SCIENTIFIC PAPER APPRAISAL

Group

: Tedo Briantono Basuki and Vidya Nurina

Paper Title

: Urolithiasis location and size and the association with microhematuria and
stone-related symptoms.

Source

http://www.researchgate.net/publication/51611645_Urolithiasis_location_and_size_and_the_
association_with_microhematuria_and_stone-related_symptoms

1. TELAAH KELENGKAPAN FORMAT PAPER

Item telaah
Judul (Title)
Abstrak dan/atau Ringkasan (Abstract and or

Ada / tidak (sebutkan

halamannya)
Yes, Page 1909
Yes, Page 1909

Summary)
Pendahuluan (Introduction, background)

Yes, Page 1909

Bahan dan Cara (Method)

Yes, Page 1910

Hasil (Result)

Yes, Page 1910

Diskusi (Discussion)

Yes, Page 1911

Ucapan terima kasih/ penghargaan

No

(acknowledgement)
Daftar Pustaka (Reference)

Yes, Page 1912

Kesimpulan : Format tidak lengkap

2. TELAAH VALIDITAS PENELITIAN

Journal Reading Responsi Besar Ilmu Penyakit Dalam
Fakultas Kedokteran Universitas Airlangga

Page 1

Tujuan penelitian :
The majority of the studies evaluating the incidence of microhematuria and urolithiasis have
been limited to the acute-care settingspecically patients presenting for evaluation in
hospital emergency departments. Our objective was to perform a study to examine the
incidence of microhematuria and urolithiasis-related symptoms and determine their possible
association with the location and size of urinary calculi in an ambulatory ofce environment.
Metode penelitian
Item telaah
Disain/rancangan (design)

Temuan (sebutkan berikut halamannya)

Analitik observasional

* Tingkatan dalam hierarchy

A cohort study

of evidence
Sampel (sample)

Data from 100 consecutive patients (63 males and 37

females) who were evaluated at our institutions urology
ofce who had received a diagnosis of urolithiasis within

Ukuran sampel (sample size)

a 6-month period. (page 1910)

Data from 100 consecutive patients (63 males and 37
females) who were evaluated at our institutions urology
ofce who had received a diagnosis of urolithiasis within

Kriteria inklusi (eligibility

a 6-month period. (page 1910)

All patients had a documented diagnosis of a urinary

criteria)

calculus via radiographic imaging (eg, ultrasonography,

radiography of the kidneys, ureters, and bladder,
urography, or CT). Patients who had a documented
urinary tract infection by a positive urinalysis and urine
culture or those who were actively menstruating were

Metode penentuan sampel

excluded from the study. (page 1910)

Patients were interviewed with regard to their symptoms

(sampling frame)

specically, ank or abdominal pain, subjective

fevers or chills, or urinary urgency. Symptoms were
recorded as either present or absent, depending on
patient response. The presence of any of the
aforementioned symptoms categorized the patient as
positive for having stone-related symptomatology. (page
1910)

Journal Reading Responsi Besar Ilmu Penyakit Dalam

Fakultas Kedokteran Universitas Airlangga

Page 2

Metode pengumpulan data

The size and location of each calculus was determined

using both information from the radiology report as well
as evaluation by theofce urologist withavailable
imaging from each patients respective diagnostic
radiographs. Stone size was categorized as either <8mm
or 8mm (cutoff represented the median stone size). The
location of all urinary stones was documented as renal
calix (upper, mid, lower, or unspecied), renal
pelvis/ureteropelvic junction (UPJ), or
withintheureter(proximalordistal).Proximalureteralstones
were those located proximal to the sacroiliac joint, and
distal ureteral stones were dened to be distal to this
landmark. None of the calculi were located in a

Cara pengukuran

diverticulum or within the bladder. (page 1910)

One urine specimen was obtained from each patient

(measurement and or

during the ofce visit. Each specimen was tested for

assessment)

blood using Chemistrip 10 strips (Boehringer Mannheim

Corporation, Indianapolis, IN). A color grading system
of negative, trace, 1+,2+,3+,4+ was given with the
product. Trace and greater dipstick reactions were
considered positive for microhematuria. In addition,
approximately 5mL of each urine specimen was
centrifuged at 2000rpms for 5 minutes. One drop of the
resuspended pellet from the centrifuged urine was placed
on a slide with a coverslip and examined under a
microscope by a single urologist in the ofce. Between
10 and 15 high-power elds (at a magnication of 40)
were inspected for each sample. The maximum number
of red blood cells seen per high power eld was noted. A
patient was considered to be positive for microhematuria
if more than three red blood cells per high power eld

Instrumen yang dipergunakan

were identied. (page 424)

One physician interpreted both the urine dipstick and

(instrument)

microscopic ndings in all study patients. Those patients

Journal Reading Responsi Besar Ilmu Penyakit Dalam

Fakultas Kedokteran Universitas Airlangga

Page 3

with multiple stones were categorized as having

microhematuria in more than one stone category pending
a positive result on urine dipstick or microscopy. In
addition, the negative microhematuria rate, dened as a
calculus negative for blood by either urine dipstick or
microscopy, was also calculated. Any patient with
microscopic hematuria subsequently underwent a
standard urologic hematuria evaluation, including a
contrasted upper tract imaging study, urine cytology, and cystoscopy to rule out any associated pathology
Metode randomisasi

other than urolithiasis. (page 1910)

-

(randomization)
Intervensi (intervention)
Metode analisis / pengolahan

Fisher exact test with a P value <0.05 demonstrating

data (analysis method)

statistical signicance (GraphPad Prism Version 5.03,

GraphPad Software, La Jolla, CA). (page 1910)

Kesesuaian antara disain dan tujuan penelitian
: sesuai / tidak sesuai
Kesesuaian cara pengukuran dan instrument yang dipergunakan
Kesimpulan

: sesuai / tidak sesuai

: valid / tidak valid (BERDASARKAN KEDUA KRITERIA DI ATAS)

3. TELAAH IMPORTANCE PENELITIAN

Our absolute rates of microhematuria and patient reported symptoms are lower than
those reported in the literature. Patients in our study were evaluated in the ambulatory
ofce, a nonemergent setting, which inherently drives these values lower when compared
with other studies based on ndings during acute stone episodes. Thus, differences in the
incidence of microhematuria and stone-related symptoms may have been more apparent
given our patient population.Inaddition, specic urine dipstick results (ie, the number of
patients with trace, 1+,2 +,3 +,4 +) and long-term follow-up data of asymptomatic
microhematuriapatientswerenot availablefor analysis. It would be interesting to investigate
this in future studies and determine if the amount of microhematuria was associated with
stone location or size or the occurrence of future symptomatic episodes in those who were
initially asymptomatic.

Journal Reading Responsi Besar Ilmu Penyakit Dalam

Fakultas Kedokteran Universitas Airlangga

Page 4

4. APPLICABILITY (KEMAMPUTERAPAN)
Pergunakan item pertimbangan di bawah ini untuk menilai kemamputerapan paper dalam
kasus anda
Pertimbangan applicability : 4 B
Item pertimbangan
burden of illness (pasien, kota)
barriers to treatment (ekonomi, geografi)
behaviours needed (perilaku kita dan pasien kita) untuk

Keputusan
sama/ tidak sama
sama/ tidak sama
Perlu banyak perubahan

mengadopsi Dx, Tx

perilaku / Tidak perlu

balance

(pertimbangan

untung

rugi

banyak perubahan perilaku

antara Untung / rugi

mengaplikasikan dengan cara yang ada di paper dan cara

yang ada dalam kasus)
Bagaimana applicability penelitian ini terhadap kasus anda? Applicable

Journal Reading Responsi Besar Ilmu Penyakit Dalam

Fakultas Kedokteran Universitas Airlangga

Page 5