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I was born …
July 25th 1949
Semarang, Central Java, Indonesia
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I am basically …
A Cardiologist
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Studied in …
Faculty of Medicine, Airlangga University
Surabaya, East Java, Indonesia
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…..
IRM Fellow in Cardiology
Philippine Heart Center for Asia, Manila
PhD in Health Science
Airlangga University, Surabaya
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Resident of Cardiology and Vascular Medicine, Faculty of Medicine,
Airlangga University, Surabaya, Indonesia(1976 – 1980)
Head of Cardiology & Vascular Medicine Outpatient Clinic, Dr. SoetomoGeneral Hospital - Airlangga University, Surabaya, Indonesia
(1981 – present)
Head of Exercise Stress Test Division of Dr. Soetomo General Hospital -Airlangga University, Surabaya, Indonesia
(1983 – present)
Staff of Cardiology & Vascular Medicine Department, Faculty of
Medicine, Airlangga University, Surabaya, Indonesia(1976 – present)
Members of Surabaya Heart Center, Dr. Soetomo General Hospital –Airlangga University, Surabaya, Indonesia
(1979 – present)
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Member of
Indonesian Medical Association
The Indonesian Society of Internal Medicine
Indonesian Heart Association
Asia Pacific Society of Cardiology
Asean Federation of Cardiology
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Scientific Publication & Research
…
Writer
145 Papers
• Co-Writer – 100 Papers
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Nice to meet you …
Let’s begin …
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Prof.DR.dr.Djoko Soemantri,SpJP, (K) FIHA,FASCCFaculty of Medicine, Airlangga University /Dr. Soetomo General Hospital
Surabaya Indonesia
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Rationalist
Empirist Pragmatist
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The JNC 7 Key Messages1. In persons > 50 years SBP of > 140 mmHg is a much
more important CVD risk factor than DBP.2. CVD risk, beginning at 115/75 mmHg, doubles with 20/10 mmHg. Normotensive at 55 years have 90%risk for HPN.
3. SBP of 120-139 mmHg or DBP of 80-89mmHg requirelife style modifications to prevent CVD.
4. Thiazides should be used, either alone or in combina-tion.
5. Goad BP < 140/90 mmHg, < 130/80 mmHg for DM or
chronic Kidney disease.6. Initiating Tx with 2 agents should be considered
7. The responsible physician’s judgement remains para-mount.
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Preface
“… if a man declares to you that he has found
facts that he has observed and confirmed
with his own experience, be cauotius in
accepting what he says. Rather , investigateand weigh this opinion or hypothesis
according to requirements of pure logic,
without paying attention to this contention
that affirms empirically.”( Moses Maimonides, 1195 )
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How to make an appropriate decision?
External Evidence
Clinical
Expertise
Cardiovascular
Pathophysiology
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And What Is Not?
External clinical Evidence can inform but
can never replace, individual clinical
expertise
EB cardiology is not restricted to randomizedclinical trials and meta-analyses
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The Practice of Evidence Based
Cardiology
Individual
clinical
expertise
Best AvailableExternal
Clinical
Evidence
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User’s guides
“ Are The Study Results Valid ?”
“What are the study result ?”
“ How will the study results help me care for mypatients ?”
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Good Doctors Use both IndividualClinical Expertise and The Best
Available External Evidence, and
Neither Alone is Enough
Allan ritchnic, David Sacket, salim Yusuf.
Evidence Based Cardiology, 1999.
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Excelent External Evidence May Be
Inapplicable To or Inappropiate for
an Individual Patient
Allan ritchnic, David Sacket, salim Yusuf.
Evidence Based Cardiology, 1999.
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How to Manage
the Patient
Institution : Physician : Patient :
1. Evident Base 1. Way of Thinking 1. Individual
2. Guideline 2. Rationale 2. Wholistic
Proper Treatment
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Thank You