Cost-effectiveness of screening for open angle glaucoma in developed countries

Abstract

As all developed countries are struggling with health care costs growing too large and too fast, the current performance and overburden of glaucoma services demand a reappraisal of current management strategies. The performance of the glaucoma care in western countries offers several opportunities to improve the simultaneous under- and over-diagnosis and treatment. Since available resources are finite, they should be targeted to produce the best eye health. There is an obvious need for prioritization of all interventions, including improving case finding. The limited evidence to date indicates that we do not have enough evidence to decide whether systematic population screening could be cost-effective in the developed world. This article gives an overview of the methods of economic evaluation and the evidence on cost-effectiveness of systematic screening for glaucoma in the developed world, need for future research and challenges related to evaluation of increasing economic literature as well as need to change behaviors on the basis of evidence.

Glaucoma detection with damato multifixation campimetry online

“…We believe that screening for only moderate and advanced visual field loss is probably more fruitful than attempting to detect early defects. 22 We would like to highlight that this was an explorative study, therefore no generalization can be made. On the basis of the present promising validation of DMCO in a preselected population, there is scope for further evaluation of DMCO both in a selected population and in a nonselected population in the community.…”

“…In other words, as long as the test is inexpensive, any significant action to trace treatable glaucoma should be considered as long as it does not overload the health-care system with false-positive cases. 9,22 The choice of gold standard influences the decision as to whether the test under investigation is reliable. 23 By analyzing our results according to GSS, we used a rather rigorous gold standard.…”

Glaucoma

“…23 24 However, it is unclear whether treating those at risk-for example, patients with ocular hypertension-is cost effective. 23 Cost effectiveness analyses of interventions typically use efficacy data based on randomised trials, which may provide optimistic estimates of outcomes compared with "real life," where adherence to care by patients and clinicians may be poorer. More reliable and realistic data from pragmatic randomised trials or cohort studies are therefore needed.…”

Can DMCO Detect Visual Field Loss in Neurological Patients? A Secondary Validation Study

“…In line with changing demographics that impact social services and health care budgets worldwide, new ideas for diagnostic tools and treatments are gaining increasing interest, especially if they are less costly than at present [1][2][3] . There is scope for inexpensive, user-friendly, automated methods for measuring the visual field in situations where conventional methods are not practical.…”