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Arch Ophthalmol. 2009 Sep;127(9):1183-93. doi: 10.1001/archophthalmol.2009.113.

Use of Global Visual Acuity Data in a time trade-off approach to calculate the cost utility of cataract surgery.

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1
Fundacion Vision, Asuncion, Paraguay.

Erratum in

  • Arch Ophthalmol. 2009 Dec;127(12):1609.

Abstract

OBJECTIVE:

To determine the cost utility of cataract surgery worldwide using visual acuity (VA) outcomes and utility values determined by the time trade-off (TTO) method.

DATA SOURCES:

Some cost data were taken from a previous search conducted for 1995 to 2006 and we searched MEDLINE and Scopus and Google for more recent data (2006 and 2007).

STUDY SELECTION:

Articles were identified from the literature using "cataract surgery" in combination with the terms outcome or visual acuity. Additional searches were conducted using individual countries as a term in combination with VA, outcome, or cost. Regression curves were constructed from utility values derived from a TTO study and VA data. Gains in quality-adjusted life-years (QALYs) were calculated based on life expectancy tables from the World Health Organization and discounts of 3% for both cost and benefit. Sensitivity analyses explored the effect of changes in discounting, life expectancy, preoperative VA, and cost.

DATA EXTRACTION:

If the data were usable, they were kept; otherwise they were discarded.

DATA SYNTHESIS:

Preoperative VA (logMAR) correlated with increasing gross national income per capita (Pearson correlation coefficient, -0.784; P < .001) and showed that in developing countries preoperative vision is much poorer compared with developed countries. Cost utility data ranged from $3.5 to $834/QALY in developing countries to $159 to $1356/QALY in developed countries. Sensitivity analysis showed that changing life expectancy, VA, and discount rate resulted in moderate changes.

CONCLUSIONS:

The TTO approach demonstrates that cataract surgery is extremely cost-effective.

PMID:
19752429
DOI:
10.1001/archophthalmol.2009.113
[Indexed for MEDLINE]
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