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Is it worthwhile to conduct a randomized controlled trial of glaucoma screening in the United Kingdom?

Lookup NU author(s): Dr Jill Francis, Professor Luke ValeORCiD


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Objectives To assess the value of conducting a glaucoma screening randomized controlled trial in the UK. Methods Decision model based economic evaluation and value of information analysis. Model derived from a previous health technology assessment. Model updated in terms of structure and parameter estimates with data from surveys, interviews with members of the public and health care providers and routine sources. Results On average, across a range of ages of initiating screening (40-60 years), glaucoma prevalence (1-5%), screening uptake (30-100%), and the performance of current case finding, screening was not cost-effective at a 30,000 threshold per quality adjusted life year (QALY) from the perspective of the National Health Service (NHS). The societal value of removing all uncertainty around glaucoma screening is 107 pound million at a threshold of 20,000 pound per QALY. For informing policy decisions on glaucoma screening, reducing uncertainty surrounding the NHS and personal social care cost of sight impairment (74 pound million) was of most value, followed by reducing uncertainty in test performance (14 pound million) and uptake of either screening or current eye care (8 pound million each). Conclusions A glaucoma screening trial in the UK is unlikely to be the best use of research resources. Further research to quantify the costs of sight impairment falling on the NHS and personal social services is a priority. Further development of glaucoma tests and research into strategies to promote the uptake of screening or current eye care such as through the use of a behavioural intervention would be worthwhile.

Publication metadata

Author(s): Burr J, Hernandez R, Ramsay C, Prior M, Campbell S, Azuara-Blanco A, Campbell M, Francis J, Vale L

Publication type: Article

Publication status: Published

Journal: Journal of Health Services Research & Policy

Year: 2014

Volume: 19

Issue: 1

Pages: 42-51

Print publication date: 02/10/2013

ISSN (print): 1355-8196

ISSN (electronic): 1758-1060

Publisher: Sage


DOI: 10.1177/1355819613499748


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Funder referenceFunder name
Chief Scientist Office
G0701759Medical Research Council
MR/K02325X/1Medical Research Council