Economic evaluation of different methods of screening for amblyopia in kindergarten

Pediatrics
Hans-Helmut König, Jean-Cyriaque Barry

Abstract

To compare the cost-effectiveness of 5 methods of screening for untreated amblyopia in kindergarten from a third-party-payer perspective: A) uncorrected monocular visual acuity testing with pass threshold > or =0.5 (20/40) and < or =1 line difference between eyes; B) same as A, but pass threshold > or =0.6 (20/32); C) same as A, plus cover tests and examination of eye motility and head posture; D) same as C, but pass threshold > or =0.6 (20/32); and E) refractive screening without cycloplegia using the Nikon Retinomax autorefractor. A decision-analytic model was used with a time horizon until diagnostic examination. According to the model, all 3-year-old children were screened in kindergarten with 1 of the screening methods. Children with positive screening results were referred to an ophthalmologist for diagnostic examination. Children with inconclusive screening results were either referred to an ophthalmologist directly (option 1) or rescreened by the same method after 1 year and referred to an ophthalmologist if rescreening was positive or inconclusive (option 2). Screening test characteristics and costs were estimated on the basis of a field study in which 1180 3-year-old children were examined by orthoptists in 121 German...Continue Reading

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Citations

Mar 8, 2005·Survey of Ophthalmology·Kurt Simons
Mar 15, 2003·Optometry and Vision Science : Official Publication of the American Academy of Optometry·Afshin GandjourKarl Wilhelm Lauterbach
Jun 19, 2003·The British Journal of Ophthalmology·J-C Barry, H-H König
Mar 14, 2007·Vojnosanitetski pregled. Military-medical and pharmaceutical review·Branislav Stanković
Oct 29, 2009·Indian Journal of Ophthalmology·Rajiv KhandekarAshraf Arabi
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Apr 14, 2005·Journal of Pediatric Ophthalmology and Strabismus·Robert W ArnoldLynn J Coon

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