Cost-effectiveness of digital surveillance clinics with optical coherence tomography versus hospital eye service follow-up for patients with screen-positive maculopathy
Cost-effectiveness of digital surveillance clinics with optical coherence tomography versus hospital eye service follow-up for patients with screen-positive maculopathy
Background: annually 2.7 million individuals are offered screening for diabetic retinopathy (DR) in England. Spectral-Domain Optical Coherence Tomography (SD-OCT) has the potential to relieve pressure on NHS services by correctly identifying patients who are screen positive for maculopathy on two-dimensional photography without evidence of clinically significant macular oedema (CSMO), limiting the number of referrals to hospitals. We aim to assess whether the addition of SDOCT imaging in digital surveillance clinics is a cost-effective intervention relative to hospital eye service (HES) follow-up.
Methods: we used patient-level data from the Gloucestershire Diabetic Eye Screening Service linked to the local digital surveillance programme and HES between 2012 and 2015. A model was used to simulate the progression of individuals with background diabetic retinopathy (R1) and diabetic maculopathy (M1) following DR screening across the clinic pathways over 12 months.
Results: between January 2012 and December 2014, 696 people undergoing DR screening were found to have screen-positive maculopathy in at least one eye for the first time, with a total of 766 eyes identified as having R1M1. The mean annual cost of assessing and surveillance through the SD-OCT clinic pathway was £101 (95% CI: 91–139) as compared with £177 (95%CI: 164–219) under the HES pathway. Surveillance under an SD-OCT clinic generated cost savings of £76 (95% CI: 70–81) per patient.
Conclusions: our analysis shows that SD-OCT surveillance of patients diagnosed as R1M1 at DR screening is not only cost-effective but generates considerable cost savings.
640-647
Leal, Jose
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Luengo-Fernandez, Ramon
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Stratton, Irene M.
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Dale, Angela
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Ivanova, Katerina
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Scanlon, Peter H.
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April 2019
Leal, Jose
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Luengo-Fernandez, Ramon
ed6abe8d-64d2-44a6-9216-3ede3530e7fc
Stratton, Irene M.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Dale, Angela
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Ivanova, Katerina
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Scanlon, Peter H.
4e3d2310-c79e-42db-ae29-7a7d6b278aa3
Leal, Jose, Luengo-Fernandez, Ramon, Stratton, Irene M., Dale, Angela, Ivanova, Katerina and Scanlon, Peter H.
(2019)
Cost-effectiveness of digital surveillance clinics with optical coherence tomography versus hospital eye service follow-up for patients with screen-positive maculopathy.
Eye (Basingstoke), 33 (4), .
(doi:10.1038/s41433-018-0297-7).
Abstract
Background: annually 2.7 million individuals are offered screening for diabetic retinopathy (DR) in England. Spectral-Domain Optical Coherence Tomography (SD-OCT) has the potential to relieve pressure on NHS services by correctly identifying patients who are screen positive for maculopathy on two-dimensional photography without evidence of clinically significant macular oedema (CSMO), limiting the number of referrals to hospitals. We aim to assess whether the addition of SDOCT imaging in digital surveillance clinics is a cost-effective intervention relative to hospital eye service (HES) follow-up.
Methods: we used patient-level data from the Gloucestershire Diabetic Eye Screening Service linked to the local digital surveillance programme and HES between 2012 and 2015. A model was used to simulate the progression of individuals with background diabetic retinopathy (R1) and diabetic maculopathy (M1) following DR screening across the clinic pathways over 12 months.
Results: between January 2012 and December 2014, 696 people undergoing DR screening were found to have screen-positive maculopathy in at least one eye for the first time, with a total of 766 eyes identified as having R1M1. The mean annual cost of assessing and surveillance through the SD-OCT clinic pathway was £101 (95% CI: 91–139) as compared with £177 (95%CI: 164–219) under the HES pathway. Surveillance under an SD-OCT clinic generated cost savings of £76 (95% CI: 70–81) per patient.
Conclusions: our analysis shows that SD-OCT surveillance of patients diagnosed as R1M1 at DR screening is not only cost-effective but generates considerable cost savings.
Text
s41433-018-0297-7
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Accepted/In Press date: 21 October 2018
Published date: April 2019
Additional Information:
Funding Information: project was funded by an unrestricted grant from Gloucestershire NHS Foundation Trust from funding received from Public Health England.
Identifiers
Local EPrints ID: 487095
URI: http://eprints.soton.ac.uk/id/eprint/487095
ISSN: 0950-222X
PURE UUID: 3bab327d-f441-486d-880a-5d6c78a40607
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Date deposited: 13 Feb 2024 17:32
Last modified: 18 Mar 2024 04:01
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Contributors
Author:
Jose Leal
Author:
Ramon Luengo-Fernandez
Author:
Irene M. Stratton
Author:
Angela Dale
Author:
Katerina Ivanova
Author:
Peter H. Scanlon
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