20,047) = 155,394 + 0,05 = 155,444
7 155,394 Abnormal bila > 155,444
4. Total Kolesterol 137,23 32,40 137,23 + 2 (32,405) = 202,04 + 0.05 = 202,09
5 202,04 Abnormal bila > 202,09
5. HDL 89,44 17,11 89,44 - 2 (17,119) = 55,202 55,202 -0.05 = 55,152
9 Abnormal bila < 55, 152
6. LDL 74,64 13,63 74,64 + 2 (13,634) = 101,908 + 0,05 = 101,958
4 101,908 Abnormal bila > 101,958
2. Tersedia Clinical Scenario sebagai berikut:
Patients presenting to Clinical doctor with a sore throat should not automatically be
prescribed antibiotics as many sore throats are non-bacterial in origin. The gold standard
for diagnosing bacterial sore throat is a throat swab and culture but this is expensive and
time-consuming. Clinical doctor need a quick, easy diagnostic tool (e.g. a checklist or
scorecard) to help them to decide whether a sore throat is bacterial or non-bacterial in
origin.
Dari clinical skenario di atas buatlah:
2.1 Tabel P.I.C.O

P Patient with sore throat

I Checklist or scorecard

C Throat swab

O Accurate diagnosis of etiology sore throat

2.2 Buatlah clinical question

Does a sore throat checklist or scorecard different with throat swab to diagnosing
bacterial infection or non bacterial infection in sore throat patients?
2.3 Buatlah search term/search/keyword
Sore throat AND (checklist OR scorecard) AND throat swab AND accurate diagnosis
Karena hasil tidak ada, jadi disederhanakan:
Sore throat AND (checklist OR scorecard) AND throat swab
2.4 Lakukan searching
www.pubmed.gov
2.5 Pastekan abstrak artikel yang didapat pada lembar jawaban

The usefulness of a clinical 'scorecard' in managing patients with sore throat in general
practice.
Bakare TM1, Schattner P.

Author information

Abstract

BACKGROUND:

OBJECTIVE:

To evaluate the usefulness of a clinical scorecard in managing sore throat in general practice.

DESIGN:

Validation study of scorecard for sore throat with a throat swab culture used as the 'gold
standard'.

SETTING:

A solo family practice in rural New South Wales, AustraliaParticipants: Patients attending with
sore throat.

METHODS:

Patients from the age of 5 years and above presenting with the main symptom of a sore throat,
and who have not had any antibiotic treatment in the previous two weeks, were invited to
participate in the study. The doctor completed a scorecard for each patient participating and took
a throat swab for culture. Adult patients (> 16 yrs) were asked to complete a patient satisfaction
questionnaire, while guardians accompanying children (5 yr to < 16 yrs old) were asked to
complete a similar, guardian questionnaire.

MAIN OUTCOME MEASURES:

1. Ability of a new scorecard to differentiate between bacterial and non-bacterial sore throat.2.
Patients' trust in the scorecard.

RESULTS:

The scorecard has a sensitivity of 93.33%, a specificity of 63.16%, a positive predictive value of
50% and a negative predictive value of 96%. The sensitivity is better than other sore throat
scorecards that have been published but with a slightly lower specificity.There was a high level
of patient trust in the scorecard was (85.8% agreement). Patients also trusted their doctor's
judgement based on the scorecard (90.6% agreement).

CONCLUSIONS:
As the scorecard has a high sensitivity but only a moderate specificity, this means that it is more
reliable for negative results, i.e. when the result suggests a viral infection. When the result
favours a bacterial sore throat, then a high sensitivity can mean that there are a number of false
positives. GPs can be confident in withholding antibiotics when the scorecard indicates a viral
infection.

PMID:
20670439
PMCID:
PMC2919449
DOI:
10.1186/1447-056X-9-9

2.6 Lakukan critical appraisal dari artikel dengan critical appraisal worksheet
(Homework)

DIAGNOSIS WORKSHEET

Citation:

Bakare TM, Schattner P. The usefulness of a clinical 'scorecard' in managing patients

with sore throat in general practice. Asia Pac Fam Med. 2010;9(1):9. Published 2010
Jul 29. doi:10.1186/1447-056X-9-9

Are the results of this diagnostic study valid?

Was there an independent, blind
comparison with a reference (“gold”)
standard of diagnosis?
Was the diagnostic test evaluated in an
appropriate spectrum of patients (like
those in whom it would be used in
practice)?
No. Patients were made aware of the
study via a poster placed in the waiting
room and at the reception area
Yes. Patients from the age of 5 years and
above presenting predominantly with a
sore throat and who had not had any
antibiotic treatment in the previous two
 weeks were sequentially invited to
participate
Was the reference standard applied Yes
regardless of the diagnostic test result?
Was the test (or cluster of tests) validated Yes
in a second, independent group of
patients?

Are the valid results of this diagnostic study important?

Sensitivity = 93%

Specificity = 63%

Likelihood ratio for a positive test result = LR+ = 2.53

Likelihood ratio for a negative test result = LR - = 0.11

Positive Predictive Value = 50%

Negative Predictive Value = 96%

Pre-test probability (prevalence) = 28 %

Pre-test odds = prevalence/(1-prevalence) = 28%/72% = 0.39

Can you apply this valid, important evidence about a diagnostic test in caring for your
patient?

Is the diagnostic test available, affordable, YES

accurate, and precise in your setting?
Can you generate a clinically sensible
estimate of your patient’s pre-test probability
(from personal experience, prevalence
statistics, practice databases, or primary
studies)?
 Are the study patients similar to your  YES
own?  YES
 Is it unlikely that the disease
possibilities or probabilities have
changed since the evidence was
gathered?
Will the resulting post-test probabilities
affect your management and help your
patient?
  Could it move you across a test-
treatment threshold?  YES
 Would your patient be a willing  YES
partner in carrying it out?
Would the consequences of the test help Yes
your patient?

Additional notes:
As the scorecard has a high sensitivity but only a moderate specificity, this means that it is more
reliable for negative results, i.e. when the result suggests a viral infection. When the result
favours a bacterial sore throat, then a high sensitivity can mean that there are a number of false
positives. GPs can be confident in withholding antibiotics when the scorecard indicates a viral
infection.

3. Dalam file excel tersedia DATA diagnostik. Data diagnostik terdiri dari variabel LDL
dan kreatinin kinase.
3.1 Buatlah grafik titik potong diagnostik pastekan pada lembar jawaban
a. Kreatinin kinase dan MCI
 b. LDL dan MCI

3.2 Perkirakan secara visual nilai titik potong diagnostik dan intreprestasikan
a. Titik potong kratinin kinase berada pada > 69.098, artinya nilai normal untuk
kreatinin kinase adalah > 69.098
 b. Titik potong LDL MCI berada pada ≤143.002, artinya nilai normal untuk LDL
adalah ≤143.002
3.3 Hitunglah seluruh nilai diagnostik memakai MedCalc, Epical dan CAT Maker,
buatlah kesimpulan
A. Nilai diagnostik kreatinin kinase

ROC curve

Variable Kreatinin_kinase
Kreatinin Kinase
Classification variabl MCI
e MCI
 
Sample size   100
Positive group :  MCI = 1 13
Negative group :  MCI = 0 87
 
Disease prevalence (%) unknown
 
Area under the ROC curve (AUC) 
 
Area under the ROC curve (AUC)  0,973
a
Standard Error 0,0140
b
95% Confidence interval 0,919 to 0,995
z statistic 33,901
Significance level P (Area=0.5) <0,0001
a
DeLong et al., 1988
b
Binomial exact
 
Youden index
 
Youden index J 0,9195
Associated criterion >69,1098
 
Criterion values and coordinates of the ROC curve [Hide]
 
Criterion Sensitivity 95% CI Specificity 95% CI +LR -LR
≥40,0886 100,00 75,3 - 100, 0,00 0,0 - 4,2 1,00  
0
>69,109 100,00 75,3 - 100, 91,95 84,1 - 96,7 12,4 0,00
8 0 3
>70,164 92,31 64,0 - 99,8 93,10 85,6 - 97,4 13,3 0,083
1 8
>72,903 76,92 46,2 - 95,0 93,10 85,6 - 97,4 11,1 0,25
8 5
>73,249 69,23 38,6 - 90,9 94,25 87,1 - 98,1 12,0 0,33
5 5
>75,240 69,23 38,6 - 90,9 96,55 90,3 - 99,3 20,0 0,32
7 8
>76,514 61,54 31,6 - 86,1 97,70 91,9 - 99,7 26,7 0,39
8 7
>76,887 53,85 25,1 - 80,8 98,85 93,8 - 100,0 46,8 0,47
2 5
>77,457 38,46 13,9 - 68,4 98,85 93,8 - 100,0 33,4 0,62
4 6
>77,995 30,77 9,1 - 61,4 100,00 95,8 - 100,0   0,69
>78,675 0,00 0,0 - 24,7 100,00 95,8 - 100,0   1,00
1
 

Kelompok Kreatinin Kinase * MCI Crosstabulation

Count
MCI Total
MCI MCI
Negatif Positif
>=69.109
Kelompok Kreatinin 9 13 22
8
Kinase
<69.1098 78 0 78
Total 87 13 100

Hasil Epicalc

Tables - 2-by-2 unstratified

11:04:30, 06/03/2019

| + - | Total
-------+-------------+-------
+ | 13 9 | 22
- | 0 78 | 78
-------+-------------+-------
Total | 13 87 | 100
Tests of significance
Fisher exact test (one tailed) : 0,000000
Fisher exact test (two tailed) : 0,000000
Uncorrected chi-square : 52,98
p-value : 0,000001
Yates corrected Chi-square : 47,88
p-value : 0,000001

Measures of exposure effect [95% CI]

Risk ratio : **** [****; ****]
Odds ratio : **** [****; ****]
Risk difference : 0,59 [0,39; 0,80]
Proportional attributable risk : **** [****; ****]
Population proportional attr. risk : **** [****; ****]

Vaccine efficacy [95% CI]

Vaccine efficacy : **** [****; ****]

Screening [95% CI]

Prevalence : 0,13 [0,07; 0,22]
Sensitivity : 1,00 [0,72; 0,99]
Specificity : 0,90 [0,81; 0,95]
Accuracy : 0,91 [0,83; 0,96]
Predictive value of +ve result : 0,59 [0,37; 0,79]
Predictive value of -ve result : 1,00 [0,94; 1,00]

Matched data
Z : 2,67
One-sided p-value : 0,003830
Two-sided p-value : 0,007661
McNemar Chi-square : 7,11
p-value : 0,007661
McNemar odds ratio [95% CI] : **** [1,69; 96,56]
Difference in proportions [95% CI] : 0,09 [0,03; 0,15]
Sensitivity = a/(a+c) = 100%

Specificity = d/(b+d) = 90%

Likelihood ratio for a positive test result = LR+ = sens/(1-spec) = 9.67

Likelihood ratio for a negative test result = LR - = (1-sens)/spec = -

Positive Predictive Value = a/(a+b) = 59%

Negative Predictive Value = d/(c+d) = 100%

Pre-test probability (prevalence) = (a+c)/(a+b+c+d) = 13 %

Pre-test odds = prevalence/(1-prevalence) = 28%/72% = 0.15
 B. Nilai diagnostik LDL

ROC curve

Variable LDL
LDL

Classification variab MCI
le MCI
 

Sample size   100

Positive group :  MCI =  13
1

Negative group  MCI =  87
:  0
 

Disease prevalence (%) 13,0
 

Area under the ROC curve (AUC) 
 

Area under the ROC curve (A 0,598
UC) 

Standard Errora 0,0855

95% Confidence intervalb 0,495 to 0,695

z statistic 1,143

Significance level P (Area=0.5 0,2531
)

a
DeLong et al., 1988
b
Binomial exact

 
 Youden index
 

Youden index J 0,3174

Associated criterion ≤143,002
 

Criterion values and coordinates of the ROC curve [Hide]
 

Criterio Sens 95% CI Spec 95% CI +LR 95% C -LR 95% C +PV 95% C - 95% CI
n itivit ificit I I I P
y y V

<96,38 0,00 0,0 - 24,7 100, 95,8 - 10     1,00 1,0 - 1,     87 78,8 - 92

96 00 0,0 0 ,0 ,9

≤96,38 0,00 0,0 - 24,7 98,8 93,8 - 10 0,00   1,01 1,0 - 1, 0,0 0,0 - 10 86 78,6 - 92
96 5 0,0 0 0,0 ,9 ,8

≤105,5 0,00 0,0 - 24,7 97,7 91,9 - 99, 0,00   1,02 1,0 - 1, 0,0 0,0 - 97 86 78,4 - 92
96 0 7 1 ,5 ,7 ,7

≤110,3 7,69 0,2 - 36,0 97,7 91,9 - 99, 3,35 0,3 - 34 0,94 0,8 - 1, 33,3 0,2 - 96 87 79,4 - 93
94 0 7 ,3 1 ,0 ,6 ,4

≤112,7 7,69 0,2 - 36,0 96,5 90,3 - 99, 2,23 0,3 - 19 0,96 0,8 - 1, 25,0 0,2 - 86 87 79,2 - 93
61 5 3 ,9 1 ,8 ,5 ,4

≤113,4 7,69 0,2 - 36,0 95,4 88,6 - 98, 1,67 0,2 - 13 0,97 0,8 - 1, 20,0 0,5 - 71 87 79,0 - 93
05 0 7 ,8 1 ,6 ,4 ,3

≤114,3 15,3 1,9 - 45,4 95,4 88,6 - 98, 3,35 0,7 - 16 0,89 0,7 - 1, 33,3 4,3 - 77 88 80,0 - 94
36 8 0 7 ,5 1 ,7 ,3 ,0

≤115,0 15,3 1,9 - 45,4 94,2 87,1 - 98, 2,68 0,6 - 12 0,90 0,7 - 1, 28,6 3,7 - 71 88 79,8 - 93
06 8 5 1 ,4 1 ,0 ,2 ,9

≤116,8 15,3 1,9 - 45,4 93,1 85,6 - 97, 2,23 0,5 - 9, 0,91 0,7 - 1, 25,0 3,2 - 65 88 79,6 - 93
79 8 0 4 9 2 ,1 ,0 ,9

≤118,2 15,3 1,9 - 45,4 91,9 84,1 - 96, 1,91 0,4 - 8, 0,92 0,7 - 1, 22,2 2,8 - 60 87 79,4 - 93
08 8 5 7 2 2 ,0 ,9 ,8
≤118,8 15,3 1,9 - 45,4 90,8 82,7 - 95, 1,67 0,4 - 7, 0,93 0,7 - 1, 20,0 2,5 - 55 87 79,2 - 93
27 8 0 9 0 2 ,6 ,8 ,7

≤118,8 15,3 1,9 - 45,4 89,6 81,3 - 95, 1,49 0,4 - 6, 0,94 0,7 - 1, 18,2 1,9 - 53 87 79,0 - 93
8 8 6 2 1 2 ,7 ,6 ,7

≤121,1 23,0 5,0 - 53,8 89,6 81,3 - 95, 2,23 0,7 - 7, 0,86 0,6 - 1, 25,0 5,0 - 58 88 80,1 - 94
68 8 6 2 2 2 ,8 ,6 ,4

≤122,3 23,0 5,0 - 53,8 88,5 79,9 - 94, 2,01 0,6 - 6, 0,87 0,6 - 1, 23,1 4,6 - 55 88 79,9 - 94
23 8 1 3 3 2 ,2 ,5 ,3

≤122,6 23,0 5,0 - 53,8 87,3 78,5 - 93, 1,83 0,6 - 5, 0,88 0,6 - 1, 21,4 4,3 - 52 88 79,7 - 94
37 8 6 5 7 2 ,1 ,4 ,3

≤123,4 23,0 5,0 - 53,8 86,2 77,1 - 92, 1,67 0,5 - 5, 0,89 0,7 - 1, 20,0 4,3 - 48 88 79,4 - 94
18 8 1 7 1 2 ,1 ,2 ,2

≤124,3 23,0 5,0 - 53,8 85,0 75,8 - 91, 1,54 0,5 - 4, 0,90 0,7 - 1, 18,8 4,0 - 45 88 79,2 - 94
31 8 6 8 7 2 ,6 ,1 ,1

≤124,4 23,0 5,0 - 53,8 83,9 74,5 - 90, 1,43 0,5 - 4, 0,92 0,7 - 1, 17,6 3,8 - 43 88 79,0 - 94
49 8 1 9 3 3 ,4 ,0 ,1

≤124,9 30,7 9,1 - 61,4 83,9 74,5 - 90, 1,91 0,7 - 4, 0,83 0,6 - 1, 22,2 6,4 - 47 89 80,2 - 94
8 7 1 9 9 2 ,6 ,0 ,9

≤125,2 30,7 9,1 - 61,4 82,7 73,2 - 90, 1,78 0,7 - 4, 0,84 0,6 - 1, 21,1 6,1 - 45 88 80,0 - 94
75 7 6 0 6 2 ,6 ,9 ,8

≤125,3 30,7 9,1 - 61,4 81,6 71,9 - 89, 1,67 0,7 - 4, 0,85 0,6 - 1, 20,0 5,7 - 43 88 79,7 - 94
07 7 1 1 2 2 ,7 ,7 ,7

≤128,0 30,7 9,1 - 61,4 80,4 70,6 - 88, 1,57 0,6 - 4, 0,86 0,6 - 1, 19,0 5,4 - 41 88 79,5 - 94
24 7 6 2 0 3 ,9 ,6 ,7

≤128,4 30,7 9,1 - 61,4 79,3 69,3 - 87, 1,49 0,6 - 3, 0,87 0,6 - 1, 18,2 5,0 - 40 88 79,2 - 94
27 7 1 3 7 3 ,9 ,5 ,6

≤128,5 30,7 9,1 - 61,4 78,1 68,0 - 86, 1,41 0,6 - 3, 0,89 0,6 - 1, 17,4 4,8 - 39 88 79,0 - 94
5 7 6 3 5 3 ,4 ,3 ,5

≤129,6 30,7 9,1 - 61,4 77,0 66,8 - 85, 1,34 0,5 - 3, 0,90 0,6 - 1, 16,7 4,7 - 37 88 78,7 - 94
15 7 1 4 3 3 ,4 ,2 ,4

≤130,0 30,7 9,1 - 61,4 75,8 65,5 - 84, 1,27 0,5 - 3, 0,91 0,6 - 1, 16,0 4,5 - 36 88 78,4 - 94
24 7 6 4 1 3 ,1 ,0 ,4
≤130,0 30,7 9,1 - 61,4 74,7 64,3 - 83, 1,22 0,5 - 3, 0,93 0,6 - 1, 15,4 4,4 - 34 87 78,2 - 94
75 7 1 4 0 4 ,9 ,8 ,3

≤130,5 30,7 9,1 - 61,4 73,5 63,0 - 82, 1,16 0,5 - 2, 0,94 0,6 - 1, 14,8 4,2 - 33 87 77,9 - 94
44 7 6 4 8 4 ,7 ,7 ,2

≤130,7 30,7 9,1 - 61,4 72,4 61,8 - 81, 1,12 0,5 - 2, 0,96 0,7 - 1, 14,3 4,0 - 32 87 77,6 - 94
68 7 1 5 7 4 ,7 ,5 ,1

≤132,2 30,7 9,1 - 61,4 71,2 60,6 - 80, 1,07 0,4 - 2, 0,97 0,7 - 1, 13,8 3,8 - 32 87 77,3 - 94
09 7 6 5 6 4 ,1 ,3 ,0

≤132,8 30,7 9,1 - 61,4 70,1 59,4 - 79, 1,03 0,4 - 2, 0,99 0,7 - 1, 13,3 3,6 - 31 87 77,0 - 93
83 7 1 5 5 5 ,1 ,1 ,9

≤133,0 30,7 9,1 - 61,4 68,9 58,1 - 78, 0,99 0,4 - 2, 1,00 0,7 - 1, 12,9 3,5 - 30 87 76,7 - 93
28 7 7 5 4 5 ,2 ,0 ,9

≤133,2 30,7 9,1 - 61,4 67,8 56,9 - 77, 0,96 0,4 - 2, 1,02 0,7 - 1, 12,5 3,5 - 29 86 76,4 - 93
64 7 2 4 3 5 ,0 ,8 ,8

≤133,4 30,7 9,1 - 61,4 66,6 55,7 - 76, 0,92 0,4 - 2, 1,04 0,7 - 1, 12,1 3,4 - 28 86 76,0 - 93
79 7 7 4 2 5 ,2 ,6 ,7

≤134,4 30,7 9,1 - 61,4 65,5 54,6 - 75, 0,89 0,4 - 2, 1,06 0,7 - 1, 11,8 3,3 - 27 86 75,7 - 93
1 7 2 4 1 6 ,5 ,4 ,6

≤135,1 30,7 9,1 - 61,4 64,3 53,4 - 74, 0,86 0,4 - 2, 1,08 0,7 - 1, 11,4 3,2 - 26 86 75,3 - 93
9 7 7 4 0 6 ,7 ,2 ,5

≤135,3 30,7 9,1 - 61,4 63,2 52,2 - 73, 0,84 0,4 - 2, 1,10 0,7 - 1, 11,1 3,1 - 26 85 75,0 - 93
16 7 2 3 0 6 ,1 ,9 ,4

≤135,6 30,7 9,1 - 61,4 62,0 51,0 - 72, 0,81 0,3 - 1, 1,12 0,7 - 1, 10,8 3,0 - 25 85 74,6 - 93
32 7 7 3 9 7 ,7 ,7 ,3

≤135,7 38,4 13,9 - 68, 62,0 51,0 - 72, 1,01 0,5 - 2, 0,99 0,6 - 1, 13,2 4,3 - 28 87 76,1 - 94
13 6 4 7 3 1 6 ,3 ,1 ,3

≤135,7 38,4 13,9 - 68, 60,9 49,9 - 71, 0,98 0,5 - 2, 1,01 0,6 - 1, 12,8 4,3 - 27 86 75,8 - 94
76 6 4 2 2 1 6 ,4 ,9 ,2

≤135,9 38,4 13,9 - 68, 59,7 48,7 - 70, 0,96 0,5 - 2, 1,03 0,6 - 1, 12,5 4,2 - 26 86 75,4 - 94
39 6 4 7 1 0 6 ,8 ,7 ,1

≤136,4 38,4 13,9 - 68, 58,6 47,6 - 69, 0,93 0,4 - 1, 1,05 0,7 - 1, 12,2 4,1 - 26 86 75,0 - 94
31 6 4 2 1 9 7 ,2 ,4 ,0
≤136,5 46,1 19,2 - 74, 58,6 47,6 - 69, 1,12 0,6 - 2, 0,92 0,5 - 1, 14,3 5,4 - 28 87 76,7 - 95
31 5 9 2 1 1 6 ,5 ,9 ,0

≤136,9 53,8 25,1 - 80, 58,6 47,6 - 69, 1,30 0,7 - 2, 0,79 0,4 - 1, 16,3 6,8 - 30 89 78,5 - 96
69 5 8 2 1 3 5 ,7 ,5 ,0

≤139,3 61,5 31,6 - 86, 58,6 47,6 - 69, 1,49 0,9 - 2, 0,66 0,3 - 1, 18,2 8,2 - 32 91 80,4 - 97
97 4 1 2 1 4 3 ,7 ,1 ,0

≤140,2 69,2 38,6 - 90, 58,6 47,6 - 69, 1,67 1,1 - 2, 0,52 0,2 - 1, 20,0 9,6 - 34 92 82,4 - 98
12 3 9 2 1 6 2 ,6 ,7 ,0

≤140,3 69,2 38,6 - 90, 57,4 46,4 - 68, 1,63 1,1 - 2, 0,54 0,2 - 1, 19,6 9,4 - 33 92 82,0 - 98
41 3 9 7 0 5 2 ,9 ,6 ,0

≤140,6 69,2 38,6 - 90, 56,3 45,3 - 66, 1,59 1,0 - 2, 0,55 0,2 - 1, 19,1 9,1 - 33 92 81,8 - 97
75 3 9 2 9 4 3 ,3 ,5 ,9

≤140,7 69,2 38,6 - 90, 55,1 44,1 - 65, 1,54 1,0 - 2, 0,56 0,2 - 1, 18,8 8,9 - 32 92 81,5 - 97
27 3 9 7 9 4 3 ,6 ,3 ,9

≤141,0 69,2 38,6 - 90, 54,0 43,0 - 64, 1,51 1,0 - 2, 0,57 0,2 - 1, 18,4 8,8 - 32 92 81,1 - 97
5 3 9 2 8 3 3 ,0 ,2 ,8

≤141,5 69,2 38,6 - 90, 52,8 41,9 - 63, 1,47 1,0 - 2, 0,58 0,3 - 1, 18,0 8,6 - 31 92 80,8 - 97
76 3 9 7 7 2 3 ,4 ,0 ,8

≤141,6 69,2 38,6 - 90, 51,7 40,8 - 62, 1,43 0,9 - 2, 0,59 0,3 - 1, 17,6 8,4 - 30 91 80,4 - 97
57 3 9 2 6 2 4 ,9 ,8 ,7

≤141,6 69,2 38,6 - 90, 50,5 39,6 - 61, 1,40 0,9 - 2, 0,61 0,3 - 1, 17,3 8,2 - 30 91 80,0 - 97
84 3 9 7 5 1 4 ,5 ,7 ,7

≤141,8 69,2 38,6 - 90, 49,4 38,5 - 60, 1,37 0,9 - 2, 0,62 0,3 - 1, 17,0 8,1 - 29 91 79,6 - 97
89 3 9 3 4 1 4 ,8 ,5 ,6

≤142,7 69,2 38,6 - 90, 48,2 37,4 - 59, 1,34 0,9 - 2, 0,64 0,3 - 1, 16,7 7,8 - 29 91 79,2 - 97
34 3 9 8 2 0 5 ,4 ,3 ,6

≤142,7 76,9 46,2 - 95, 48,2 37,4 - 59, 1,49 1,0 - 2, 0,48 0,2 - 1, 18,2 9,0 - 31 93 81,7 - 98
87 2 0 8 2 1 3 ,0 ,3 ,6

≤142,9 76,9 46,2 - 95, 47,1 36,3 - 58, 1,45 1,0 - 2, 0,49 0,2 - 1, 17,9 8,9 - 30 93 81,3 - 98
07 2 0 3 1 1 4 ,4 ,2 ,6

≤143,0 84,6 54,6 - 98, 47,1 36,3 - 58, 1,60 1,2 - 2, 0,33 0,09 - 1 19,3 10,0 - 3 95 84,2 - 99
02 2 1 3 1 2 ,2 1,9 ,3 ,4
≤143,6 84,6 54,6 - 98, 45,9 35,2 - 57, 1,57 1,2 - 2, 0,33 0,09 - 1 19,0 9,9 - 31 95 83,8 - 99
57 2 1 8 0 1 ,2 ,4 ,2 ,4

≤143,7 84,6 54,6 - 98, 44,8 34,1 - 55, 1,53 1,1 - 2, 0,34 0,09 - 1 18,6 9,7 - 30 95 83,5 - 99
91 2 1 3 9 1 ,3 ,9 ,1 ,4

≤144,5 84,6 54,6 - 98, 43,6 33,1 - 54, 1,50 1,1 - 2, 0,35 0,10 - 1 18,3 9,5 - 30 95 83,1 - 99
91 2 1 8 7 0 ,3 ,4 ,0 ,4

≤144,8 84,6 54,6 - 98, 42,5 32,0 - 53, 1,47 1,1 - 2, 0,36 0,10 - 1 18,0 9,3 - 30 94 82,7 - 99
83 2 1 3 6 0 ,3 ,1 ,9 ,4

≤145,2 84,6 54,6 - 98, 41,3 30,9 - 52, 1,44 1,1 - 1, 0,37 0,1 - 1, 17,7 9,2 - 29 94 82,3 - 99
89 2 1 8 4 9 4 ,5 ,7 ,4

≤145,6 84,6 54,6 - 98, 40,2 29,9 - 51, 1,42 1,1 - 1, 0,38 0,1 - 1, 17,5 9,0 - 29 94 81,8 - 99
75 2 1 3 3 9 4 ,2 ,6 ,3

≤145,7 84,6 54,6 - 98, 39,0 28,8 - 50, 1,39 1,0 - 1, 0,39 0,1 - 1, 17,2 8,9 - 28 94 81,3 - 99
92 2 1 8 1 8 4 ,7 ,4 ,3

≤146,0 84,6 54,6 - 98, 37,9 27,7 - 49, 1,36 1,0 - 1, 0,41 0,1 - 1, 16,9 8,8 - 28 94 80,6 - 99
63 2 1 3 0 8 5 ,3 ,3 ,3

≤146,3 84,6 54,6 - 98, 36,7 26,7 - 47, 1,34 1,0 - 1, 0,42 0,1 - 1, 16,7 8,6 - 27 94 80,3 - 99
04 2 1 8 8 8 5 ,9 ,1 ,3

≤146,8 84,6 54,6 - 98, 35,6 25,6 - 46, 1,31 1,0 - 1, 0,43 0,1 - 1, 16,4 8,5 - 27 93 79,8 - 99
09 2 1 3 6 7 6 ,5 ,9 ,3

≤149,2 84,6 54,6 - 98, 34,4 24,6 - 45, 1,29 1,0 - 1, 0,45 0,1 - 1, 16,2 8,4 - 27 93 79,2 - 99
52 2 1 8 4 7 6 ,1 ,8 ,2

≤149,7 84,6 54,6 - 98, 33,3 23,6 - 44, 1,27 1,0 - 1, 0,46 0,1 - 1, 15,9 8,2 - 26 93 78,2 - 99
17 2 1 3 3 7 7 ,7 ,5 ,2

≤150,4 84,6 54,6 - 98, 32,1 22,6 - 43, 1,25 0,9 - 1, 0,48 0,1 - 1, 15,7 8,1 - 26 93 77,6 - 99
3 2 1 8 1 6 8 ,4 ,3 ,2

≤150,4 84,6 54,6 - 98, 31,0 21,5 - 41, 1,23 0,9 - 1, 0,50 0,1 - 1, 15,5 8,0 - 26 93 77,2 - 99
91 2 1 3 9 6 8 ,0 ,1 ,2

≤151,1 84,6 54,6 - 98, 29,8 20,5 - 40, 1,21 0,9 - 1, 0,51 0,1 - 1, 15,3 7,8 - 25 92 76,5 - 99
53 2 1 9 6 6 9 ,8 ,9 ,1

≤152,2 84,6 54,6 - 98, 28,7 19,5 - 39, 1,19 0,9 - 1, 0,54 0,1 - 2, 15,1 7,8 - 25 92 75,3 - 99
31 2 1 4 4 6 0 ,4 ,6 ,1
≤152,3 84,6 54,6 - 98, 27,5 18,5 - 38, 1,17 0,9 - 1, 0,56 0,1 - 2, 14,9 7,7 - 25 92 74,9 - 99
97 2 1 9 2 5 1 ,0 ,3 ,1

≤154,5 84,6 54,6 - 98, 26,4 17,6 - 37, 1,15 0,9 - 1, 0,58 0,2 - 2, 14,7 7,6 - 24 92 74,0 - 99
7 2 1 4 0 5 2 ,7 ,0 ,0

≤154,6 84,6 54,6 - 98, 25,2 16,6 - 35, 1,13 0,9 - 1, 0,61 0,2 - 2, 14,5 7,5 - 24 91 73,0 - 99
05 2 1 9 7 5 3 ,4 ,7 ,0

≤154,9 84,6 54,6 - 98, 24,1 15,6 - 34, 1,12 0,9 - 1, 0,64 0,2 - 2, 14,3 7,3 - 24 91 72,0 - 98
59 2 1 4 5 4 4 ,2 ,3 ,9

≤155,1 84,6 54,6 - 98, 22,9 14,6 - 33, 1,10 0,8 - 1, 0,67 0,2 - 2, 14,1 7,3 - 23 90 70,8 - 98
53 2 1 9 2 4 5 ,8 ,9 ,9

≤156,4 84,6 54,6 - 98, 21,8 13,7 - 32, 1,08 0,8 - 1, 0,70 0,2 - 2, 13,9 7,2 - 23 90 69,6 - 98
96 2 1 4 0 4 7 ,5 ,5 ,8

≤156,7 84,6 54,6 - 98, 20,6 12,7 - 30, 1,07 0,8 - 1, 0,74 0,2 - 2, 13,8 7,1 - 23 90 68,3 - 98
71 2 1 9 7 4 8 ,3 ,0 ,8

≤157,4 84,6 54,6 - 98, 19,5 11,8 - 29, 1,05 0,8 - 1, 0,79 0,2 - 3, 13,6 7,0 - 23 89 66,9 - 98
44 2 1 4 4 4 0 ,0 ,5 ,7

≤157,6 84,6 54,6 - 98, 18,3 10,9 - 28, 1,04 0,8 - 1, 0,84 0,2 - 3, 13,4 6,9 - 22 88 65,3 - 98
61 2 1 9 1 3 2 ,7 ,9 ,6

≤158,4 84,6 54,6 - 98, 17,2 10,0 - 26, 1,02 0,8 - 1, 0,89 0,2 - 3, 13,3 6,8 - 22 88 63,6 - 98
11 2 1 4 8 3 5 ,5 ,2 ,5

≤158,8 92,3 64,0 - 99, 17,2 10,0 - 26, 1,12 0,9 - 1, 0,45 0,06 - 3 14,3 7,6 - 23 93 69,8 - 99
68 1 8 4 8 3 ,1 ,6 ,8 ,8

≤159,0 92,3 64,0 - 99, 16,0 9,1 - 25,5 1,10 0,9 - 1, 0,48 0,07 - 3 14,1 7,5 - 23 93 66,8 - 99
1 1 8 9 3 ,3 ,4 ,3 ,9

≤159,8 92,3 64,0 - 99, 14,9 8,2 - 24,2 1,09 0,9 - 1, 0,51 0,07 - 3 14,0 7,4 - 23 92 66,1 - 99
42 1 8 4 3 ,6 ,1 ,9 ,8

≤160,6 92,3 64,0 - 99, 13,7 7,3 - 22,9 1,07 0,9 - 1, 0,56 0,08 - 3 13,8 7,3 - 22 92 64,0 - 99
33 1 8 9 3 ,9 ,9 ,3 ,8

≤160,8 92,3 64,0 - 99, 12,6 6,5 - 21,5 1,06 0,9 - 1, 0,61 0,09 - 4 13,6 7,2 - 22 91 61,5 - 99
74 1 8 4 3 ,3 ,6 ,7 ,8

≤161,0 92,3 64,0 - 99, 11,4 5,7 - 20,1 1,04 0,9 - 1, 0,67 0,09 - 4 13,5 7,2 - 22 90 58,7 - 99
81 1 8 9 2 ,8 ,4 ,9 ,8
≤161,4 92,3 64,0 - 99, 10,3 4,8 - 18,7 1,03 0,9 - 1, 0,74 0,1 - 5, 13,3 7,1 - 22 90 55,5 - 99
3 1 8 4 2 4 ,1 ,0 ,7

≤161,9 92,3 64,0 - 99, 9,20 4,1 - 17,3 1,02 0,9 - 1, 0,84 0,1 - 6, 13,2 7,0 - 21 88 51,8 - 99
22 1 8 2 2 ,9 ,9 ,7

≤162,9 92,3 64,0 - 99, 8,05 3,3 - 15,9 1,00 0,8 - 1, 0,96 0,1 - 7, 13,0 6,9 - 21 87 44,0 - 99
59 1 8 2 2 ,7 ,5 ,8

≤167,9 92,3 64,0 - 99, 6,90 2,6 - 14,4 0,99 0,8 - 1, 1,12 0,1 - 8, 12,9 6,8 - 21 85 38,1 - 99
67 1 8 2 5 ,5 ,7 ,8

≤168,9 92,3 64,0 - 99, 5,75 1,9 - 12,9 0,98 0,8 - 1, 1,34 0,2 - 10 12,8 6,8 - 21 83 31,1 - 99
2 1 8 2 ,6 ,2 ,3 ,8

≤170,3 92,3 64,0 - 99, 4,60 1,3 - 11,4 0,97 0,8 - 1, 1,67 0,2 - 13 12,6 6,7 - 21 80 22,8 - 99
81 1 8 1 ,8 ,0 ,0 ,8

≤178,8 92,3 64,0 - 99, 3,45 0,7 - 9,7 0,96 0,8 - 1, 2,23 0,3 - 19 12,5 6,6 - 20 75 13,2 - 99
69 1 8 1 ,9 ,8 ,0 ,8

≤184,7 92,3 64,0 - 99, 2,30 0,3 - 8,1 0,94 0,8 - 1, 3,35 0,3 - 34 12,4 6,6 - 20 66 4,0 - 99,
59 1 8 1 ,3 ,6 ,7 8

≤185,2 92,3 64,0 - 99, 1,15 0,03 - 6,2 0,93 0,8 - 1, 6,69 0,4 - 10 12,2 6,5 - 20 50 0,04 - 10
06 1 8 1 0,6 ,4 ,0 0,0

≤187,6 100, 75,3 - 10 1,15 0,03 - 6,2 1,01 1,0 - 1, 0,00   13,1 7,2 - 21 10 2,5 - 100
8 00 0,0 0 ,4 0, ,0
0

≤192,2 100, 75,3 - 10 0,00 0,0 - 4,2 1,00 1,0 - 1,     13,0 7,1 - 21    

17 00 0,0 0 ,2
 

LDLGRP * MCI Crosstabulation

MCI

MCI MCI
Negatif Positif Total

1,00 Count 41 3 44
LDLGR % within
93,2% 6,8% 100,0%
P LDLGRP

2,00 Count 46 10 56

% within
82,1% 17,9% 100,0%
LDLGRP

Total Count 87 13 100

% within
87,0% 13,0% 100,0%
LDLGRP

Tables - 2-by-2 unstratified

15.56.57, 06/03/2019

| + - | Total

-------+-------------+-------

+| 3 41 | 44

-| 10 46 | 56

-------+-------------+-------

Total | 13 87 | 100

Tests of significance

Fisher exact test (one tailed) : 0,089853

Fisher exact test (two tailed) : 0,137979

Uncorrected chi-square : 2,65

p-value : 0,103237

Yates corrected Chi-square : 1,77

p-value : 0,183569
Measures of exposure effect [95% CI]

Risk ratio : 0,38 [0,11; 1,30]

Odds ratio : 0,34 [0,09; 1,31]

Risk difference : -0,11 [-0,24; 0,01]

Proportional attributable risk : -1,62 [-7,95; 0,23]

Population proportional attr. risk : -0,37 [-0,64; 0,12]

Vaccine efficacy [95% CI]

Vaccine efficacy : 0,62 [-0,30; 0,89]

Screening [95% CI]

Prevalence : 0,13 [0,07; 0,22]

Sensitivity : 0,23 [0,06; 0,54]

Specificity : 0,53 [0,42; 0,64]

Accuracy : 0,49 [0,39; 0,59]

Predictive value of +ve result : 0,07 [0,02; 0,20]

Predictive value of -ve result : 0,82 [0,69; 0,91]

Matched data

Z : 4,20

One-sided p-value : 0,000013

Two-sided p-value : 0,000027

McNemar Chi-square : 17,65

p-value : 0,000027
McNemar odds ratio [95% CI] : 4,10 [1,98; 8,72]

Difference in proportions [95% CI] : 0,31 [0,17; 0,45]

Sensitivity = a/(a+c) = 23%

Specificity = d/(b+d) = 53%

Likelihood ratio for a positive test result = LR+ = sens/(1-spec) = 0.49

Likelihood ratio for a negative test result = LR - = (1-sens)/spec = 1.45

Positive Predictive Value = a/(a+b) = 7%

Negative Predictive Value = d/(c+d) = 82%

Pre-test probability (prevalence) = (a+c)/(a+b+c+d) = 13 %

Pre-test odds = prevalence/(1-prevalence) = 0.15

4. Dalam file excel tersedia DATA Therapy Bad Outcome.

4.1 Hitunglah nilai-nilai Importance
4.2 Buatlah kesimpulan

Kelompok * Outcome Crosstabulation

Count
Outcome Total
Hidup Meningga
l
Ace
Kelompo 44 6 50
Inhibitor
k
Placebo 37 13 50
Total 81 19 100
Interpretasi:

CER = 0,26
EER = 0,12
RR = 0,46 ; artinya kelompok ACEi memiliki resiko kematian karena MCI sebanyak 0,46
kali dibandingkan dengan kelompok placebo . ACEi mengurangi risiko kematian pada
MCI
ARR = 0,14 ; artinya selisih jumlah insidens kematian apabila ACEi digunakan sebagai terapi
denga placebo sebesar 14%
RRR = 0,58 ; artinya apabila ACEi digunakan sebagai terapi makan insidens kematian MCI
dapat diturunkan sebesar 58% dari insidens sebelumnya

NNT = 7,14; artinya Dibutuhkan terapi ACE inhibitor sebanyak antara 7-8 orang selama 2
tahun untuk mencegah 1 kematian pada pasien MCI

Kesimpulan: Hasil penelitian ini penting/sangat bermakna secara klinis

5. Dalam file excel tersedia DATA Therapy Effectiveness.

5.1 Hitunglah nilai-nilai Importance
5.2 Buatlah kesimpulan
 Kelompok * Outcome Crosstabulation
Outcome Total
Sembuh Tidak
Sembuh
Count 26 24 50
Enalapril + ASA % within
52,0% 48,0% 100,0%
Kelompo Kelompok
k Count 9 41 50
Isossorbid Prodiprogrel
% within
+ Deuretik 18,0% 82,0% 100,0%
Kelompok
Count 35 65 100
Total % within
35,0% 65,0% 100,0%
Kelompok

Interpretasi:
CER = 0,18
EER = 0,52
RR = 2,88. Kesembuhan subjek pada kelompok terapi enalapril + ASA sebesar 2,88 kali
dibandingkan isosorbid + diuretik
ABI = 0,34 ; artinya selisih insiden sembuh antara enalapril + ASA dengan isosorbid +
diuretic = 34%
RBI = 1,889 ; artinya apabila enalapril + ASA digunakan sebagai terapi maka insidens
sembuh dapat ditingkatkan sebesar 188,9% (secara klinis penggunaan enalapril dan ASA
sengat bermakna sebab RBI > 50%)
NNT = 2,94; artinya dibutuhkan 2-3 pasien MCI yang mendapat terapi enalapril + ASA untuk
menyembuhkan 1 pasien MCI
Kesimpulan: Hasil penelitian ini penting/sangat bermakna secara klinis