The development of QUADAS : a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews

BACKGROUND: In the era of evidence based medicine, with systematic reviews as its cornerstone, adequate quality assessment tools should be available. There is currently a lack of a systematically developed and evaluated tool for the assessment of diagnostic accuracy studies. The aim of this project was to combine empirical evidence and expert opinion in a formal consensus method to develop a tool to be used in systematic reviews to assess the quality of primary studies of diagnostic accuracy. METHODS: We conducted a Delphi procedure to develop the quality assessment tool by refining an initial list of items. Members of the Delphi panel were experts in the area of diagnostic research. The results of three previously conducted reviews of the diagnostic literature were used to generate a list of potential items for inclusion in the tool and to provide an evidence base upon which to develop the tool. RESULTS: A total of nine experts in the field of diagnostics took part in the Delphi procedure. The Delphi procedure consisted of four rounds, after which agreement was reached on the items to be included in the tool which we have called QUADAS. The initial list of 28 items was reduced to fourteen items in the final tool. Items included covered patient spectrum, reference standard, disease progression bias, verification bias, review bias, clinical review bias, incorporation bias, test execution, study withdrawals, and indeterminate results. The QUADAS tool is presented together with guidelines for scoring each of the items included in the tool. CONCLUSIONS: This project has produced an evidence based quality assessment tool to be used in systematic reviews of diagnostic accuracy studies. Further work to determine the usability and validity of the tool continue

Pengaruh Model Pembelajaran Kooperatif Tipe Student Team Achievement Division Terhadap Motivasi Belajar Dan Hasil Belajar IPA

This research aims to investigate the difference of learning motivation dan learning result on fifth grade students in primary school cluster I sub-district Buleleng specifically in natural science, between students who followed a cooperative learnig model type Student Team Achievement Division and those who followed a conventional learning model. This is a quasi-experimental research using postest only control group design with sample 60 students. Data of learning motivation were collected by using questionnaire and data of learning result were acquired by using multiple choice test. Data were analyzed using MANOVA. The result shows that; first, there's a significant difference on student's learning motivation between students who followed cooperative learning model type Student Team Achievement Division and those who followed the conventional learning method (F=16,857, sig=0,000; p<0,05). Second, there's a significant difference on natural science result between students students who followed cooperative learning model type Student Team Achievement Division and those who followed the conventional learning method (F= 3,850, sig=0,027; p<0,05). Third there's a difference on learning motivation and natural science learning result between students who followed cooperative learning model type Student Team Achievement Division and those who followed the conventional learning method simultaneously (F=7,757, sig=0,000; p<0,05)

SISTEM INFORMASI PASIEN RAWAT INAP DI BADAN RUMAH SAKIT UMUM(BRSU)KABUPATEN TABANAN

Pada pembuatan karya tulis yang berjudul ‘Sistem Informasi Pasien Rawat Inap Di Badan Rumah sakit Umum(BRSU) Kabupaten Tabana ‘ ini memberi informasi tenteng data data pasien rawat inap serta hal hal yang berhubungan dengan pasien rawat inap. Dimana sistem informasi ini sangat membantu pihak manajemen rumah sakit dalam memberikan informasi dan data tentang pasien rawat inap yang menggunakan jasa rumah sakit. Pembuatan program Sistem Informasi Pasien Rawat Inap Di Badan Rumah sakit Umum(BRSU) Kabupaten Tabana ini menggunakan Pemrograman Delphi. Tabel yang digunakan terdiri dari tabel Bangsal, tabel Kamar, tabel Pasien, tabel Masuk, tabel Periksa, tabel Obat_Pelapor, tabel Dokter, tabel Rinci biaya, table Periksa Biaya, table Periksa Obat dan table keluar. Pemilihan aplikasi pemrograman Delphi sebagai pembangun system ini dikarekan kemudahannya pengunaan dan konsep pemrograman yang mudah dimengerti. Sistem informasi ini akan memberikan laporan berupa laporan data bangsal, laporan kamar per bangsal, laporan seluruh biaya kamar, laporan seluruh data pasien, laporan data pasien masuk perpasien, laporan data pasien masuk perperiode, laporan data periksa per pasien, laporan pengunaan dokter per pasien, laporan obat per pasien, laporan rincian biaya per pasien, laporan seluruh data periksa, laporan seluruh data dokter, laporan seluruh data obat, laporan seluruh data rincian biaya, laporan pasien periksa perperiode, laporan pasien rawat jalan per periode, laporan pasien opname per periode, laporan pasien keluar per periode

SUBSTITUSI TEPUNG SORGUM DAN TEPUNG KACANG MERAH PADA PEMBUATAN COOKIES

Hiperkolesterolemia adalah peningkatan kadar satu atau lebih lipoprotein (VLDL, LDL) serta penurunan HDLyang terjadi akibat tingginya kadar kolesterol dalam masing-masing lipoprotein atau gabungan keduanya.. Data yang dihimpun WHO dalam Global status report on non-communicable diseases tahun 2008 memperlihatkan bahwa faktor resiko kolesterol pada wanita di Indonesia lebih tinggi yaitu 37,2% dibandingkan dengan pria yang hanya 32,8%. Penelitian ini memiliki tujuan untuk mengetahui pengaruh substitusi tepung sorgum dan tepung kacang merah terhadap nilai gizi dan daya terima cookies. Penelitian ini termasuk dalam jenis penelitian eksperimen  yang menggunakan Rancangan Acak Lengkap (RAL) dengan 4 taraf perlakuan yaitu T0, T1, T2, dan T3. Perlakuan T0 menggunakan resep standar cookies sedangkan T1 sampai T3 menggunakan substitusi tepung sorgum dan tepung kacang merah dengan perbandingan T1: 10%:10%, T2: 20%:7,5%, dan T3: 30%:5%. Formula tersebut kemudian diuji daya terima dan nilai gizi makronya.Penelitian ini dilakukan di Laboratorium Teknologi Pangan Prodi Gizi Poltekkes Kemenkes Kupangpada Bulan Juni Tahun 2022. Daya terima cookies diuji dengan menggunakan analisis statistik Oneway Anova sedangkan untuk mengetahui nilai gizi makro digunakan perhitungan menggunakan Tabel Komposisi Pangan Indonesia. Hasil penelitian menunjukkan bahwa penilaian yang diberikan oleh panelis terhadap cookies T0 sampai T3 (aspek warna, aroma, tekstur, rasa) masuk dalam kategori suka dengan rentang nilai 3,60 – 4,20. Hasil uji statistik menunjukkan tidak ada perbedaan daya terima antara cookies yang menggunakan resep standar dan kombinasi tepung.Cookies yang menjadi rekomendasi adalah T1 karena paling disukaidan memiliki nilai gizi makro paling tinggi diantara cookies yang lain

Does self-monitoring reduce blood pressure? Meta-analysis with meta-regression of randomized controlled trials

Introduction. Self-monitoring of blood pressure (BP) is an increasingly common part of hypertension management. The objectives of this systematic review were to evaluate the systolic and diastolic BP reduction, and achievement of target BP, associated with self-monitoring. Methods. MEDLINE, Embase, Cochrane database of systematic reviews, database of abstracts of clinical effectiveness, the health technology assessment database, the NHS economic evaluation database, and the TRIP database were searched for studies where the intervention included self-monitoring of BP and the outcome was change in office/ambulatory BP or proportion with controlled BP. Two reviewers independently extracted data. Meta-analysis using a random effects model was combined with meta-regression to investigate heterogeneity in effect sizes. Results. A total of 25 eligible randomized controlled trials (RCTs) (27 comparisons) were identified. Office systolic BP (20 RCTs, 21 comparisons, 5,898 patients) and diastolic BP (23 RCTs, 25 comparisons, 6,038 patients) were significantly reduced in those who self-monitored compared to usual care (weighted mean difference (WMD) systolic −3.82 mmHg (95% confidence interval −5.61 to −2.03), diastolic −1.45 mmHg (−1.95 to −0.94)). Self-monitoring increased the chance of meeting office BP targets (12 RCTs, 13 comparisons, 2,260 patients, relative risk = 1.09 (1.02 to 1.16)). There was significant heterogeneity between studies for all three comparisons, which could be partially accounted for by the use of additional co-interventions. Conclusion. Self-monitoring reduces blood pressure by a small but significant amount. Meta-regression could only account for part of the observed heterogeneity

Factors associated with health literacy among type 2 diabetes mellitus patients attending a government health clinic, 2016

Background: Despite the numerous health education programmes provided to the type 2 diabetes patients worldwide, the outcome of the diabetic management remains a challenge globally. Health literacy plays an important role in determining the outcomes from the diabetes management. Materials and Methods: This study was aimed to determine the level of health literacy and its associated factors among type 2 diabetes mellitus patients attending a government health clinic. This study also aimed to determine the association between the associated factors, such as sociodemographic, socioeconomic characteristics, type of treatment, diabetes duration, and knowledge on diabetes and the level of health literacy as well as the predictors of the level of health literacy. This was a cross-sectional study that was conducted from 1st February 2016 to 30th July 2016. A total of 360 participants were randomly selected from a government health clinic through a systematic random sampling method. A validated, self-administered questionnaire incorporating sociodemographic characteristics, socioeconomic characteristics, history of type 2 diabetes, diabetes knowledge and health literacy level was used in this study. Data was analysed using IBM Statistical Package for Social Science Version 22.0. Chi square test, Fisher’s Exact test and simple logistic regression were used to measure the association between the associated factors and health literacy level. Multiple logistic regression analysis was used to analyse the predictors influencing health literacy level among type 2 diabetes mellitus patients. Result: The response rate was 80%. Majority of the respondents have limited health literacy level (85.8%). There were significant association between ethnic group and health literacy level (χ2=6.317, P=0.042), level of education and health literacy level (χ2=6.304, P=0.043) and diabetes knowledge score and health literacy level [Odds Ratio (OR)=1.254, 95% Confidence Interval (CI) (1.063,1.479)]. Finally, the significant predictors for adequate health literacy level were the Chinese ethnic group [Adjusted OR (AOR)=4.441, 95% CI (1.472,13.392)] and diabetes knowledge score [AOR=1.238, 95% CI (1.031,1.488)]. Conclusion: In conclusion, level of health literacy among type 2 diabetes mellitus patients was significantly associated with the ethnic group, level of education and diabetes knowledge score. It can also be concluded that Chinese ethnic group and diabetes knowledge score were the significant predictors for adequate health literacy level among type 2 diabetes mellitus patients

Opimalisasi Pupuk Cair Urine Sapi Bunting dan Slury Biogas Metode Nanometer untuk Meningkatkan Produktivitas Rumput Gajah

Penelitian ini dilaksanakan di Eksperimental Farm, membuat pupuk rair organik dari urine sapi betina bunting dan limbah biogas cair slury yang di rubah strukturnya menjadi nanometer. Untuk mengetahui uji kualitas dilakukan uji pada produktivitas rumput . Proses teknologi nano secara garis besar adalah urine atau cairan slury diproses urease fermentasi, di fraksinasi elektromagnetik dan hasil fraksinasi nano, dengan partikel berukuran nanometer maka pupuk yang diberikan langsung siap pakai di daun karena partikel nano(nanometer) menembus ke daun melalui stomata daun. Pupuk cair organik nanometer diuji keberhasilannya dengan rancangan percobaan Acak Lengkap dilanjutkan Uji beda nyata jujur produktivitas rumput gajah Penelitian dengan tiga perlakuan, aras dosis 0.5ml, 1,5ml dan 3ml per liter air, ulangan 3 kali per unit dan setiap unit berisi 21 tanaman. Hasil penelitian menunjukkan bahwa pemupukan pupuk cair urine sapi bunting menunjukkan produktivitas optimal pada dosis 0,5 ml/liter air sedangkan pupuk cair organik bahan dasar slury memberikan produktivitas optimal pada dosis 3ml/liter ai

Shallot penetration in the export market

Realization of Indonesia's shallot exports is targeted to be achieved in 2025,therefore a strategy is needed to realize the shallot as an export market. The following paperpresents 1) Export market opportunities; (2) Market structure and performance; and (3) Factorsaffecting export market access. The methodology: Research was conducted through a survey,interviewed 28 respondents in the provinces of West and Central Java in 2017. Data analysisfor Objective 1) Identifying and mapping market opportunities; Objective 2) Refers toStructure Conduct Performance (SCP); Objective 3) Qualitative analysis which is presenteddescriptively. Results: 1) Shallots have a chance to be exported to Malaysia, Russia, and theUnited States. 2) The international market structure of shallots is an oligopoly. 3) Technicalinfluential factors were no adequate Good Farming Practices technology and product qualityhave not reached the export standard, economically producers have no adequate capital, andsocially were marketing networks that are still limited to village-level traders. Strategies topenetrate shallot in the export market are: take advantage of market opportunities, implementGAP, assist certification, subsidize capital, and shorten the marketing chai

Overstating the evidence - double counting in meta-analysis and related problems

Background: The problem of missing studies in meta-analysis has received much attention. Less attention has been paid to the more serious problem of double counting of evidence. Methods: Various problems in overstating the precision of results from meta-analyses are described and illustrated with examples, including papers from leading medical journals. These problems include, but are not limited to, simple double-counting of the same studies, double counting of some aspects of the studies, inappropriate imputation of results, and assigning spurious precision to individual studies. Results: Some suggestions are made as to how the quality and reliability of meta-analysis can be improved. It is proposed that the key to quality in meta-analysis lies in the results being transparent and checkable. Conclusions: Existing quality check lists for meta-analysis do little to encourage an appropriate attitude to combining evidence and to statistical analysis. Journals and other relevant organisations should encourage authors to make data available and make methods explicit. They should also act promptly to withdraw meta-analyses when mistakes are found