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- Title
A Modeled Economic Analysis of a Digital Teleophthalmology System As Used by Three Federal Healthcare Agencies for Detecting Proliferative Diabetic Retinopathy.
- Authors
John D. Whited; Santanu K. Datta; Lloyd M. Aiello; Lloyd P. Aiello; Jerry D. Cavallerano; Paul R. Conlin; Mark B. Horton; Robert A. Vigersky; Ronald K. Poropatich; Pratap Challa; Adam W. Darkins; Sven-Erik Bursell
- Abstract
The objective of this study was to compare, using a 12-month time frame, the cost-effectivenessof a nonmydriatic digital teleophthalmology system (Joslin Vision Network) versus traditionalclinic-based ophthalmoscopy examinations with pupil dilation to detect proliferativediabetic retinopathy and its consequences. Decision analysis techniques, including MonteCarlo simulation, were used to model the use of the Joslin Vision Network versus conventionalclinic-based ophthalmoscopy among the entire diabetic populations served by the IndianHealth Service, the Department of Veterans Affairs, and the active duty Department ofDefense. The economic perspective analyzed was that of each federal agency. Data sourcesfor costs and outcomes included the published literature, epidemiologic data, administrativedata, market prices, and expert opinion. Outcome measures included the number of true positivecases of proliferative diabetic retinopathy detected, the number of patients treated withpanretinal laser photocoagulation, and the number of cases of severe vision loss averted.In the base-case analyses, the Joslin Vision Network was the dominant strategy in all buttwo of the nine modeled scenarios, meaning that it was both less costly and more effective.In the active duty Department of Defense population, the Joslin Vision Network would bemore effective but cost an extra $1,618 per additional patient treated with panretinal laser photo-coagulation and an additional $13,748 per severe vision loss event averted. Based on our economicmodel, the Joslin Vision Network has the potential to be more effective than clinicbasedophthalmoscopy for detecting proliferative diabetic retinopathy and averting cases ofsevere vision loss, and may do so at lower cost.
- Subjects
OPHTHALMOLOGY; MEDICAL telematics; MEDICAL care; MEDICAL informatics
- Publication
Telemedicine & e-Health, 2005, Vol 11, Issue 6, p641
- ISSN
1530-5627
- Publication type
Article
- DOI
10.1089/tmj.2005.11.641