The Effectiveness of Teleglaucoma versus In-patient Examination. Assessment: Systematic Review, Meta-Analysis, and Cost-Effectiveness Analysis

Teleglaucoma is a screening device that remotely detects glaucoma cases at earlier stages using electronically-transferred stereoscopic digital imaging. Thus, patient wait and travel times are reduced, as well as, patient load in ophthalmic clinics. The purpose is to synthesize literature to evaluate teleglaucoma: its diagnostic accuracy, the healthcare system benefits, and its cost-effectiveness. A systematic review was conducted with published and unpublished studies. A meta-analysis was conducted to provide estimates of diagnostic accuracy, diagnostic odds ratio, and the relative percentage of glaucoma cases detected. Using Markov Modelling, a cost-effectiveness analysis was conducted. Of 11237 studies reviewed, 45 were included. Teleglaucoma was more specific and less sensitive than in-person examination. The pooled estimates of sensitivity was 0.832 [95% CI 0.770, 0.881] and specificity was 0.790 [95% CI 0.668, 0.876]. The ICER calculated for teleglaucoma was $27,460/QALY. In conclusion, teleglaucoma was found to be more cost-effective than in-person examination in rural areas.

Name thesis:degree_name

M Sc

Discipline thesis:degree_discipline

Epidemiology and Biostatistics

Grantor dc:publisher

The University of Western Ontario

Year dc:date.issued

2015

Author dc:creator

• Thomas, Sera-Melisa

Advisor dc:contributor.advisor

• Monali Malvankar-Mehta

• Teleglaucoma
• tele-ophthalmology
• glaucoma
• systematic review
• meta-analysis
• cost-effectiveness analysis

Language dc:language.iso

en_ca

Handle dc:identifier.uri

https://hdl.handle.net/20.500.14721/35883

OAI identifier oai:identifier

oai:uwo.scholaris.ca:20.500.14721/35883