Colour vision testing for diabetic retinopathy: a systematic review of diagnostic accuracy and economic evaluation.

摘要: Objective To determine the diagnostic performance and cost-effectiveness of colour vision testing (CVT) to identify monitor progression diabetic retinopathy (DR). Data sources Major electronic databases including MEDLINE, EMBASE, Cumulative Index Nursing Allied Health Literature, Cochrane Database Systematic Reviews were searched from inception September 2008. Review methods A systematic review evidence was carried out according standard methods. An online survey National Screening Programme for Diabetic Retinopathy (NSPDR) clinical leads programme managers assessed tools used routinely by local centres their views on future research priorities. decision tree Markov model developed estimate incremental costs effects adding CVT current NSPDR. Results In total, 25 studies met inclusion criteria review, 18 presenting 2 x accuracy data. The quality reporting generally poor. Automated or computerised CVTs reported variable sensitivities (63-97%) specificities (71-95%). One study good estimates plus retinal photography detection sight-threatening DR, but it included few cases in total. pseudoisochromatic plates, anomaloscopes arrangement tests largely inadequate DR screening, with Youden indices (sensitivity + specificity - 100%) close zero. No located that addressed patient preferences relating DR. Retinal is universally employed as primary method screening responding survey; none CVT. economic evaluation literature found no previous describing cost any type Our suggested national could be cost-effective if adequately increases sensitivity relatively inexpensive. deterministic base-case analysis indicated per quality-adjusted life-year gained may 6364 pounds 12,432 1 diabetes respectively. However, probabilistic highlighted substantial probability not diagnostically accurate enough either an effective a addition results should treated caution based only one small study. Conclusions There insufficient support use alone, combination photography, patients diabetes. Better directly comparing value are needed before drawing conclusions cost-effectiveness. most frequently cited preference optical coherence tomography clinically significant macular oedema.