Dampak dari penyakit dan pengobatan kanker dapat diukur dengan indikator kualitas hidup menggunakan kuesioner EORTC QLQ C-30. Penelitian cross-sectional dilakukan menggunakan 30 pasien. Data dikumpulkan melalui metode purposive sampling pada pasien yang memenuhi kriteria inklusi, yaitu wanita berusia 30-70 tahun yang didiagnosis kanker ginekologi, pernah menjalani kemoterapi di RSUP Sanglah Denpasar, dan bersedia menandatangani formulir persetujuan pasca penjelasan. Pasien yang tidak dapat berkomunikasi secara rasional menjadi bagian kelompok eksklusi. Validitas dan reliabilitas instrumen diuji menggunakan analisis faktor konfirmatori dengan program STATA® versi 12. Hasil analisis faktor konfirmatori menunjukkan seluruh item pertanyaan memiliki loading factor () > 0,70 sehingga seluruh butir pertanyaan adalah valid. Uji reliabilitas item memberikan nilai >0,50 untuk seluruh item pertanyaan yang menunjukkan seluruh item pertanyaan adalah reliabel. Hasil perhitungan validitas konstrak menghasilkan nilai VE= 0,90 dan reliabilitas konstrak (RF) adalah 1 yang berarti kuesioner EORTC QLQ C-30 memenuhi validitas dan reliabilitas konstrak. Kuesioner EORTC QLQ C-30 sebagai alat ukur kualitas hidup pasien kanker ginekologi di RSUP Sanglah Denpasar adalah valid dan reliabel.

Pemberian kemoterapi pada pasien kanker serviks stadium IIB-IIIB selain menimbulkan efek terapi juga menimbulkan efek samping berupa penurunan kualitas hidup. Penelitian ini dilakukan pada Februari-Juni 2014 di Bagian Obstetri dan Gineklogi RSUP Sanglah Denpasar secara observasional dengan metode case study prospective. Pengumpulan data dilakukan menggunakan kuesioner EORTC QLQ C30 yang dikombinasikan dengan wawancara sebelum dan setelah kemoterapi paklitaksel-karboplatin sebanyak 3 seri pada pasien kanker serviks sel skuamosa stadium IIB-IIIB. Penelitian kualitas hidup dilakukan secara umum dan pada 15 domain yang memengaruhi kualitas hidup. Terdapat 12 pasien yang memenuhi kriteria inklusi. Pemberian kemoterapi regimen paklitaksel-karboplatin dapat meningkatkan kualitas hidup dengan penurunan nilai mean dari 48,083±5,451 menjadi 44,083±3,872. Terdapat perbedaan bermakna pada nilai kualitas hidup pasien sebelum dan setelah kemoterapi paklitaksel-karboplatin (nilai p=0,038). Terdapat penurunan kualitas hidup pada domain mual muntah, penurunan nafsu makan, fatigue, dan fungsi sosial. Domain dengan peningkatan kualitas hidup yaitu nyeri, fungsi fisik, fungsi emosional, sulit tidur, dan kesulitan keuangan. Pemberian kemoterapi paklitaksel-karboplatin pada 12 pasien dapat meningkatkan kualitas hidup pasien kanker serviks.

ObjectivesTo assess cost-effectiveness of direct oral anticoagulants (DOACs) compared with vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF) by pooling incremental net benefits (INBs).DesignSystematic review and meta-analysis.SettingWe searched PubMed, Scopus and Centre for Evaluation of Value and Risks in Health Registry from inception to December 2019.ParticipantsPatients with AF.Main outcome measuresThe INB was defined as a difference of incremental effectiveness multiplied by willing to pay threshold minus the incremental cost; a positive INB indicated favour treatment. These INBs were pooled (stratified by level of country income, perspective, time-horizon, model types) with a random-effects model if heterogeneity existed, otherwise a fixed effects model was applied. Heterogeneity was assessed using Q test and I2 statistic. Risk of bias was assessed using the economic evaluations bias (ECOBIAS) checklist.ResultsA total of 100 eligible economic evaluation studies (224 comparisons) were included. For high-income countries (HICs) from a third-party payer (TPP) perspective, the pooled INBs for DOAC versus VKA pairs were significantly cost-effective with INBs (95% CI) of $6632 ($2961.67 to $10 303.72; I2=59.9%), $6353.24 ($4076.03 to $8630.45; I2=0%), $7664.58 ($2979.79 to $12 349.37; I2=0%) and $8573.07 ($1877.05 to $15 269.09; I2=0%) for dabigatran, apixaban, rivaroxaban and edoxaban relative to VKA, respectively but only dabigatran was significantly cost-effective from societal perspective (SP) with an INB of $11 746.96 ($2429.34 to $21 064.59; I2=52.4%). The pooled INBs of all comparisons for upper-middle income countries (UMICs) were not significantly cost-effective. The ECOBIAS checklist indicated that risk of bias was mostly low for most items with the exception of five items which should be less influenced on pooling INBs.ConclusionsOur meta-analysis provides comprehensive economic evidence that allows policy makers to generalise cost-effectiveness data to their local context. All DOACs may be cost-effective compared with VKA in HICs with TPP perspective. The pooling results produced moderate to high heterogeneity particularly in UMICs. Further studies are required to inform UMICs with SP.PROSPERO registeration numberCRD 42019146610.

Objective: Cervical cancer was the prominent cause of women's death in developing states. Decrease in life quality was often encountered by patients with cervical cancer in advanced stages. One treatment method of cervical cancer at Sanglah Hospital was using paclitaxel cisplatin chemotherapy. Information on cervical cancer patient's life quality who received paclitaxel cisplatin chemotherapy was still limited, so research was required to observe cervical cancer patients’ life quality before the first and after the sixth paclitaxel cisplatin chemotherapy regimen.Methods: Observational study with prospective case study design was undertaken at the Polyclinic of Obstetrics and Gynecology Sanglah Hospital from January to August 2016. Sampling was conducted before chemotherapy I and after chemotherapy VI using consecutive sampling method. The EORTC QLQ C30 questionnaires were completed by the patients before chemotherapy I and after chemotherapy VI. Patients' life quality who had received paclitaxel cisplatin chemotherapy were assessed with 15 domains in EORTC QLQ C30 questionnaire. The data obtained were processed with STATA® version 14 and analysed using paired t test and Wilcoxon test with a confidence level of 95%.Results: The number of samples used in this study was 7 patients who received paclitaxel cisplatin chemotherapy. The results of the analysis showed that there were differences in cervical cancer patients’ life quality who had received paclitaxel cisplatin regimen chemotherapy before chemotherapy I and after chemotherapy VI with the result of p-value is 0.0005.Conclusion: There was a significant decrease in the value of cervical cancer patients' life quality who received paclitaxel cisplatin chemotherapy before chemotherapy I and after chemotherapy VI.