Prognosis Flashcards
Beda Prognosis vs Risk Factors
Prognosis: terjadi pada penyakit yang SUDAH terjadi, belum tentu menimbulkan outcome
Risk Factors: sebelum pasien terdiagnosis penyakit
Tipe Prognosis Reports
Terbaik: SR of Prognosis Studies
Sering: Kohort
Sumber lain: RCT, case control
Bias in A Study of Prognosis (5)
- Selection bias
- Allocation bias
- Mantained Bias
- Measurement/
Observation Bias - Confounding bias
Selection/recruitment bias, how to look at?
Apakah seleksi sampel tepat
Allocation bias, how to?
Pendefinisian faktor prognostik
Maintained bias
long and complete follow-up
Measrements/observation bias
blinding and objective measurement
Confounding bias
multivariate and/or subgroup analysis
Apakah sampel sudah representatif? (2)
- ada kriteria inklusi/eksklusi, metode samplng
- titik pengamatan yang sama dari perjalanan penyakit sampel (inception cohort)
Syarat Follow Up yang cukup lama dan lengkap (5)
- periode FU ideal: hingga pasien sembuh atau muncul outcome yg dimau
- Short FU time: outcome terlalu sedikit
- Loss to FU: mempengaruhi estimate of the risk of the outcome (validity)
- “5 and 20” rule –> dibawah 5% tidak mengganggu validitas, diatas 20% sudah mengganggu
- Best & worst case scenario (sensitivity analysis) –> subjek loss to FU dimasukkan sebagai best or worst scenario
Minimize measurement bias (3)
- Observers blinded
- careful criteria (definition) for all outcome
- apply equally rigorous efforts
Importance of the results (2)
How likely are the outcomes over time?
How precise is this prognostic estimate?
Beneficial of Pognostic Study (3)
Communicating to patients their likely fate
Guiding treatment decisions
Comparing outcomes to make inferences about quality
of care
