Abstract
Purpose :
When the methods and data of vision screening programmes are known in detail, and software is available to calculate their cost-effectiveness, it should be possible to compare their cost-effectiveness. We assessed the current state of data collection and its availability in all countries in Europe.
Methods :
In the EUSCREEN Survey (2017-2019) representatives of 42 European countries provided data on demography, existing screening programmes, coverage and attendance, screening tests, follow-up, diagnosis, treatment, benefit and adverse effect of screening. As part of the EUSCREEN Study, software was developed to calculate the cost-effectiveness of screening programmes (miscan.euscreen.org). By sensitivity analysis 6 items essential for cost-effectiveness analysis were identified: prevalence, sensitivity, specificity, coverage, attendance, loss to follow-up. Five others: age at screening, screening test, test threshold, screening professional and costs are determined in the screening protocol or can be calculated with relative ease. In the autumn of 2021, Survey items on data collection, monitoring and evaluation, and the six items essential for cost-effectiveness analysis were updated with an additional questionnaire.
Results :
Data was obtained from all countries in Europe and Israel and Turkey, not from Norway and Portugal. For 3 countries, vision screening was reported for a large region instead of a country. The practice of data collection in vision screening was reported in 36% (N=42) of countries; collected data were published in 10%. Procedures for quality assurance in vision screening were reported in 19%, research of screening effectiveness in 43%, whereas cost-effectiveness analysis was performed in 12%. Data on prevalence of amblyopia were reported in 40% of countries, on sensitivity of screening tests in 17%, on their specificity in 19%, on coverage of screening in 45%, on attendance in 21% and on loss to follow-up in 12%.
Conclusions :
Data collection in vision screening programmes is deplorable: data essential for cost-effectiveness comparison could not be reported from most countries. It mostly takes place at a local or regional level, for quality assurance or for accountability to commissioners, and the data is often not accessible. The resulting inability to compare cost-effectiveness of vision screening programmes perpetuates their diversity and inefficiency.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.