Cost-effectiveness of glaucoma screening: a systematic review protocol.

Abstract

Glaucoma is an increasing global health problem and the leading cause of irreversible blindness which affects millions of people worldwide. Multiple studies on the cost-effectiveness of glaucoma screening conducted at community, clinic or hospital in developed and developing countries have been conducted, but evidence from systematic reviews is lacking. Therefore, this systematic review aims to assess the cost-effectiveness of glaucoma screening among adult populations across various countries and healthcare settings. A systematic search will be conducted in databases including PubMed using a combination of Medical Subject Headings such as glaucoma and cost-effectiveness analysis along with relevant keywords like screening. Following the predefined inclusion criteria, two reviewers will independently screen the titles, abstract and full text, and any disagreements will be discussed or resolved by a third reviewer. Methodological quality will be assessed using the Joanna Briggs Institute (JBI) checklist for economic evaluations. Data will be extracted using the JBI economic evaluation data extraction form with any suitable modifications. JBI Dominance Ranking Matrix for economic evaluations will be used to summarise and compare the results for data synthesis. All reported costs will be converted into a single currency and year prior to synthesis. Cost-effectiveness evidence will be synthesised on the basis of cost per case detected or blindness prevented, cost per quality-adjusted life year gained or cost per disability-adjusted life year averted. Grading of Recommendations, Assessment, Development and Evaluation assessment will be conducted to evaluate the certainty of economic evidence, such as use of resources and expenditures, and to incorporate the results into the decision-making process. This systematic review will analyse published peer-reviewed studies and targeted grey literature only and does not require ethics committee approval. Results will be disseminated through publication in a peer-reviewed journal and through conference presentations. Extracted data and supporting materials will be made available on reasonable request. CRD42017057560.