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    This critical appraisal worksheet summarizes a meta-analysis examining the risk of placenta previa in second births after a first birth cesarean section. The study addressed a focused clinical question and used appropriate criteria to select articles for inclusion, making it unlikely important studies were missed. The validity of the included studies was appraised and assessments were reproducible. The results showed an increased risk of placenta previa with an odds ratio of 1.98 for women who had a prior cesarean delivery compared to vaginal delivery. The benefits of the results were determined to outweigh the harms and costs and the results were applicable to patient care.

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    This critical appraisal worksheet summarizes a meta-analysis examining the risk of placenta previa in second births after a first birth cesarean section. The study addressed a focused clinical question and used appropriate criteria to select articles for inclusion, making it unlikely important studies were missed. The validity of the included studies was appraised and assessments were reproducible. The results showed an increased risk of placenta previa with an odds ratio of 1.98 for women who had a prior cesarean delivery compared to vaginal delivery. The benefits of the results were determined to outweigh the harms and costs and the results were applicable to patient care.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    85 views6 pages

    Critical Appraisal Worksheet

    Uploaded by

    Zahruddin Ahmad
    This critical appraisal worksheet summarizes a meta-analysis examining the risk of placenta previa in second births after a first birth cesarean section. The study addressed a focused clinical question and used appropriate criteria to select articles for inclusion, making it unlikely important studies were missed. The validity of the included studies was appraised and assessments were reproducible. The results showed an increased risk of placenta previa with an odds ratio of 1.98 for women who had a prior cesarean delivery compared to vaginal delivery. The benefits of the results were determined to outweigh the harms and costs and the results were applicable to patient care.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 6

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

    3. Is it unlikely that Yes


    important relevant
    studies were missed?
    Sampel terpenuhi?

    4. Was the validity of the Yes


    included studies
    appraised?

    1
    5. Were assesments of Yes
    studies reproducible?
    6. Were the results similar Yes
    from study to study?

    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 Yes
    my patient (care)?

    2
    2. Were all clinically important Yes
    outcomes considered?

    3. Are the benefits worth the Yes


    harms and costs? Manfaat
    cukup baik

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

    3
    Critical Appraisal Worksheet – Harm/Etiology

    Student: Qonitatun Nahdliyyah, Nieko Caesar Date: 09-01-2013


    A.M.

    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 Yes
    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)?

    4
    Was the follow-up Yes
    sufficiently long and
    complete?
    Do the results satisfy the Can’t tell
    common tests for Sejauh ini kami belum menemukan penelitian yang
    causation (e.g., temporal, menjelaskan hubungan sebab akibat yg terjadi antara
    dose-response, biological riwayat SC sebelumnya dengan kejadian plasenta
    plausibility)? previa pada kehamilan sekarang.
    What are the Results?*
    Questions Comments
    How strong is the P<0,001
    association between 95% CI (1,71-2,07)
    exposure & outcome?
    How precise is the Adverse Outcome
    estimate of the risk? Present Absent
    Exposed to CS Delivery 8,7 991,6
    treatment Vaginal 4,4 995,6
    Delivery
    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 Untuk mengurangi angka kejadian plasenta previa
    the risk/should I stop maka kejadian SC pd kehamilan sebelumnya juga harus
    exposure? dikurangi yaitu dengan melaksanakan periksa
    kehamilan (ANC) secara teratur sehingga penyulit

    5
    kehamilan dapat terdeteksi dini
    Do the results of this Yes
    study fit with other Jurnal ini juga merupakan penelitian metaanalisis yang
    available evidence? 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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