Barry J C, Hartmann A, Pongs U M, Jöckel M
Augenklinik, RWTH Aachen.
Ophthalmologe. 1998 Jan;95(1):19-27. doi: 10.1007/s003470050230.
In Germany, 750,000 children are born per year who should be screened for developmental visual defects in the age range 24-48 months. However, the established pediatric screening program is not sufficient to prevent amblyopia. The purpose of this study was to examine the cost-effectiveness of alternatives for amblyopia and microtropia screening.
Three options were compared: (1) an orthoptic screening carried out in the field, for instance in kindergartens, (2) an examiner-independent objective apparatus-based screening, and (3) a complete ophthalmological and strabismological examination carried out in a practice. The costs of screening, follow-up examinations and of the treatment were modelled for prevalences of 1% (microtropia) and 5% (amblyopia). The benefit due to treatment was calculated as the result of an avoided whole-person impairment of 3% and 1%. The income related, increased tax and health care payments were used to cover the costs.
In options (1) and (2) there were favorable cost-effective ratios. The practice-based option 3 was economically less promising. The higher the prevalence was, the higher the resulting cost-effectiveness.
在德国，每年有75万儿童出生，这些儿童应在24至48个月龄时接受发育性视觉缺陷筛查。然而，现有的儿科筛查项目不足以预防弱视。本研究的目的是检验弱视和微小斜视筛查替代方案的成本效益。
比较了三种方案：（1）在实地进行的斜视检查，例如在幼儿园；（2）基于独立于检查者的客观仪器的筛查；（3）在诊所进行的全面眼科和斜视检查。针对1%（微小斜视）和5%（弱视）的患病率对筛查、随访检查和治疗的成本进行了建模。因治疗带来的益处被计算为避免3%和1%的全人损伤的结果。相关收入、增加的税收和医疗保健支付用于支付成本。
方案（1）和（2）具有良好的成本效益比。基于诊所的方案3在经济上前景较差。患病率越高，产生的成本效益越高。
