ArticleApplied health economics and health policy2020
Cost-utility Analysis of Opportunistic and Systematic Diabetic Retinopathy Screening Strategies from the Perspective of the Brazilian Public Healthcare System.
Article in Applied health economics and health policy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Economic Evaluation of Diabetic Retinopathy Screening in Developing Countries: A Systematic Review.Korean journal of ophthalmology : KJO · 2025Pooled it
- Application of decision analytical models to diabetes in low- and middle-income countries: a systematic review.BMC health services research · 2022Pooled it
- Opportunistic Eye Disease Screening in Mazovia, Poland: Lessons from a Local Government Program: "Good Vision for Mazovians".Healthcare (Basel, Switzerland) · 2025Article
- Optimizing Diabetic Retinopathy Screening at Primary Health Centres in India: A Cost-Effectiveness Analysis.PharmacoEconomics - open · 2025Article
- Advancing healthcare with artificial intelligence: diagnostic accuracy of machine learning algorithm in diagnosis of diabetic retinopathy in the Brazilian population.Diabetology & metabolic syndrome · 2024Article
- The use of social simulation modelling to understand adherence to diabetic retinopathy screening programs.Scientific reports · 2024Article
- Pharmacoeconomic Aspects of Diabetes Mellitus: Outcomes and Analysis of Health Benefits Approach.Current diabetes reviews · 2024Review
- Cost-Utility Analysis of Deep Learning and Trained Human Graders for Diabetic Retinopathy Screening in a Nationwide Program.Ophthalmology and therapy · 2023Article
- Cost-effectiveness analysis of artificial intelligence-based diabetic retinopathy screening in rural China based on the Markov model.PloS one · 2023Article
- Cost-effectiveness and cost-utility of traditional and telemedicine combined population-based age-related macular degeneration and diabetic retinopathy screening in rural and urban China.The Lancet regional health. Western Pacific · 2022Article
- Diabetic Retinopathy Screening Using Artificial Intelligence and Handheld Smartphone-Based Retinal Camera.Journal of diabetes science and technology · 2022Article
- Cost-effectiveness of Artificial Intelligence as a Decision-Support System Applied to the Detection and Grading of Melanoma, Dental Caries, and Diabetic Retinopathy.JAMA network open · 2022Article
- Cost-Utility Analysis of Screening for Diabetic Retinopathy in China.Health data science · 2022Article
- Applicability of portable retinal cameras and telemedicine as facilitating tools in screening diabetic retinopathy in the COVID-19 pandemic scenario.Arquivos brasileiros de oftalmologia · 2022Article
- Diabetic retinopathy screening and the COVID-19 pandemic in Brazil.Arquivos brasileiros de oftalmologia · 2020Article
- Cost-effectiveness of diabetic retinopathy screening programs using telemedicine: a systematic review.Cost effectiveness and resource allocation : C/E · 2020Review
- Increased vitreal levels of interleukin-10 in diabetic retinopathy: a Meta-analysis.International journal of ophthalmology · 2020Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
objectiveTo perform a cost-utility analysis of diabetic retinopathy (DR) screening strategies from the perspective of the Brazilian Public Healthcare System.
methodsA model-based economic evaluation was performed to estimate the incremental costs per quality-adjusted life-year (QALY) gained between three DR screening strategies: (1) the opportunistic ophthalmology referral-based (usual practice), (2) the systematic ophthalmology referral-based, and (3) the systematic teleophthalmology-based. The target population included individuals with type 2 diabetes (T2D) aged 40 years, without retinopathy, followed over a 40-year time horizon. A Markov model was developed with five health states and a 1-year cycle. Model parameters were based on literature and country databases. One-way and probabilistic sensitivity analyses were performed to assess model parameters' uncertainty. WHO willingness-to-pay (WHO-WTP) thresholds were used as reference (i.e. one and three times the Brazilian per capita Gross Domestic Product of R$32747 in 2018).
resultsCompared to usual practice, the systematic teleophthalmology-based screening was associated with an incremental cost of R$21445/QALY gained ($9792/QALY gained). The systematic ophthalmology referral-based screening was more expensive (incremental costs = R$4) and less effective (incremental QALY = -0.012) compared to the systematic teleophthalmology-based screening. The probability of systematic teleophthalmology-based screening being cost-effective compared to usual practice was 0.46 and 0.67 at the minimum and the maximum WHO-WTP thresholds, respectively.
conclusionSystematic teleophthalmology-based DR screening for the Brazilian population with T2D would be considered very cost effective compared to the opportunistic ophthalmology referral-based screening according to the WHO-WTP threshold. However, there is still a considerable amount of uncertainty around the results.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.