title: Screening for glaucoma in Canada: a systematic review of the literature.
abstract: BACKGROUND
  To provide a recommendation on screening for glaucoma in Canada based on a review of recent evidence available in the literature.
  
  
  METHODS
  A systematic literature review was performed to identify publications from MEDLINE, EMBASE, HealthSTAR, and Cochrane databases from 1990 to 2005. Relevant articles were categorized as economic studies, epidemiologic and intervention studies, or policy papers. Web sites and publications from provincial, state, national, and international health authorities were reviewed for policy recommendations and guidelines.
  
  
  RESULTS
  We identified 39 articles (34 epidemiology and intervention, and 5 economic studies) for the review. From the economic studies, 2 were simple cost analyses and 3 were full economic evaluations (cost-effectiveness). Gaps were observed from these economic studies, where incremental cost-effectiveness analyses of modelled screening programmes were not observed. A large number of alternatives (i.e., screening techniques) and diverse outcome measures were found in the 34 epidemiology and intervention studies. This shows that evidence on the effectiveness of glaucoma screening programmes is available to be used in future modelled analyses. Neutral recommendation made by the Canadian Task Force on Periodic Health Examination regarding glaucoma screening in Canada could be related to the lack of reliable data and models used in past cost-effectiveness analyses.
  
  
  CONCLUSIONS
  A need exists to reevaluate the cost-effectiveness of a screening programme for glaucoma in Canada with updated efficacy and cost data. Health and monetary benefits could be improved compared with current practice and decision-makers would have the best available data when reevaluating the policy on screening for glaucoma.
authors.affiliation: PharmIdeas Research and Consulting Inc., ON, Canada.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Einarson
authors.forename: Colin
authors.initials: C
authors.lastname: Vicente
authors.forename: Márcio
authors.initials: M
authors.lastname: Machado
authors.forename: David
authors.initials: D
authors.lastname: Covert
authors.forename: Graham E
authors.initials: GE
authors.lastname: Trope
authors.forename: Michael
authors.initials: M
authors.lastname: Iskedjian
mesh_terms: D002170:Canada / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D003937:Diagnosis, Differential; D005901:Glaucoma / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000458:organization & administration*; D018803:Models, Economic; D015397:Program Evaluation / Q000191:economics / Q000639:trends; D012189:Retrospective Studies