The clinical and cost-effectiveness of screening for open angle glaucoma

Purpose: The research will assess the extent to which screening for open angle glaucoma meets the UK National Screening Committee criteria for a screening programme; these criteria concern the condition, the test, the treatment and the screening programme. The specific objectives are: 1. To determine the most valid and acceptable tests or combination of tests for population screening and subsequent diagnosis of open angle glaucoma in a primary care setting and to assess the impact of testing on patient management and outcome 2. To estimate the treatment effects of alternative glaucoma interventions 3. To model the effects of treatment on the prevention of long-term visual impairment 4. To estimate the relative cost-effectiveness of alternative screening strategies and diagnostic pathways, including total costs and the potential benefits and harms of screening and subsequent management 5. To identify future research needs Methods: The research will have the following components: 1. A systematic review of screening and diagnostic strategies to determine the accuracy, reliability and acceptability of alternative strategies in different population groups (age specific, family history and racial groups) in a UK setting 2. An update of Cochrane reviews to assess short-term effects of alternative management strategies for glaucoma 3. A review with statistical modelling to extrapolate the effects of intraocular pressure (IOP) change on later visual impairment 4. A systematic review of economic evaluations, followed by economic modelling of cost-effectiveness and cost-utility, if possible, of alternative approaches to screening Output of the research: An evaluation report will be produced presenting the clinical and cost effectiveness of alternative models for screening for open angle glaucoma. The report will make recommendations based on these findings.