Warna-Warni Indonesia

Satuan Tugas IAHF Kemenkes: Kajian Metode IAHF sebagai Terapi

Kontroversi Terapi IAHF Dokter Terawan

JAKARTA (tandaseru.id) – Tulisan ini disadur dari kajian terhadap metode Intra-Arterial Heparin Flushing (IAF) sebagai terapi yang digunakan oleh dokter Terawan. Kajian ini dilakukan Stuan Tugas Kementerian Kesehatan.

Latar belakang Kajian ini dilakukan atas dasar Keputusan Menteri Kesehatan No HK.0.1.07/ 272/2018 tertanggal 22 Mei 2018 tentang Satuan Tugas Penyelesaian Pelayanan Kesehatan dengan Metode Intraarterial Heparin Flushing (IAHF) sebagai Terapi – untuk selanjutnya disebut sebagai Satgas.

Inti SK Menteri Kesehatan tersebut adalah menugaskan kepada Satgas untuk melakukan kajian tentang penggunaan IAHF untuk tujuan terapi termasuk stroke iskemik kronik dari segi ilmiah, etika, dan hukum.

Praktik IAHF untuk tujuan terapi (yang merupakan modifikasi digital subtraction angiography / DSA) telah dilakukan terhadap banyak pasien, namun belum jelas apakah prosedur tersebut telah didukung oleh bukti ilmiah yang sahih sehingga memicu kontroversi baik di masyarakat maupun di kalangan kedokteran.

Karena itu yang menjadi pertanyaan pertama, apakah telah terdapat bukti ilmiah yang sahih yang dapat menjadi dasar untuk penggunaan IAHF untuk tujuan terapi termasuk pada pasien dengan stroke iskemik kronik?

Kedua, dengan mengacu pada hasil kajian butir 01, apakah penggunaan IAHF untuk terapi stroke iskemik kronik selaras dengan dengan etika kedokteran?. Ketiga, dengan mengacu pada hasil kajian butir 01, apakah penggunaan IAHF untuk terapi stroke dapat dibenarkan secara hukum dan praktik profesi kedokteran?

Keempat, apakah metode IAHF untuk terapi stroke memiliki standar yang disahkan oleh Konsil Kedokteran Indonesia sesuai dengan peraturan yang ada?.

Metode Untuk menjawab pertanyaan pertama dilakukan pencarian bukti ilmiah berupa artikel asli atau systematic review atau meta-analisis melalui pelbagai database kedokteran yang besar.

Bila ditemukan artikel yang relevan maka dilakukan penilaian menurut kaidah evidence based medicine (EBM): apakah studinya sahih, apakah hasilnya secara klinis penting, dan apakah bukti ilmiah tersebut dapat diterapkan 2 pada pasien.

Penilaian juga dilakukan dengan skor Jadad serta CONSORT (Consolidated Standard of Reporting Trials), serta beberapa rincian yang dianggap perlu. Untuk pertanyaan kedua dilakukan kajian yang mengacu pada KODEKI (Kode Etik Kedokteran Indonesia) dan etika kedokteran secara umum.

Untuk menjawab pertanyaan ketiga dan keempat dilakukan kajian yang mengacu pada undang[1]undang, peraturan dan ketetapan menteri, serta sumber-sumber lain yang relevan.

Juga dilakukan penelusuran terhadap standar pendidikan dan standar kompetensi dokter spesialis radiologi, neurologi, dan bedah saraf yang telah disahkan oleh Konsil Kedokteran Indonesia.

Selain itu diundang sejumlah nara sumber yang terkait dengan pokok bahasan, yakni wakil-wakil dari organisasi profesi radiologi (Perhimpunan Dokter Spesialis Radiologi Indonesia, PDSRI), neurologi (Perhimpunan Dokter Spesilais Saraf Indonesia, PERDOSSI), dan bedah saraf (Perhimpunan Spesialis Bedah Saraf Indonesia, PERSPEBSI), Ketua Komite Etika Penelitian dan Pengembangan Kesehatan Nasional (KEPPKN), serta Dr. dr. Terawan Agus Putranto, SpRad yang selain dianggap paling mengetahui praktik penggunaan IAHF untuk terapi, juga sebagai penulis disertasi.

Diundang pula nara sumber Prof. dr. Irawan Yusuf, PhD sebagai promotor Dr. dr. Terawan Agus Putranto, SpRad.

Akhirnya dilakukan kunjungan Ketua Satgas disertai beberapa anggota ke RS Gatot Subroto untuk memperoleh keterangan tambahan yang diperlukan.

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