SENSITIVITAS DAN SPESIFISITAS INSTRUMEN SKRINING HIPOTIROID UNTUK DIAGNOSIS HIPOTIROID PADA ANAK BATITA DI DAERAH ENDEMIK GAKI
Abstract
Latar Belakang. Penemuan kasus dan pengobatan dini hipotiroid pada anak batita sangat penting karena keterlambatan hal tersebut menyebabkan kelainan intelektual dan atau fungsi neurologis yang menetap. Penegakan diagnosis hipotiroid lebih akurat dengan pemeriksaan laboratorium, tetapi akan mahal dan kurang praktis jika di lakukan di lapangan. Instrumen skrining hipotiroid dapat digunakan sebagai alternatif untuk mendeteksi hipotiroid pada anak batita. Instrumen seharusnya mudah, murah, dan memberikan hasil diagnostik yang dapat diandalkan. Tujuan. Tujuan penelitian untuk mendapatkan sensitifitas dan spesifisitas instrumen skrining hipotiroid. Metode. Penelitian observasional dengan desain uji diagnostik ini dilakukan di kabupaten Magelang, Wonosobo, Temanggung, Purworejo, Situbondo dan Jember, selama 10 bulan. Variabel yang dianalisis adalah 26 gejala hipotiroid pada anak batita. Baku emas berdasarkan pemeriksaan laboratorium kadar TSH dan fT4. Analisis untuk mendapatkan nilai sensitifitas dan spesitifitas dilakukan tabulasi silang dengan tingkat kemaknaan 5%. Hasil. Nilai sensitivitas dan spesifisitas instrumen skrining hipotiroid (ISH) dengan cut off >5 dibandingkan dengan baku emas rendah (Se 26,3, Sp 90,3; area under curve (AUC) 58,3%). Kekuatan hubungan antara skor ISH dengan cut off >5 dibandingkan baku emas adalah OR 3,329 (1,621-6,835; 95% CI). Uji multivariat mengoreksi probabilitas anak batita yang mempunyai skor ISH >5 untuk menjadi hipotiroid 2,253 (1,011-5,022 95% CI) dan terjadi peningkatan area under the curve (AUC) menjadi 70%. Kesimpulan. Instrumen skrining hipotiroid pada anak batita kurang sensitif dan kurang spesifik untuk mendiagnosis hipotiroid.
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