PMID- 24787570
OWN - NLM
STAT- MEDLINE
DCOM- 20140729
LR  - 20240503
IS  - 1552-5783 (Electronic)
IS  - 0146-0404 (Print)
IS  - 0146-0404 (Linking)
VI  - 55
IP  - 6
DP  - 2014 May 1
TI  - A comparative effectiveness analysis of visual field outcomes after projected 
      glaucoma screening using SD-OCT in African American communities.
PG  - 3491-500
LID - 10.1167/iovs.14-14014 [doi]
AB  - PURPOSE: To assess the impact on visual function of community glaucoma screening 
      in an African American population using spectral-domain optical coherence 
      tomography (SD-OCT). METHODS: Using a Monte Carlo microsimulation model with a 
      10-year time horizon, we analyzed the efficacy of SD-OCT screening on visual 
      field outcomes in a population of African Americans who are not otherwise seeking 
      office-based care. Outcomes included classification of visual field severity, 
      quality-adjusted life years, and direct health care costs. RESULTS: Assuming a 
      60% follow-up rate, screening decreased the prevalence of undiagnosed glaucoma 
      from 75% to 38%, and decreased the prevalence of severe visual field loss in 
      patients with glaucoma from 29.1% to 23.9%. Conversely, screening increased the 
      prevalence of mild visual field loss in patients with glaucoma from 9.2% to 
      18.7%. From initial screening through confirmatory eye examination, the screening 
      program ("screen only") cost $98 per screened individual, and $2561 per new 
      diagnosis of glaucoma. When considering the costs of initial screening though the 
      resultant treatment, the screening program ("screen and treat") had an average 
      annual cost of $79 and $2138, respectively, over a 10-year time period. The cost 
      of one quality-adjusted life year (QALY) gained by screening, including 
      management and treatment, in comparison with opportunistic case finding, ranged 
      from $46,416 to $67,813. CONCLUSIONS: Our findings suggest that community SD-OCT 
      screening in an African American population will minimize glaucoma-related visual 
      morbidity. Ideally, strategies to maximize treatment efficacy through improved 
      medication adherence and improved compliance with follow-up should be identified 
      and implemented before instituting a screening program.
CI  - Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.
FAU - Blumberg, Dana M
AU  - Blumberg DM
AD  - Department of Ophthalmology, Harkness Eye Institute, Columbia University, New 
      York, New York, United States.
FAU - Vaswani, Reena
AU  - Vaswani R
AD  - Department of Ophthalmology, Harkness Eye Institute, Columbia University, New 
      York, New York, United States.
FAU - Nong, Eva
AU  - Nong E
AD  - Columbia University College of Physicians and Surgeons, New York, New York, 
      United States.
FAU - Al-Aswad, Lama
AU  - Al-Aswad L
AD  - Department of Ophthalmology, Harkness Eye Institute, Columbia University, New 
      York, New York, United States.
FAU - Cioffi, George A
AU  - Cioffi GA
AD  - Department of Ophthalmology, Harkness Eye Institute, Columbia University, New 
      York, New York, United States.
LA  - eng
GR  - KM1 CA156709/CA/NCI NIH HHS/United States
GR  - KM1 CA 156709/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20140501
PL  - United States
TA  - Invest Ophthalmol Vis Sci
JT  - Investigative ophthalmology & visual science
JID - 7703701
SB  - IM
MH  - *Black or African American
MH  - Female
MH  - Follow-Up Studies
MH  - Glaucoma/*diagnosis/ethnology
MH  - Humans
MH  - Male
MH  - Mass Screening/*methods
MH  - Middle Aged
MH  - Monte Carlo Method
MH  - Prevalence
MH  - Quality-Adjusted Life Years
MH  - Scotoma/*diagnosis/ethnology/etiology
MH  - Time Factors
MH  - Tomography, Optical Coherence/*methods
MH  - United States/epidemiology
MH  - *Visual Fields
PMC - PMC4073998
OTO - NOTNLM
OT  - Markov model
OT  - SD-OCT
OT  - comparative effectiveness
OT  - glaucoma
OT  - screening
EDAT- 2014/05/03 06:00
MHDA- 2014/07/30 06:00
PMCR- 2014/12/01
CRDT- 2014/05/03 06:00
PHST- 2014/05/03 06:00 [entrez]
PHST- 2014/05/03 06:00 [pubmed]
PHST- 2014/07/30 06:00 [medline]
PHST- 2014/12/01 00:00 [pmc-release]
AID - iovs.14-14014 [pii]
AID - 10.1167/iovs.14-14014 [doi]
PST - epublish
SO  - Invest Ophthalmol Vis Sci. 2014 May 1;55(6):3491-500. doi: 10.1167/iovs.14-14014.