The cost-effectiveness of three screening alternatives for people with diabetes with no or early diabetic retinopathy.
The cost-effectiveness of three screening alternatives for people with diabetes with no or early diabetic retinopathy.
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DOI：
10.1111/j.1475-6773.2011.01263.x
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发表时间：
2011-10
影响因子：
3.4
通讯作者：
Vision Cost-Effectiveness Study Group
中科院分区：
文献类型：
--
作者：
Rein DB;Wittenborn JS;Zhang X;Allaire BA;Song MS;Klein R;Saaddine JB;Vision Cost-Effectiveness Study Group
确定两年一次的眼科评估或远程医疗筛查是否是目前对估计1000万30至84岁糖尿病患者但无或轻微糖尿病视网膜病变的建议的具有成本效益的替代方案。英国前瞻性糖尿病研究，国家健康和营养检查调查，美国眼科学会首选实践模式，医疗保险支付计划。成本效益蒙特卡罗模拟。文献综述，现有调查分析。当模型中包括检测其他眼部疾病的能力时，两年一次的眼部评估是最具成本效益的治疗选择。在不考虑其他眼部疾病或假定远程医疗可检测屈光不正的情况下，远程医疗的成本效益最高。目前的年度眼科评估建议与任何一种治疗方案相比都是昂贵的。自我推荐是最具成本效益的支付意愿（WTP）的37,600美元，无论是两年期或年度评估最具成本效益的更高的WTP水平。每年的眼睛评估是昂贵的，并增加很少的好处相比，任何一个合理的替代方案。需要对远程医疗检测其他眼部疾病的能力进行更多的研究，以确定它是否比两年一次的眼部评估更具成本效益。
To determine whether biennial eye evaluation or telemedicine screening are cost-effective alternatives to current recommendations for the estimated 10 million people aged 30 to 84 with diabetes but no or minimal diabetic retinopathy. United Kingdom Prospective Diabetes Study, National Health and Nutrition Examination Survey, American Academy of Ophthalmology Preferred Practice Patterns, Medicare Payment Schedule. Cost-effectiveness Monte Carlo simulation. Literature review, analysis of existing surveys. Biennial eye evaluation was the most cost-effective treatment option when the ability to detect other eye conditions was included in the model. Telemedicine was most cost-effective when other eye conditions were not considered or when telemedicine was assumed to detect refractive error. The current annual eye evaluation recommendation was costly compared to either treatment alternative. Self-referral was most cost-effective up to a willingness to pay (WTP) of $37,600, with either biennial or annual evaluation most cost-effective at higher WTP levels. Annual eye evaluations are costly and add little benefit compared to either plausible alternative. More research on the ability of telemedicine to detect other eye conditions is needed to determine whether it is more cost-effective than biennial eye evaluation.
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影响因子：
3
作者：
DASBACH, EJ;FRYBACK, DG;KLEIN, BEK
通讯作者：
KLEIN, BEK
影响因子：
13.7
作者：
Fransen, SR;Leonard-Martin, TC;Hildebrand, PL
通讯作者：
Hildebrand, PL
影响因子：
16.2
作者：
Ahmed, Jehanara;Ward, Thomas P.;Vigersky, Robert A.
通讯作者：
Vigersky, Robert A.
DOI：
10.1177/0272989x8500500205
发表时间：
1985-01-01
期刊：
Medical decision making : an international journal of the Society for Medical Decision Making
影响因子：
--
作者：
Doubilet, P;Begg, C B;McNeil, B J
通讯作者：
McNeil, B J
影响因子：
4.4
作者：
Freeman, EE;Egleston, BL;Rubin, G
通讯作者：
Rubin, G