CAT

(Critical Appraisal
of The Topics)
Jurnal ini mempunyai nilai validitas dan relevansi
yang tinggi karena :

• Studi ini tidak disponsori oleh organisasi yang

dapat berdampak pada desain dan hasil studi
• Jika informasi ini benar maka akan merubah
sikap kita terhadap cara kita dalam melayani
pasien
• Tidak ada kejelasan data karakteristik pasien di
Indonesia, sehingga belum tentu memiliki
kemiripan dan dapat dipergunakan di senter
kita
 Menentukan Isi dan tujuan dari
artikel
• Jurnal ini bertujuan untuk memberikan
gambaran bahwa terdapat perbedaan dalam hal
pentingnya pemantauan kondisi pasien dengan
tumor mediastinum serta prognosis pada pasien
dengan tumor mediastinum
• Klinikal kategori : Prognosis
 Clinical Description Prefered Study
category Design

Therapy Tests the effectiveness of a Randomized, double-

treatment, such as a drug, blinded, placebo-
surgical procedure, or other controlled trial
intervention
Diagnosis Measures the validity (is it Cross-sectional
dependable?) and reliability (will survey (comparing
the same results be obtained the new test with a
every time?) of a diagnostic test, reference standard)
or evaluates the effectiveness of
a test in detecting disease at a
presymptomatic stage when
applied to a large population
Causation Assesses whether a substance is Cohort or case-
related to the development of control
an illness or condition
Prognosis Determines the outcome of a Longitudinal cohort
disease study
 Level 1 of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm

1a SR (with homogeneity*) of RCTs SR (with homogeneity*) of SR (with homogeneity*) of Level 1

inception cohort studies; diagnostic studies; CDR† with
CDR† validated in different 1b studies from different
populations clinical centres

1b Individual RCT (with narrow Individual inception cohort Validating** cohort study with
Confidence Interval‡) study with > 80% follow- good††† reference standards; or
up; CDR† validated in a CDR† tested within one clinical
single population centre

1c All or none All or none case-series Absolute SpPins and SnNouts††

 Level 2 of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm
2a SR (with homogeneity*) of cohort SR (with homogeneity*) of SR (with homogeneity*) of Level >2
studies either retrospective cohort diagnostic studies
studies or untreated control
groups in RCTs
2b Individual cohort study (including Retrospective cohort study or Exploratory** cohort study with
low quality RCT; e.g., <80% follow- follow-up of untreated control good††† reference standards; CDR†
up) patients in an RCT; Derivation after derivation, or validated only on
of CDR† or validated on split- split-sample§§§ or databases
sample§§§ only
2c "Outcomes" Research; Ecological "Outcomes" Research
studies
 Level 3,4,5 of Evidence
Level Therapy/Prevention, Prognosis Diagnosis
Aetiology/Harm
3a SR (with homogeneity*) of case- Exploratory** prospective SR (with homogeneity*) of 3b and
control studies study with good††† reference better studies
standards; CDR† after
derivation, or validated only on
split-sample
3b Individual Case-Control Study Non-consecutive study; or without
consistently applied reference
standards

4 Case-series (and poor quality Case-series (and poor quality Case-control study, poor or non-
cohort and case-control studies§) prognostic cohort studies***) independent reference standard

5 Expert opinion without explicit Expert opinion without explicit Expert opinion without explicit
critical appraisal, or based on critical appraisal, or based on critical appraisal, or based on
physiology, bench research or "first physiology, bench research or physiology, bench research or "first
principles" "first principles" principles"
 Grades of Recommendation

A consistent level 1 studies

B consistent level 2 or 3 studies or extrapolations

from level 1 studies
C level 4 studies or extrapolations from level 2 or 3
studies
D level 5 evidence or troublingly inconsistent or
inconclusive studies of any level