ArticleDiabetologia2020
A personalised screening strategy for diabetic retinopathy: a cost-effectiveness perspective.
Article in Diabetologia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Economic Evaluation of Diabetic Retinopathy Screening in Developing Countries: A Systematic Review.Korean journal of ophthalmology : KJO · 2025Pooled it
- Prognostic models for predicting the risk of foot ulcer or amputation in people with type 2 diabetes: a systematic review and external validation study.Diabetologia · 2021Pooled it
- The Burden of Delayed Diabetic Retinopathy Management and Use of Artificial Intelligence-Driven Screening Tools: A Systematic Literature Review.Ophthalmology and therapy · 2026Review
- Universal nomogram for predicting referable diabetic retinopathy: a validated model for community and ophthalmic outpatient populations using easily accessible indicators.Frontiers in endocrinology · 2025Article
- Cost-Effectiveness of SGLT2 Inhibitors in a Real-World Population: A MICADO Model-Based Analysis Using Routine Data from a GP Registry.PharmacoEconomics · 2023Article
- A risk prediction model for type 2 diabetes mellitus complicated with retinopathy based on machine learning and its application in health management.Frontiers in medicine · 2023Article
- Testing the performance of risk prediction models to determine progression to referable diabetic retinopathy in an Irish type 2 diabetes cohort.The British journal of ophthalmology · 2022Article
- Real-world outcomes of a clinical decision support system for diabetic retinopathy in Spain.BMJ open ophthalmology · 2022Article
- Usefulness of Machine Learning for Identification of Referable Diabetic Retinopathy in a Large-Scale Population-Based Study.Frontiers in medicine · 2021Article
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Authors and funding
8 authors.
Funding
Abstract
aims/hypothesisIn this study we examined the cost-effectiveness of three different screening strategies for diabetic retinopathy: using a personalised adaptive model, annual screening (fixed intervals), and the current Dutch guideline (stratified based on previous retinopathy grade).
methodsFor each individual, optimal diabetic retinopathy screening intervals were determined, using a validated risk prediction model. Observational data (1998-2017) from the Hoorn Diabetes Care System cohort of people with type 2 diabetes were used (n = 5514). The missing values of retinopathy grades were imputed using two scenarios of slow and fast sight-threatening retinopathy (STR) progression. By comparing the model-based screening intervals to observed time to develop STR, the number of delayed STR diagnoses was determined. Costs were calculated using the healthcare perspective and the societal perspective. Finally, outcomes and costs were compared for the different screening strategies.
resultsFor the fast STR progression scenario, personalised screening resulted in 11.6% more delayed STR diagnoses and €11.4 less costs per patient compared to annual screening from a healthcare perspective. The personalised screening model performed better in terms of timely diagnosis of STR (8.8% less delayed STR diagnosis) but it was slightly more expensive (€1.8 per patient from a healthcare perspective) than the Dutch guideline strategy. CONCLUSIONS/
interpretationThe personalised diabetic retinopathy screening model is more cost-effective than the Dutch guideline screening strategy. Although the personalised screening strategy was less effective, in terms of timely diagnosis of STR patients, than annual screening, the number of delayed STR diagnoses is low and the cost saving is considerable. With around one million people with type 2 diabetes in the Netherlands, implementing this personalised model could save €11.4 million per year compared with annual screening, at the cost of 658 delayed STR diagnoses with a maximum delayed time to diagnosis of 48 months.
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