CRITICAL APPRAISAL OF A COHORT STUDY

COHORT WORKSHEET

Name: Viko Bagus Lisephano

Date: 25 Juni 2015

Citation:
Body Mass Index and Mortality among Adults with Incident Type 2 Diabetes

Are the results valid?

1. Was there a clearly defined, focused
research question? What was the study
question?

Ya, Pertanyaan Penelitian nya adalah apakah ada

hubungan angka kematian dengan BMI pada pasien
dengan diabetes melitus tipe 2

2. How was the exposed cohort selected? Was

there a well defined selection procedure for
inclusion into the cohort? What proportion of
eligible subjects was actually included?

Peserta yang masuk dalam penelitian ini adalah,

pasien yang terdiagnosis DM tipe 2 tanpa ada
penyakit penyulit lain seperti penyakit
kardiovaskuler dan kanker. Kelompok terpapar
adalah kelompok yang dibedakan dengan melihat
ada riwayat merokok dan melihat umur saat
diagnosis
Kelompok yang tidak terpapar, diambil dari peserta
yang di diagnosis DM tetapi tidak merokok

3. How was the non-exposed cohort selected?

Was this cohort drawn from the same source
population as the exposed cohort? Was there a
well defined selection procedure for inclusion
into the cohort? What proportion of eligible
subjects was actually included?

4. How were the main exposures ascertained?

Were the exposures clear, specific and
measurable? Any likelihood of exposure
misclassification?

Semua pasien sama terdiagnosis diabetes melitus

akan tetapi yang membedakan hanya riwayat
(merokok, jenis kelamin, dll.)

5. Was the cohort free of the disease (outcome)

at the start of follow-up? Were only people at
risk of the outcome included?

Peserta yang dipilih adalah pasien yang mempunyai

resiko untuk terkena diabetes melitus tipe 2

6. Was duration of follow-up adequate (i.e.

long enough for main outcomes to occur)?

Ya, jangka waktu follow up cukup lama untuk

menilai dan mengetahui primary outcome

7. Was follow-up complete? Were efforts

Ya, Follow up dilakukan hingga peserta meninggal

.

made to limit the loss to follow-up? What

was the rate of attrition and was loss to
follow-up similar in the exposed and non
exposed cohorts?

Atau hingga batas waktu penelitian berakhir yaitu 1

januari 2012

8. What were the primary and secondary

outcomes of the study? How well were the
outcomes measured? Was the outcome clear,
specific and measurable? Were surrogate
outcomes used?

Primari outcome nya adalah menghitung jumlah

kematian oleh penyebab apapun pada peserta dengan
diabetes tipe 2.

9. Were outcomes measures similarly in

exposed and non exposed cohorts? Was
outcome ascertainment influenced by
knowledge of the exposure status (i.e. lack of
blinding)?

Metode pengukuran sama berdasarkan BMI dan

riwayat lifestyle seperti merokok

10. How comparable were the exposed and nonexposed cohorts? Have the authors identified all
potentially important confounders? Is there
information on how the potential confounders
are distributed between the comparison groups?
What confounders were adjusted for and was
the adjustment adequate? Is residual
confounding a concern?

Secondary outcome nya adalah untuk mencari

penyebab tersering kematian yabg terjadi.

What are the results?

What are the study results?
1. How strong was the association between
exposure and outcome (e.g. rate ratio or
hazard ratio or odds ratio)?

2. How precise was the estimate of the

association (i.e. confidence intervals around
the point estimates or p-values)?

Terdapat 3083 kematian pada periode 15.8 tahun

follow up. Asosiasi J-Shaped melakukan observasi
pada kategori BMI (18.5 sampai 22.4, 22.5
sampai 24.9, 25.0 sampai 27.4, 27.5 sampai 29.9,
30.0 sampai 34.9 dan lebih dari 35.0) untuk
semua penyebab kematian (Hazard ratio, 1.29 [95
Confidence interval{CI}, 1.05 to 1.59]; 1.00; 1.12
[95% CI, 0.98 to 1.14 to 1.55], masing-masing).
Hubungan ini linear pada peserta yang memiliki
riwayat tidak pernah merokok (hazard ratio
menurut kategori BMI : 1.12, 1.00, 1.16, 1.21,
1.36, dan 1.56, berturut-turut) tetapi hasil nonlinear didapatkan pada peserta yang mempunyai
riwayat merokok merokok (hazard ratio menurut
kategori BMI : 1.32, 1.00, 1.09, 1.04, 1.14, dan
1.21) (P=0.04 untuk interaksi)

1. Were the study participants similar to the

patient in your practice?
-Does your patient match the study
inclusion criteria?

Pasien dalam penelitian mirip dengan pasien di

lokasi saya. pasien memiliki DM dan riwayat
merokok serta dengan obesitas.

-If not, are there compelling reasons why

the results should not apply to your patient?
2. Were all clinically important outcomes
considered?

Hasil penelitian ini berguna sebagai bukti untuk

dapat memberikan edukasi pada pasien diabetes
melitus dengan riwayat merokok

3. Do the results of this study fit with other

available evidence?

Ya,

Can you apply the results to patient care?