WINNER: 1 year and 100 days.

WINNER - 걔 세(I'm him) MINO SOLO M/V

Mino.. You are crazy, weird, dork.. And you are my chingu

Gossip

"Great minds discuss ideas, average minds discuss events, small minds discuss people"

 - Eleanor Roosevelt -

Hmm.. i got this quote from someone's comment in one of my fave japanese dorama. "Gossip" is a bad thing right but it's so hard to avoid it in daily life. Well for at least 21 years of my life ( i am 21 y.o right now), i can summarize one thing, if you ever met someone who likes bad mouthing other. You need to be careful of her/him. If you ever made a little mistake to her/him 90% chance she/he's gonna tell someone and bad mouthing about you. Well maybe it's not 90% but there is a high chance she/he's gonna do it.

The Cat And Me

This afternoon when i walked through the flyover. I met a black cat. It's so rare for me to see it. So i stopped and turned around. The cat also stopped. We just stared each other. I became fascinated. Since there's no people at that time i talked to the cat and say good bye. Then i turned my back pretending to walk away. The cat also continued its walking. When the cat walked away I stopped and took a look at it. I saw the cat took a little jump when it walked down the stairs. That is so cute. Well it’s just a small thing actually. But we can get something from that. I mean, even an animal like a cat knows what’s the function of a flyover but we, as a human, many of us still prefer crossing through the street instead of using the flyover. The reason is because people love “instant” thing and sedentary life. Well we need to change that. I mean walking or jogging is the cheapest exercises, right. So why don’t we try that :)

Soal IKM dan EBM Part 2

CASE-CONTROL

Data dari studi case control terhadap miokardial infark (MI) telah diringkas sebagai berikut:

Usia	MI (-)		MI (+)
	Bukan Perokok	Perokok	Bukan perokok	Perokok
<50	130	126	11	13
≥50	55	42	4	19

1. Estimasi Odd Ratio dari MI termasuk merokok (tanpa memperhatikan usia)?

2. Estimasi Adjusted Odds Ratio. Apakah terdapat beberapa efek confounding dari usia? Mengapa atau mengapa tidak?

3. Apakah usia merupakan efek modifier pada studi ini? Mengapa atau mengapa tidak?

Penyelesaian Soal

1. Menentukan OR dari MI (tanpa memperhatikan usia)

	MI (+)	MI (-)
Perokok	32 (a)	168 (b)
Bukan Perokok	15 (c)	185 (d)

OR = ad/bc = 32(185)/168(15) = 5920/2520 = 2,349

Interpretasi:

Perokok memiliki peluang 2,349 kali lebih besar terkena miokardial infark dibanding bukan perokok.

2. Menentukan Adjusted OR

Usia <50

	MI (+)	MI (-)	Total
Perokok	13 (a)	126 (b)	139 (a+b)
Bukan Perokok	11 (c)	130 (d)	141 (c+d)
Total	24 (a+c)	256 (b+d)	280 (n)

OR (<50) = ad/bc = 13(130)/126(11) = 1690/1386 = 1,219

Usia ≥50

	MI (+)	MI (-)	Total
Perokok	19 (a)	42 (b)	61 (a+b)
Bukan Perokok	4 (c)	55 (d)	59 (c+d)
Total	23 (a+c)	97 (b+d)	120 (n)

OR (≥50) = ad/bc = 19(55)/42(4) = 1045/168 = 6,22

Adjusted Odd Ratio

OR      = (a₁d₁/n₁ +a₂d₂/n₂) : (b₁c₁/n₁+b₂c₂/n₂)

            = (13(130)/280+19(55)/120) : (126(11)/280+42(4)/120)

            = (1690/280+1045/120)/(1386/280+168/120)

            = (6,036+8,708)/(4,95+1,4)

            = 14,744/6,35

            = 2,322

Interpretasi:

Karena nilai crude OR ≠ Adjusted OR maka terdapat confounding factor. Selisih crude OR dan adjusted OR yaitu 0,027 (2,349-2,322) atau 27%. Selisih<10% maka confounding factor tidak penting/ potensial.

3. Menentukan usia sebagai efek modifier

Efek modifier adalah jika pengaruh pajanan terhadap kejadian suatu penyakit dipengaruhi oleh level variabel lainnya.

Pada studi ini, nilai OR pasien usia <50 ≠ nilai OR pasien usia ≥50 maka usia merupakan efek modifier yang mempengaruhi paparan (merokok) terhadap kejadian MI.