Cost effectiveness analysis of screening for sight threatening diabetic eye disease

doi:10.1136/bmj.320.7250.1627

BMJ 2000;320:1627-1631 ( 17 June )

Papers

Cost effectiveness analysis of screening for sight threatening diabetic eye disease

Marilyn James, head of health economics (research and development) unit, ^a David A Turner, research fellow, ^a Deborah M Broadbent, clinical assistant, ^b Jiten Vora, consultant diabetologist, ^c Simon P Harding, consultant ophthalmologist. ^b

^a Centre for Health Planning and Management, University of Keele, Keele, Staffordshire ST5 5BG, ^b St Paul's Eye Unit, Royal Liverpool University Hospitals, Liverpool L7 8XP, ^c Department of Diabetes and Endocrinology, Royal Liverpool University Hospitals

Correspondence to: M James m.james{at}keele.ac.uk

Objective: To measure the cost effectiveness of systematicphotographic screening for sight threatening diabetic eye diseasecompared with existingpractice.
Design: Cost effectiveness analysis
Setting: Liverpool.
Subjects: A target population of 5000 diabetic patientsinvited forscreening.
Main outcome measures: Cost effectiveness (cost per true positive)of systematic and opportunistic programmes; incremental cost effectivenessof replacing opportunistic with systematicscreening.
Results: Baseline prevalence of sight threatening eyedisease was 14.1%. The cost effectiveness of the systematic programmewas £209 (sensitivity 89%, specificity 86%, compliance 80%, annualcost £104 996) and of the opportunistic programme was £289 (combinedsensitivity 63%, specificity 92%, compliance 78%, annual cost£99 981). The incremental cost effectiveness of completely replacingthe opportunistic programme was £32. Absolute values of cost effectivenesswere highly sensitive to varying prevalence, sensitivity and specificity,compliance, and programmesize.
Conclusion: Replacing existing programmes with systematicscreening for diabetic eye disease isjustified.

© BMJ 2000

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Article

Systematic screening for diabetic eye disease is cost effective
BMJ 2000 320: 0. [Full Text]

This article has been cited by other articles:

Scanlon, P H (2008). The English national screening programme for sight-threatening diabetic retinopathy. J Med Screen 15: 1-4 [Abstract] [Full text]
Philip, S, Fleming, A D, Goatman, K A, Fonseca, S, Mcnamee, P, Scotland, G S, Prescott, G J, Sharp, P F, Olson, J A (2007). The efficacy of automated "disease/no disease" grading for diabetic retinopathy in a systematic screening programme. Br J Ophthalmol 91: 1512-1517 [Abstract] [Full text]
Scotland, G S, McNamee, P, Philip, S, Fleming, A D, Goatman, K A, Prescott, G J, Fonseca, S, Sharp, P F, Olson, J A (2007). Cost-effectiveness of implementing automated grading within the national screening programme for diabetic retinopathy in Scotland. Br J Ophthalmol 91: 1518-1523 [Abstract] [Full text]
Stefansson, E (2006). Prevention of diabetic blindness. Br J Ophthalmol 90: 2-3 [Full text]
Philip, S, Cowie, L M, Olson, J A (2005). The impact of the Health Technology Board for Scotland's grading model on referrals to ophthalmology services. Br J Ophthalmol 89: 891-896 [Abstract] [Full text]
Murgatroyd, H, Ellingford, A, Cox, A, Binnie, M, Ellis, J D, MacEwen, C J, Leese, G P (2004). Effect of mydriasis and different field strategies on digital image screening of diabetic eye disease. Br J Ophthalmol 88: 920-924 [Abstract] [Full text]
Trevisan, R., Vedovato, M., Mazzon, C., Coracina, A., Iori, E., Tiengo, A., Del Prato, S. (2002). Concomitance of Diabetic Retinopathy and Proteinuria Accelerates the Rate of Decline of Kidney Function in Type 2 Diabetic Patients. Diabetes Care 25: 2026-2031 [Abstract] [Full text]
Donaldson, C., Currie, G., Mitton, C. (2002). Cost effectiveness analysis in health care: contraindications. BMJ 325: 891-894 [Full text]
Montori, V. M (2001). Review: mydriatic retinal photography is the most effective test for detecting diabetic retinopathy. Evid. Based Med. 6: 56-56 [Full text]