CRITICAL APPRAISAL WORKSHEET

AN META ANALYSIS JOURNAL

Authors : Qonitatun Nahdliyyah, Nieko Caesar A. M.

Journal : 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 the overview

address a focused

clinical question?

Yes

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

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5. Were assesments of

studies reproducible?

Yes

6. Were the results similar

from study to study?

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 Yes

2

outcomes considered?

3. Are the benefits worth the

harms and costs? Manfaat

cukup baik

Yes

CONCLUSIONS

The results or recommendation are

valid (from A)

Yes

The results are clinically important

(from B)

Yes

The results are relevant to my

practice (from C)

Yes

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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

groups of subjects, similar

in all important ways

other than exposure to the

treatment or other cause?

Yes

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

4

Was the follow-up

sufficiently long and

complete?

Yes

Do the results satisfy the

common tests for

causation (e.g., temporal,

dose-response, biological

plausibility)?

Can’t 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.

What are the Results?*

Questions Comments

How strong is the

association between

exposure & outcome?

P<0,001

95% CI (1,71-2,07)

How precise is the

estimate of the risk?

Adverse Outcome

Present Absent

Exposed to

treatment

CS Delivery 8,7 991,6

Vaginal

Delivery

4,4 995,6

RR = ((a/(a+b))/(c/(c+d))=(8,7/1000)/(4,4/1000)=1,98

How Can the Results Apply to Patient Care?*

Questions Comments

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

kehamilan (ANC) secara teratur sehingga penyulit

5

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

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