June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
EUSCREEN APP calculates the cost-effectiveness of vision screening programs, taking local circumstances into account
Author Affiliations & Notes
  • Huibert Jan Simonsz
    Erasmus Medical Center, Rotterdam, Netherlands
    Netherlands Institute for Neuroscience, Amsterdam, Netherlands
  • Hans Hoeve
    University of Reading, Reading, United Kingdom
  • Eveline Heijnsdijk
    Erasmus Medical Center, Rotterdam, Netherlands
  • Jan Kik
    Erasmus Medical Center, Rotterdam, Netherlands
  • Anna Horwood
    University of Reading, Reading, United Kingdom
  • Inger Úhlen
    Karolinska Institutet, Stockholm, Sweden
  • Gwen Carr
    Independent consultant in Early Hearing Detection, Intervention and Family Centered Practice, United Kingdom
  • Mandy Nordmann
    Erasmus Medical Center, Rotterdam, Netherlands
  • Harry de Koning
    Erasmus Medical Center, Rotterdam, Netherlands
  • Footnotes
    Commercial Relationships   Huibert Simonsz, None; Hans Hoeve, None; Eveline Heijnsdijk, None; Jan Kik, None; Anna Horwood, None; Inger Úhlen, None; Gwen Carr, None; Mandy Nordmann, None; Harry de Koning, None
  • Footnotes
    Support  European Union’s Horizon 2020 research and innovation programme under Grant Agreement No 733352
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 148. doi:
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      Huibert Jan Simonsz, Hans Hoeve, Eveline Heijnsdijk, Jan Kik, Anna Horwood, Inger Úhlen, Gwen Carr, Mandy Nordmann, Harry de Koning; EUSCREEN APP calculates the cost-effectiveness of vision screening programs, taking local circumstances into account. Invest. Ophthalmol. Vis. Sci. 2021;62(8):148.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Vision screening programs vary in organization, location, screening tests, screening professionals, referral criteria and coverage, which makes comparison of their cost-effectiveness difficult. We develop a web-based application that calculates their cost-effectiveness.

Methods : The EUSCREEN APP at www.euscreen.org simulates the path followed by a child within a vision screening program consisting of several screening steps. Users enter demographic data like birth figures, tests used, screening location, screening professionals etc. The model simulates this screening program and calculates the number of tests, number of referrals to diagnostics, number of cases detected, costs of screening until referral, costs of diagnostic assessment, total costs, costs per test and costs per case detected. Then the user adjusts variables to see what effect a change of age of screening, screening test, number of screening steps, screening professional etcetera has.

Results : The accuracy of the prediction depends upon the quality of the input data. Notably, the sensitivity and specificity of a screening test at a specific age, performed by a given professional with a given training and a given experience are difficult to estimate and are the most critical component of the model. Costs of screening, diagnostic assessment and treatment are calculated from salaries, overhead, visual acuity charts and other material, housing etc. Combination of vision screening with other screening or with school attendance reduces cost components. Photorefraction and prescription of glasses at age 1 or 2 may precede measurement of visual acuity at age 4-6. As the model is also intended for use in Low-Income Countries, questions check if lack of healthcare infrastructure, competing healthcare priorities, lack of awareness of advantages of prevention and long travel distances render vision screening unacceptable, inappropriate or unsustainable.

Conclusions : The EUSCREEN APP for cost-effectiveness of vision screening programs will assist professionals in their decisions to introduce, modify or disinvest childhood vision screening programs. Utility and quality of life, effectiveness of treatment, newborn vision screening, type and severity of amblyopia and orthoptic training need to be added. Ubiquitous lack of data collection in vision screening makes it difficult for the user to know the correct input values.

This is a 2021 ARVO Annual Meeting abstract.


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