JOURNAL CRITICAL APPRAISAL

Analisis PICO
Item Jawaban
Patient/Problem Pasien dengan keratokonjungtivitis adenovirus
Intervention Tetes mata povidone-iodine + deksamethasone
Comparison Tetes mata deksamethasone, artificial tears
Outcome Efektivitas terapi

Pertanyaan Penelitian: Bagaimanakah efektivitas tetes mata povidone-

iodine/deksamethasone dibandingkan tetes mata deksamethasone, dan artificial
tears sebagai terapi keratokonjungtivitis adenovirus?

Identitas Jurnal
Judul Artikel : Treatment of adenoviral keratoconjunctivitis with a
combination of povidone-iodine 1.0% and dexamethasone 0.1%
drops: a clinical prospective controlled randomized study
Penulis : Natalya Kovalyuk, Igor Kaiserman, Michael Mimouni, Ornit
Cohen, Shmuel Levartovsky, Hilda Sherbany, and Michal
Mandelboim
Nama Jurnal : Acta Ophthalmologica Scandinavica Foundation. Published by
John Wiley & Sons Ltd
Tahun Terbit : 2017

Checklist Critical Appraisal

(A) Are the results of the trial valid?
1. Did the trial address a clearly focused issue? Ya
“To determine the efficacy of combination povidone-iodine (PVP-I) 1.0% eyedrops
and dexamethasone 0.1% eyedrops in the treatment of adenoviral
keratoconjunctivitis”.

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2. Was the assignment of patients to treatments randomised? Ya
Patients were randomly divided into three groups:
(1) The study group: PVP-I 1.0% eyedrops and dexamethasone 0.1% eyedrops
four times a day to the involved eye.
(2) Control group 1: Dexamethasone 0.1% eyedrops four times a day to involved
eye.
(3) Control group 2: Artificial tears (hypromellose 0.3%) four times a day to the
involved eye.
3. Were all of the patients who entered the trial properly Tidak
accounted for at its conclusion?
“During the study, 74 participants were enrolled. In five patients, adenovirus was
not detected via PCR (study group, n = 1; control group 1, n = 2; control group
2, n = 2), and therefore, they were excluded. In addition, one patient from the study
group was lost to follow-up and was excluded. There- fore, a total of 78 eyes of 68
patients were included in the statistical analysis”.
4. Were patients, health workers and study personnel ‘blind’ to Ya
treatment?
“...Each treatment group received one bottle and the labels were removed from
the treatment bottles, and the patients were not told which treatment arm they
were assigned to. ...All the patients were examined at the day of presentation
before treatment (baseline examination) and on the third, fifth and seventh days
of treatment or until the recovery was complete (but at least three examinations)
by a blinded examiner”.
5. Were the groups similar at the start of the trial? Ya
“There was no statistically significant difference between the 3 groups in their
baseline characteristics (age and gender, see Table 1)”
6. Aside from the experimental intervention, were the groups Ya
treated equally?
(1) The study group: PVP-I 1.0% eyedrops and dexamethasone 0.1% eyedrops
four times a day to the involved eye.

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 (2) Control group 1: Dexamethasone 0.1% eyedrops four times a day to
involved eye.
(3) Control group 2: Artificial tears (hypromellose 0.3%) four times a day to
the involved eye.
(B) What are the results?
7. How large was the treatment effect?
“Figures 1 and 2 show a comparison of itching and foreign body perception
respectively. Briefly, the study group demonstrated a similar and superior
reduction in terms of both parameters (p < 0.001) with a gradual reduction from
a median of 2.0 at baseline to 0.0 by day 5...”
“Figure 3 shows a comparison of tearing perception. The study group
demonstrated a superior reduction in terms of tearing (p < 0.001) with a gradual
reduction from a median of 3.0 at baseline to 0.0 by day 7...”
“The study group demonstrated a superior reduction in terms of redness (p <
0.001) with a gradual reduction from a median of 3.0 at baseline to 0.0 by day
7...”
“The study group demonstrated a superior reduction in terms of eyelid reduction
(p < 0.001) with a gradual reduction from a median of 2.0 at baseline to 0.0 by
day 7...”
8. How precise was the estimate of the treatment effect?
“In both cases, 95% confidence intervals were used”.
(C) Will the results help locally?
9. Can the results be applied in your context? (or to the local Ya
population?)
Hasil penelitian dapat diterapkan pada pasien di RSUD Dr. Soedirman, Kebumen.,
karena secara profil klinikodemografi pasien pada penelitian memiliki
kesamaan/kemiripan dengan pasien di RSUD Dr. Soedirman.
10. Were all clinically important outcomes considered? Ya

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 Hasil penelitian ini dapat dijadikan sebagai bahan pertimbangan dalam
pengelolaan kasus/ pengobatan pada pasien dengan keratokonjungtivitis
adenovirus.
11. Are the benefits worth the harms and costs? Ya
Kombinasi terapi tetes mata povidone-iodine 1.0% dan deksamethasone 0.1%
dapat dipertimbangkan sebagai pengobatan pada pasien dengan
keratokonjungtivitis adenovirus. Selain aman, biaya yang diperlukan juga tidak
terlalu mahal.

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