NAMA : AZILLAH SYUKRIA NOVITRI

NIM : 04054821820095

1. DATA ABNORMALITAS

In healthy adults, is influenza immunization compared with no immunization effective in

reducing incidence of flu?
2. Dari Clinical Scenario dibuat:
a. Tabel P.I.C.O

P Healthy adults
I Influenza immunization
C Adults with Influenza immunization and no influenza immunization
O Reducing incidence of flu

b. Buatlah Clinical Question

In healthy adults, is influenza immunization compared with no immunization effective in
reducing incidence of flu?
c. Buatlah Search Term/Search/Keyword
(influenza immunization) and (flu incidence) Lakukan searching
d. Pastekan abstract artikel yang didapat pada lembar jawaban

Background: Influenza and pneumococcal vaccine uptake in the older population aged 65 years
or over of Hong Kong dramatically increased since the 2003 SARS outbreak. This study is aimed
to evaluate the impact of increased coverage of influenza and pneumococcal vaccines by
comparing the change of disease burden in the older population of Hong Kong, with the burden
in the older population of Brisbane with relatively high vaccine coverage in the past fifteen
years.
Methods: Time series segmented regression models were applied to weekly numbers of cause-
specific mortality orhospitalization of Hong Kong and Brisbane. Annual excess rates of mortality
or hospitalization associated with influenza in the older population were estimated for the pre-
SARS (reference period), post-SARS and post-pandemic period, respectively. The rate ratios
(RRs) between these periods were also calculated to assess the relative change of disease burden.
Results: Compared to the pre-SARS period, excess rates of mortality associated with influenza
during the post-SARS period in Hong Kong decreased for cardiorespiratory diseases (RR = 0.90,
95% CI 0.80, 1.01), stroke (RR = 0.74, 95% CI 0.50, 1.09), and ischemic heart diseases (RR =
0.45, 95% CI 0.34, 0.58). The corresponding RRs in Brisbane were 0.79 (95% CI 0.54, 1.15),
0.33 (0.13, 0.80), and 1.09 (0.62, 1.90), respectively. Only the mortality of ischemic heart
diseases showed a greater reduction in Hong Kong than in Brisbane. During the post-pandemic
period, excess rates of all-cause mortality increased in Hong Kong, but to a lesser extent than in
Brisbane (RR = 1.41 vs 2.39).
Conclusion: A relative decrease (or less of an increase) of influenza disease burden was
observed in the older population of Hong Kong after increased coverage of influenza and
pneumococcal vaccines in this population, as compared to those of Brisbane where vaccination
rates remained stable. The lack of significant findings in some disease categories highlights the
challenges of evaluating the benefits of vaccination at the population level.
Keywords: Influenza, Disease burden, Mortality, Morbidity, Elderly, Vaccine

e. Lakukan Critical appraisal dari artikel dengan criticla appraisal worksheet

VALIDITY:Are the results of the trial valid? (Internal Validity)

Yang dinilai FRISBEC
F: Patient Follow-Up Yes
 Were all patients who entered the trial Yes
properly accounted for at its
conclusion? Losses to follow-up should
be less than 20% and reasons for drop-
out given.
 Was follow-up long enough?

R: Randomization Yes
 Were the recruited patients Yes
representative of the target
population?
 Was the allocation (assignment) of
patients to treatment randomized and
concealed?
I: Intention to Treat Analysis Yes
 Were patients analyzed in the groups Yes
to which they were randomized?
 Were all randomized patient data
analyzed? If not, was a sensitivity or
“worst case scenario” analysis done?
S: Similar Baseline Characteristics of Yes
Patients
 Were groups similar at the start of the
trial?
B: Blinding Yes
 Were patients, health workers, and
study personnel “blind” to treatment?
 If blinding was impossible, were blinded
raters and/or objective outcome measures
used?
E: Equal Treatment Yes
 Aside from the experimental
intervention, were the groups treated
equally?
Conflict of Interest No
 Are the sources of support and other
potential conflicts of interest
acknowledged and addressed?
Summary of Article’s Validity yes
 Notable study strengths or weaknesses
or concerns?
 How serious are the threats to validity
and in what direction could they bias the
study outcomes?
IMPORTANCY (What were the results?)
A relative decrease (or less of an increase) of influenza disease burden was observed in the
older population of Hong Kong after increased coverage of influenza and pneumococcal
vaccines in this population, as compared to those of Brisbane where vaccination rates
remained stable. The lack of significant findings in some disease categories highlights the
challenges of evaluating the benefits of vaccination at the population level.
Yang dinilai/dihitung
CER 0.774
EER 0,208
RR 0,269
RRR /RBI 0,730 (73%)
Dilihat dari RRR, dianggap sangat bermakna
(>50%)
ARI/ABI 0,565
NNT 1.767
Summary Penelitian ini sangat bermakna secara klinis
C.APPLICABILIITY
Will the results help me in caring for my patient? (ExternalValidity/Applicability)
Is my patient so different to those in the study no
that the result cannot apply?
Is the treatment feasible in my setting? Yes
Will the potenntial benefits of treatment Yes
outweigh the potential harms of treatment for
my patient?

Present Absent
Experiment 177 673 850
Control 592 173 765
Totals 769 846 1615