The Cost-Effectiveness of an Artificial Intelligence-Based Population-Wide Screening Program for Primary Open-Angle Glaucoma in The Netherlands
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Le résumé fourni par la source
OBJECTIVES: Population-wide screening for primary open-angle glaucoma (glaucoma) is typically not cost-effective because of low prevalence and high costs. We evaluated the cost-effectiveness of repeated artificial intelligence (AI)-based glaucoma screening using fundus photos in the Dutch population aged 50 to 75, compared with opportunistic case finding. METHODS: We developed a health-economic model consisting of a decision tree for screening simulation and a Markov model for disease progression and treatment effects. In AI screening, the population is invited every 5 years for fundus photography in primary care labs, followed by AI triage. Positive cases undergo ophthalmological evaluation. Model inputs included screening repetitions, AI sensitivity (85%), specificity (95%), screening compliance (50%), referral compliance (60%), and glaucoma progression probabilities, based on AI development data, a Dutch cohort, expert opinions, and literature. We performed analyses from societal and healthcare perspectives over a lifetime. RESULTS: AI screening identified glaucoma earlier than opportunistic methods, detecting 1.60 times more cases and reducing visual impairment by 0.8 months per invited individual. Societal perspective analysis indicated a gain of 0.014 quality-adjusted life-years and an incremental cost of €284 per individual, resulting in an incremental cost-effectiveness ratio of €19 311, with a 51.2% probability of being below the €20 000 threshold. Outcomes were most sensitive to glaucoma progression rates, utilities, and visual impairment costs. CONCLUSIONS: AI-based glaucoma screening in The Netherlands could cost-effectively improve early detection and reduce visual impairment burden. Further research should focus on reducing uncertainty regarding disease progression rates and impairment-related costs.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- The Cost-Effectiveness of an Artificial Intelligence-Based Population-Wide Screening Program for Primary Open-Angle Glaucoma in The Netherlands
- Date Crossref
- 01/09/2025
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Erasmus University Rotterdam pays non établi dans la noticeUniversité ou école supérieure
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Rotterdam Eye Hospital pays non établi dans la noticeÉtablissement de santé
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Erasmus MC pays non établi dans la noticeÉtablissement de santé
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Radboud University Nijmegen pays non établi dans la noticeUniversité ou école supérieure
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Radboud University Medical Center Erasmus Medical Center pays non établi dans la noticeOrganisme public
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Erasmus School of Health Policy and Management pays non établi dans la noticeUniversité ou école supérieure
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Institute for Medical Technology Assessment pays non établi dans la noticeStructure de recherche
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Rotterdam Ophthalmic Institute pays non établi dans la noticeStructure de recherche
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Erasmus Medical Center Ophthalmology pays non établi dans la noticeÉtablissement de santé
Erasmus University Rotterdam, Rotterdam Eye Hospital et Erasmus MC, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.