LAMPIRAN. Lampiran 1. Ethical clearance

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1 LAMPIRAN Lampiran 1. Ethical clearance 69

2 Lampiran 2. Ijin penelitian 70

3 71 Lampiran 3. Informed consent JUDUL PENELITIAN : HUBUNGAN ABNORMALITAS HASIL CT-SCAN DENGAN DEVELOPMENTAL DELAYED PADA PASIEN SUSPEK INFEKSI CYTOMEGALOVIRUS KONGENITAL INSTANSI PELAKSANA : FAKULTAS KEDOKTERAN UNIVERSITAS DIPONEGORO Persetujuan Setelah Penjelasan (INFORMED CONSENT) Bapak/Ibu Yth : Saya Wilujeng Puja Sari, mahasiswa Fakultas Kedokteran Universitas Diponegoro Semarang, Program Studi Kedokteran Umum. Saya bermaksud melakukan penelitian mengenai Hubungan Abnormalitas Hasil CT-Scan terhadap pada Pasien Suspek Infeksi Cytomegalovirus Kongenital. Penelitian ini dilakukan sebagai tahap akhir dalam penyelesaian studi di Fakultas Kedokteran Universitas Diponogoro, Program Studi Kedokteran Umum. Pada penelitian ini akan dilakukan pengumpulan data pada catatan medis untuk mengetahui apakah kalsifikasi intrakranial, ventrikulomegali, atrofi cerebri, serta kelianan minor lainnya secara sendiri-sendiri atau bersama-sama merupakan faktor resiko terjadinya developmental delayed pada pasien suspek infeksi CMV kongenital. Peneliti akan menjaga kerahasiaan identitas dan informasi yang diberikan dan hanya digunakan untuk kepentingan penelitian. Terima kasih atas kerjasama Bapak/Ibu/Sdr. Setelah mendengar dan memahami penjelasan Penelitian, dengan ini saya menyatakan SETUJU / TIDAK SETUJU Untuk ikut sebagai responden / sampel penelitian. Semarang, Saksi : Nama Terang : Nama Terang : Alamat : Alamat :

4 Lampiran 4. Hasil Analisis Frequencies N Valid 28 Missing 0 Jenis Kelamin Frequency Percent Valid Percent Cumulative Percent Valid Laki-laki Perempuan Total Descriptives Descriptive Statistics N Minimum Maximum Mean Std. Deviation Usia (bulan) Valid N (listwise) 28 FREQUENCIES VARIABLES=AbnormalitasCTScan /PIECHART FREQ /ORDER=ANALYSIS. 72

5 73 Frequencies Statistics Abnormalitas CT Scan N Valid 28 Missing 0 Abnormalitas CT Scan Frequency Percent Valid Percent Cumulative Percent Valid Ya Tidak Total FREQUENCIES VARIABLES=Kalsifikasi Ventrikulomegali AtrofiCerebri KelMinorLain /PIECHART FREQ /ORDER=ANALYSIS. Frequencies Statistics Kalsifikasi Intracranial Ventrikulomegali Atrofi Cerebri Kelainan Minor Lainnya N Valid Missing

6 74 Frequency Table Kalsifikasi Intracranial Frequency Percent Valid Percent Cumulative Percent Valid Ya Tidak Total Ventrikulomegali Frequency Percent Valid Percent Cumulative Percent Valid Ya Tidak Total Atrofi Cerebri Frequency Percent Valid Percent Cumulative Percent Valid Ya Tidak Total Kelainan Minor Lainnya Frequency Percent Valid Percent Cumulative Percent Valid Ya Tidak Total

7 75 Pie Chart FREQUENCIES VARIABLES=Developmentaldelayed /PIECHART FREQ /ORDER=ANALYSIS. Frequencies Statistics N Valid 28 Missing 0

8 76 Frequency Percent Valid Percent Cumulative Percent Valid Ya Tidak Total CROSSTABS /TABLES=AbnormalitasCTScan BY Developmentaldelayed /FORMAT=AVALUE TABLES /STATISTICS=CHISQ RISK /CELLS=COUNT ROW /COUNT ROUND CELL. Crosstabs Case Processing Summary Cases Valid Missing Total N Percent N Percent N Percent Abnormalitas CT Scan * % 0.0% %

9 77 Abnormalitas CT Scan * Crosstabulation Ya Tidak Total Abnormalitas CT Scan Ya Count % within Abnormalitas CT Scan 90.9% 9.1% 100.0% Tidak Count % within Abnormalitas CT Scan 16.7% 83.3% 100.0% Total Count % within Abnormalitas CT Scan 75.0% 25.0% 100.0% Chi-Square Tests Asymp. Sig. (2- Exact Sig. (2- Exact Sig. (1- Value df Pearson Chi-Square a Continuity Correction b Likelihood Ratio Fisher's Exact Test Linear-by-Linear Association N of Valid Cases 28 a. 2 cells (50,0%) have expected count less than 5. The minimum expected count is 1,50. b. Computed only for a 2x2 table Risk Estimate 95% Confidence Interval Value Lower Upper Odds Ratio for Abnormalitas CT Scan (Ya / Tidak) For cohort Developmental Delayed = Ya For cohort Developmental Delayed = Tidak N of Valid Cases 28

10 78 CROSSTABS /TABLES=Kalsifikasi BY Developmentaldelayed /FORMAT=AVALUE TABLES /STATISTICS=CHISQ RISK /CELLS=COUNT ROW /COUNT ROUND CELL. Crosstabs Case Processing Summary Cases Valid Missing Total N Percent N Percent N Percent Kalsifikasi Intracranial * % 0.0% % Kalsifikasi Intracranial * Crosstabulation Ya Tidak Total Kalsifikasi Intracranial Ya Count % within Kalsifikasi Intracranial 100.0%.0% 100.0% Tidak Count % within Kalsifikasi Intracranial 66.7% 33.3% 100.0% Total Count % within Kalsifikasi Intracranial 75.0% 25.0% 100.0% Chi-Square Tests Asymp. Sig. (2- Exact Sig. (2- Exact Sig. (1- Value df Pearson Chi-Square a Continuity Correction b Likelihood Ratio Fisher's Exact Test Linear-by-Linear Association N of Valid Cases 28

11 79 Risk Estimate 95% Confidence Interval Value Lower Upper For cohort Developmental Delayed = Ya N of Valid Cases 28 a. 1 cells (25,0%) have expected count less than 5. The minimum expected count is 1,75. b. Computed only for a 2x2 table CROSSTABS /TABLES=Ventrikulomegali BY Developmentaldelayed /FORMAT=AVALUE TABLES /STATISTICS=CHISQ RISK /CELLS=COUNT ROW /COUNT ROUND CELL Crosstabs Case Processing Summary Cases Valid Missing Total N Percent N Percent N Percent Ventrikulomegali * % 0.0% % Ventrikulomegali * Crosstabulation Ya Tidak Total Ventrikulomegali Ya Count % within Ventrikulomegali 100.0%.0% 100.0% Tidak Count % within Ventrikulomegali 69.6% 30.4% 100.0% Total Count % within Ventrikulomegali 75.0% 25.0% 100.0%

12 80 Chi-Square Tests Asymp. Sig. (2- Exact Sig. (2- Exact Sig. (1- Value df Pearson Chi-Square a Continuity Correction b Likelihood Ratio Fisher's Exact Test Linear-by-Linear Association N of Valid Cases 28 a. 2 cells (50,0%) have expected count less than 5. The minimum expected count is 1,25. b. Computed only for a 2x2 table Risk Estimate 95% Confidence Interval Value Lower Upper For cohort Developmental Delayed = Ya N of Valid Cases 28 CROSSTABS /TABLES=AtrofiCerebri BY Developmentaldelayed /FORMAT=AVALUE TABLES /STATISTICS=CHISQ RISK /CELLS=COUNT ROW /COUNT ROUND CELL Crosstabs Case Processing Summary Cases Valid Missing Total N Percent N Percent N Percent Atrofi Cerebri * % 0.0% %

13 81 Atrofi Cerebri * Crosstabulation Ya Tidak Total Atrofi Cerebri Ya Count % within Atrofi Cerebri 100.0%.0% 100.0% Tidak Count % within Atrofi Cerebri 61.1% 38.9% 100.0% Total Count % within Atrofi Cerebri 75.0% 25.0% 100.0% Chi-Square Tests Asymp. Sig. (2- Exact Sig. (2- Exact Sig. (1- Value df Pearson Chi-Square a Continuity Correction b Likelihood Ratio Fisher's Exact Test Linear-by-Linear Association N of Valid Cases 28 a. 2 cells (50,0%) have expected count less than 5. The minimum expected count is 2,50. b. Computed only for a 2x2 table Risk Estimate 95% Confidence Interval Value Lower Upper For cohort Developmental Delayed = Ya N of Valid Cases 28 CROSSTABS /TABLES=KelMinorLain BY Developmentaldelayed /FORMAT=AVALUE TABLES /STATISTICS=CHISQ RISK /CELLS=COUNT ROW /COUNT ROUND CELL.

14 82 Crosstabs Case Processing Summary Cases Valid Missing Total N Percent N Percent N Percent Kelainan Minor Lainnya * % 0.0% % Kelainan Minor Lainnya * Crosstabulation Ya Tidak Total Kelainan Minor Lainnya Ya Count % within Kelainan Minor Lainnya 87.5% 12.5% 100.0% Tidak Count % within Kelainan Minor Lainnya 58.3% 41.7% 100.0% Total Count % within Kelainan Minor Lainnya 75.0% 25.0% 100.0% Chi-Square Tests Asymp. Sig. (2- Exact Sig. (2- Exact Sig. (1- Value df Pearson Chi-Square a Continuity Correction b Likelihood Ratio Fisher's Exact Test Linear-by-Linear Association N of Valid Cases 28 a. 2 cells (50,0%) have expected count less than 5. The minimum expected count is 3,00. b. Computed only for a 2x2 table

15 83 Risk Estimate 95% Confidence Interval Value Lower Upper Odds Ratio for Kelainan Minor Lainnya (Ya / Tidak) For cohort Developmental Delayed = Ya For cohort Developmental Delayed = Tidak N of Valid Cases 28 Logistic Regression LOGISTIC REGRESSION VARIABLES Developmentaldelayed /METHOD=ENTER Kalsifikasi AtrofiCerebri KelMinorLain /PRINT=CI(95) /CRITERIA=PIN(0.05) POUT(0.10) ITERATE(20) CUT(0.5). Block 1: Method = Backward Stepwise (Wald) Omnibus Tests of Model Coefficients Chi-square df Sig. Step 1 Step Block Model Step 2 a Step Block Model Step 3 a Step Block Model Step 4 a Step Step 5 Step Block Model a. A negative Chi-squares value indicates that the Chi-squares value has decreased from the previous step.

16 84 Model Summary Cox & Snell R Nagelkerke R Step -2 Log likelihood Square Square a a b c a a. Estimation terminated at iteration number 20 because maximum iterations has been reached. Final solution cannot be found. b. Estimation terminated at iteration number 5 because parameter estimates changed by less than.001. c. Estimation terminated at iteration number 4 because parameter estimates changed by less than.001. Classification Table a Predicted Observed Ya Tidak Percentage Correct Step 1 Ya Tidak Overall Percentage 82.1 Step 2 Ya Tidak Overall Percentage 78.6 Step 3 Ya Tidak Overall Percentage 78.6 Step 4 Ya Tidak Overall Percentage 78.6 Step 5 Ya Tidak Overall Percentage 78.6 a. The cut value is.500

17 85 Variables in the Equation c 95% C.I.for EXP(B) B S.E. Wald df Sig. Exp(B) Lower Upper Step Kalsifikasi a AtrofiCerebri KelMinorLain Constant Step AtrofiCerebri a KelMinorLain Constant Step KelMinorLain a Constant Step Constant 4 a Step AtrofiCerebri b Constant a. Variable(s) entered on step 1: Kalsifikasi, AtrofiCerebri, KelMinorLain. b. Variable(s) entered on step 5: AtrofiCerebri. c. Stepwise procedure stopped because removing the least significant variable results in a previously fitted model.

18 86 Variables not in the Equation Score df Sig. Step 2 a Variables Kalsifikasi Overall Statistics Step 3 b Variables Kalsifikasi AtrofiCerebri Overall Statistics Step 4 c Variables Kalsifikasi AtrofiCerebri KelMinorLain Overall Statistics Step 5 c Variables Kalsifikasi KelMinorLain Overall Statistics a. Variable(s) removed on step 2: Kalsifikasi. b. Variable(s) removed on step 3: AtrofiCerebri. c. Variable(s) removed on step 4: KelMinorLain. Score df Sig. Step 0 Variables Kalsifikasi KelMinorLain AtrofiCerebri Overall Statistics

19 87 Lampiran 5. Biodata Identitas Nama : Wilujeng Puja Sari NIM : Tempat / tanggal lahir : Samarinda / 30 Agustus 1992 Jenis Kelamin : Perempuan Alamat : Jalan Panglima Batur Gg. 2 No. 31 Samarinda Nomor HP : wilujeng.pujasari@gmail.com Riwayat Pendidikan Formal 1. SD : SD Negeri 004 Samarinda Lulus tahun : SMP : SMP Negeri 1 Samarinda Lulus tahun : SMA : SMA Negeri 1 Samarinda Lulus tahun : Pendidikan Dokter Fak. Kedokteran UNDIP Masuk tahun : 2010

20 88 Keanggotaan Organisasi 1. RISET - BEM KU FK UNDIP Tahun 2010 s/d RISET - HIMA KU UNDIP Tahun 2011 s/d PROJECT AFFAIR - HIMA KU UNDIP Tahun 2012 s/d MER-C SEMARANG Tahun 2013 s/d sekarang