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Cost-effectiveness of diabetic retinopathy screening programs using telemedicine: a systematic review

机译：使用远程医疗的糖尿病视网膜病变筛查计划的成本效益：系统评价

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Background:Diabetic retinopathy (DR) is a significant global public health and economic burden. DR accounts for approximately 15-17% of all cases of total blindness in the USA and Europe. Telemedicine is a new intervention for DR screening, however, there is not enough evidence to support its cost-effectiveness. The aim of this study is to review the most recent published literature on economic evaluations of telemedicine in DR screening and summarize the evidence on the cost-effectiveness of this technology.Methods:A systematic search of PubMed, Embase and Google Scholar for relevant articles published between January 2010 and January 2020. Studies were included if they met the following criteria: (1) recruited subjects with either type 1, type 2 diabetes (2) evaluated telemedicine technology (3) patients underwent primary screening for DR (4) compared a telemedicine-based intervention with standard care (5) performed an economic evaluation or provided sufficient data for evaluating the cost-effectiveness of the technology used.Results:Of 2238 articles screened, seven studies were included. Four of the studies were conducted in developed countries: The United States, Singapore and two studies in Canada. Three studies were conducted in developing countries: India, Brazil and South Africa. The patient populations in all studies were diabetic patients over the age of 18, previously not screened for DR. All seven studies used a telemedicine program which included capturing a retinal image and subsequently transmitting it to an ocular imaging center to assess the severity of DR. All studies compared telemedicine to a standard screening method for DR, including the option of no screening as standard of care. Although telemedicine requires initial and maintenance costs, it has the potential to provide significant cost savings by increasing patients' working ability, increasing independent living ability, increasing quality of life and reducing travel costs.Conclusions:Diabetic retinopathy telemedicine technology has the potential to provide significant cost savings, especially in low-income populations and rural patients with high transportation costs.? The Author(s) 2020.
机译：背景：糖尿病视网膜病变（DR）是一项重大的全球公共卫生和经济负担。博士占美国和欧洲所有盲目案件的约15-17％。远程医疗是博士筛查的新干预，但是，没有足够的证据来支持其成本效益。本研究的目的是审查博士筛选中远程医疗的经济评估的最新出版文献，并总结了关于这项技术成本效益的证据。方法：系统地搜索有关相关文章的PubMed，Embase和Google Scholar 2010年1月至1月2020年1月。如果他们达到以下标准，则包括研究：（1）患有1型糖尿病（2）型糖尿病技术（3）患者进行初级筛查（4）的患者比较A.基于远程医疗的干预标准护理（5）进行了经济评估或提供了足够的数据，用于评估所使用的技术的成本效益。结果：2238次筛选的文章，包括七项研究。在发达国家进行了四项研究：美国，新加坡和加拿大的两项研究。三项研究是在发展中国家进行的：印度，巴西和南非。所有研究中的患者群体都是18岁以上的糖尿病患者，以前没有筛查博士。所有七项研究用来了一个远程医疗程序，包括捕获视网膜图像并随后将其传送到眼部成像中心以评估DR的严重程度。所有研究都将远程医疗与DR的标准筛查方法进行比较，包括选择无筛选作为护理标准。虽然远程医疗需要初始和维护成本，但通过增加患者的工作能力，增加独立的生活能力，增加生活质量和降低旅行成本，可能会提供显着的成本节约。结论：糖尿病视网膜病理秘密技术有可能提供重要节省成本，特别是在低收入人口和农村运输成本患者中。作者2020年。

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