Use of Global Visual Acuity Data in a time trade-off approach to calculate the cost utility of cataract surgery.
Arch Ophthalmol
; 127(9): 1183-93, 2009 Sep.
Article
em En
| MEDLINE
| ID: mdl-19752429
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Catarata
/
Extração de Catarata
/
Acuidade Visual
/
Custos de Cuidados de Saúde
/
Anos de Vida Ajustados por Qualidade de Vida
Tipo de estudo:
Health_economic_evaluation
/
Prognostic_studies
Aspecto:
Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Arch Ophthalmol
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Paraguai
País de publicação:
Estados Unidos