• CME

  • The Potential Cost Effectiveness of Amblyopia Screening Programs

    Earn CME Credit »
  • Author(s)/Faculty: David B. Rein, PhD; John S. Wittenborn, BS; Xinzhi Zhang, MD, PhD; Michael Song, BS; Jinan B. Saaddine, MD, MPH
    Source: Journal of Pediatric Ophthalmology & Strabismus 49:3
    Type: Journal Articles/Items: 1
    Release Date: 5/1/2012 Expiration Date: 5/15/2013
    Credit Type: CME Number of Credit(s): 1
    Cost: Free Provider: Vindico Medical Education

  • Purpose: To estimate the incremental cost-effectiveness of amblyopia screening at preschool and kindergarten, the costs and benefits of three amblyopia screening scenarios were compared to no screening and to each other: (1) acuity/stereopsis (A/S) screening at kindergarten, (2) A/S screening at preschool and kindergarten, and (3) photoscreening at preschool and A/S screening at kindergarten.

    Methods: A probabilistic microsimulation model of amblyopia natural history and response to treatment with screening costs and outcomes estimated from two state programs was programmed. The probability was calculated that no screening and each of the three interventions were most cost-effective per incremental quality-adjusted life year (QALY) gained and case avoided.

    Results: Assuming a minimal 0.01 utility loss from monocular vision loss, no screening was most cost-effective with a willingness to pay (WTP) of less than $16,000 per QALY gained. A/S screening at kindergarten alone was most cost-effective at a WTP between $17,000 and $21,000. A/S screening at preschool and kindergarten was most cost-effective at a WTP between $22,000 and $75,000, and photoscreening at preschool and A/S screening at kindergarten was most cost-effective at a WTP greater than $75,000. Cost-effectiveness substantially improved when assuming a greater utility loss. All scenarios were cost-effective when assuming a WTP of $10,500 per case of amblyopia cured.

    Conclusion: All three screening interventions evaluated are likely to be considered cost-effective relative to many other potential public health programs. The choice of screening option depends on budgetary resources and the value placed on monocular vision loss prevention by funding agencies.
EDUCATIONAL OBJECTIVES

1.    Readers will be able to evaluate the cost-effectiveness of three amblyopia screening strategies to facilitate early detection and treatment.

2.    Readers should be able to discuss the operation, cost, and efficacy of school and preschool-based vision screening programs, including how effective treatment of children identified by screening programs may reduce the prevalence and long-term outcomes of amblyopia.

METHOD FOR OBTAINING CREDIT CERTIFICATE

Your answers will be graded and you will receive a certificate via mail within 4 to 6 weeks advising you whether you have passed or failed. A score of at least 75% is required to pass. Unanswered questions will be considered incorrect.

CME ACCREDITATION

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vindico Medical Education and the Journal of Pediatric Ophthalmology & Strabismus. Vindico Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

Vindico Medical Education designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This activity is approved for credit from the original date of release, May 1, 2012, through the expiration date of May 15, 2013.

FULL DISCLOSURE POLICY

In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears prior to the content.

UNLABELED AND INVESTIGATIONAL USAGE

The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage.

TARGET AUDIENCE

This CME activity is primarily targeted to pediatric ophthalmologists and ophthalmic surgeons. There are no specific background requirements for participants taking this activity.