Table 2 Cost considerations.
Author [references] (ages tested) | Title | Country and setting | Cost defined | Formal cost-effectiveness analysis/modelling | Options compared | CASP checklist items considered | Comments |
|---|---|---|---|---|---|---|---|
Arnold et al. [24] (1–5 years) | The cost and yield of photoscreening: Impact of photoscreening on overall paediatric ophthalmic costs | US (Alaska) | Per screen, per RF, cost of adding to current AAP guidelines eye care | Cost-consequence analysis using reference-case analysis over 10 years of life | Cost of adding photoscreening to current recommendations | 8 | US setting where the AAP/AAPOS guidelines recomment multiple screenings |
Arnold et al. [26] (not stated) | Predictive value of inexpensive digital eye and vision photoscreening: ʻPPV of ABCD’ | US (Alaska) | Of different equipment | No | Equipment/interpretation cost of different auto/photo methods | 1 | |
Arnold and Donahue [94] (6 months–4 years) | The yield and challenges of charitable state-wide photoscreening | US (Alaska and Tennessee) | Per child screened | No | Comparing cost per screened child in two US states | 1 | |
Cordonnier and Kallay [83] (9–36 months) | Non-cycloplegic screening for refractive errors in children with the hand-held autorefractor Retinomax: final results and comparison with non-cycloplegic photoscreening | Belgium | To diagnosis, including false positives. Per child screened, per child with confirmed risk factors | Estimated cumulative costs to diagnosis | Retinomax vs. photoscreening | 5 | Enriched population incl higher risk infants, and not community screening. |
Donahue et al. [95] (6–47 months) | Lions Clubs International Foundation core four photoscreening: Results from 17 programmes and 400,000 preschool children | US (Multi state) + Taiwan | Per child screened and per child with risk factors detected | No | Programme comparison | 3 | |
Donahue et al. [36] (6–47 months) | Screening for amblyogenic factors using a volunteer lay network and the MTI photoscreener. Initial results from 15,000 preschool children in a state-wide effort | US (Tennessee) | Per screen | No | No | 2 | |
Halegoua and Schwartz [93] (6 months–6 years) | Vision photoscreening of infants and young children in a primary care paediatric office: can it identify asymptomatic treatable amblyopic risk factors? | US (New York) | Per device | No | No | 2 | |
Joish et al. [20] (6 months–8 years) | A cost-benefit analysis of vision screening methods for preschoolers and school-age children | US | Lifetime costs to society | Societal perspective decision-analytic modelling based on published data | VA vs. photoscreening at ages 6–18 months, 3–4 years and 7–8 years | 8 | Did not consider 5–6 years |
Kemper and Clark [118] (3–5 years) | Preschool vision screening in paediatric practices | US | Survey of reimbursement issues as a barrier to screening | No | National reimpursement experiences | n/a | |
Kirk et al. [31] (<2 and 2–4 years) | Preverbal photoscreening for amblyogenic factors and outcomes in amblyopia treatment: early objective screening and visual acuities | USA (Alaska) | Estimated extrapolated cost per US child of adding screening to existing services | Partial | Adding screening at 18 months to existing provision. Comparison with comprehensive eye exam costs | 5 | |
König and Barry [56] (3 years) | Cost-effectiveness of screening for amblyopia in 3-year-old kindergarten children: Non-cycloplegic refractive screening with the Nikon Retinomax hand-held autorefractor vs. orthoptic visual acuity screening | Germany | Per case detected | Decision-analytic modelling | Five different screening modalities including photoscreening. Modelled cost of adding tests | 6 | Only considered screening at 3 years of age in German setting (GPs and Paediatricians) |
König and Barry [55] (3 years) | Economic evaluation of different methods of screening for amblyopia in kindergarten | See above | See above | See above | See above | 8 | Conference transaction paper of above study |
Lang et al. [32] (3–11 years) | Validated portable paediatric vision screening in the Alaska Bush. A VIPS-like study in the Koyukon | US (Alaska) | Per screen | No | No | 1 | Small local study |
Leman et al. [62] (3–7 years) | A comparison of patched HOTV visual acuity and photoscreening | US (Alaska) | Per test | No | No | 3 | |
Longmuir et al. [92] (6 months–6 years) | Nine-year results of a volunteer lay network photoscreening programme of 147,809 children using a photoscreener in Iowa | US (Iowa) | Per child screened | No | No | 2 | |
Lowry et al. [68] (31 months–6 years) | Efficient Referral Thresholds in Autorefraction-Based Preschool Screening | US (California) | Cost per case detected screening and follow-up visits, but not glasses prescriptions | Retrospective evaluation. Modelling to arrive at optimum referral criteria towith minimal cost | Different referral criteria for same photoscreener | 6 | Optimal model verified with follow-up study. Cost from persective of ʻ3rd party care providers’ |
Lowry and Campomanes [57] (31 months–6 years) | Cost-effectiveness of School-Based Eye Examinations in Preschoolers Referred for Follow-up From Visual Screening | US (California) | Cost per case detected at follow-up funded a service | Decision-analytic modelling and probabilistic sensitivity analysis | Community vs. mobile follow-up | 3 | Modelling costs of different types of follow-up, not screening itself |
Lowry et al. [80] (3–4 years) | Repeat Retinomax screening changes positive predictive value | US (California) | Cost savings made by re-screening | No | Single screening vs. repeat before referral | 4 | |
Matsuo et al. [65] (3.5 years) | Is refraction with a hand-held autorefractometer useful in addition to visual acuity testing and questionnaires in preschool vision screening at 3.5 years in Japan? | Japan | No | No | Value of adding photoscreening to established programme | 1 | Not cost effective |
Miller et al. [63] (3–5 years) | Cost-efficient vision screening for astigmatism in native american preschool children | US (Arizona—native American) | Cost of running service/case detected (but not technician time or consumables) | Modelled cost in different size populations to be screened | Four different screening modalities | 4 | Population with high astigmatism risk. Refrral criterion was ʻenough astigmatism to warrant glasses’ |
Morgan and Kennemer [96] (5, 7, 11 years) | Off-axis photorefractive eye screening in children | US (East Coast states) | Cost per screen and cost per affected child (incl ref. error) | No | No | 2 | Early paper |
Rein et al. [58] (3 years) | The potential cost-effectiveness of amblyopia screening programmes | USA | Programme cost, referral rate follow-up data | Yes. Randomised person-level simulation. Probablistic sensitivity analysis | Three different screening scenarios including photoscreening at 3 years + VA screening at 5 years | 9 | All screening modalities likely to be cost effective compared to other public health programmes. The scenario involving photoscreening was most costly. Did not assess photoscreening as a stand-alone test |
Terveen et al. [71] (6 months–12 years) | Results of a paediatric vision screening programme in western South Dakota | USA (South Dakota) | Cost for a State run service. Cost of lost earning power of of undetected amblyopia. Cost ratio of cost to QALY | Cost-utility reference-case analysis | SPOT screener compared to no screening | 3 |
