Screening for open angle glaucoma: systematic review of cost-effectiveness studies.
OBJECTIVE
To systematically review current evidence on the cost-effectiveness of screening strategies for open angle glaucoma (OAG).


METHODS
Studies that reported both costs and outcomes of alternative screening strategies for OAG were identified by a highly sensitive search of electronic databases (eg, MEDLINE, EMBASE, NHS EED, HTA Database), last search December 2005. Data on costs regarding cases and years of visual impairment prevented, cases of blindness prevented, and cases of OAG detected were extracted. Incremental cost-effectiveness ratios were calculated using data provided in the included studies.


RESULTS
Four studies met the inclusion criteria. The latest of these was published in 1997. The screening tests and treatments reported in these studies are now not considered to be best practice. Furthermore, data were not reported in sufficient detail to reinterpret the results of the studies in terms of a common outcome measure. Finally, these studies suffered from methodologic weaknesses that further limit their usefulness for decision making.


CONCLUSIONS
Currently, there is insufficient economic evidence on which to base recommendations regarding screening for OAG. New technologies, potentially suitable as screening devices, and new treatments are available. Further research, both in terms of economic models and conduct of clinical trials with concurrent economic evaluation, may help inform policy makers regarding cost-effectiveness and acceptability of screening for OAG.
Hernández
Rodolfo
R
Health Economics Research Unit, University of Aberdeen, Aberdeen, Scotland, UK. r.a.hernandez@abdn.ac.uk
Rabindranath
Kannaiyan
K
Fraser
Cynthia
C
Vale
Luke
L
Blanco
Augusto Azuara
AA
Burr
Jennifer M
JM
D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000191:economics*; D006801:Humans; D007429:Intraocular Pressure; D008403:Mass Screening / Q000191:economics*; D009887:Ophthalmoscopy / Q000191:economics; D011237:Predictive Value of Tests; D014065:Tonometry, Ocular / Q000191:economics; D015351:Vision Screening / Q000191:economics*; D058609:Visual Field Tests / Q000191:economics; D014794:Visual Fields