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Cost-effectiveness of general population screening for glaucoma unproven, difficult to evaluate
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PRAGUE — Systematic screening has so far failed to prove cost-effective and to improve the management of glaucoma in clinical practice, according to one specialist speaking at the European Glaucoma Society Congress.
If half of the glaucoma population in Western countries remains undiagnosed, systematic population screenings have led to over-referral, increasing the burden of false positives and overtreatment, Anja Tuulonen, MD, PhD, said.
Anja Tuulonen
Guidelines for opportunistic case finding, such as the NICE guidelines in the UK, led to increased referral but no gain in finding new glaucoma cases and a reduction in accuracy of detecting abnormal optic discs, she said.
Two studies, conducted in Finland and the UK, evaluated the clinical effectiveness and cost-effectiveness of screening. They both reached the conclusion that general population screenings are not cost-effective and suggested that resources would be better spent doing selective screening of groups with higher prevalence due to proven risk factors.
“What we would really need to evaluate cost-effectiveness is a randomized clinical trial in which one arm receives screening and the other arm does not, and then evaluate if this screening leads to improved outcomes in the long run in terms of visual disability and quality of life cost-effectiveness,” Tuulonen said. – by Michela Cimberle
Reference:
Tuulonen A. Can glaucoma screening be cost effective? Presented at: European Glaucoma Society Congress; June 19-22, 2016; Prague.
Disclosure: Tuulonen reports no relevant financial disclosures.