Summary:
Goal: To make the reader familiar with the term evidence based medicine (EBM),
to explain the principle of cost-effectiveness analysis (price-profit), and to show
its usefulness to compare the effectiveness of different medical procedures.
Method: Based on few examples, in this article the relevance and calculation of
important parameters of cost-effectiveness analysis (CE), as utility value (UV),
quality adjusted life years (QALY) is explained. In addition, calculation of UV and
QALY for the cataract surgery, including its complications, is provided.
Results: According to this method, laser photocoagulation and cryocoagulation of
the early stages of retinopathy of prematurity, treatment of amblyopia, cataract
surgery of one or both eyes, from the vitreoretinal procedures the early vitrectomy
in cases of hemophtalmus in proliferative diabetic retinopathy or grid laser
photocoagulation in diabetic macular edemaor worsening of the visual acuity due
to the branch retinal vein occlusion belong to highly effective procedures. On the
other hand, to the procedures with low cost effectiveness belongs the treating of
the central retinal artery occlusion with anterior chamber paracentesis, as well
as with CO2 inhalation, or photodynamic therapy in choroidal neovascularization
in age-related macular degeneration with visual acuity of the better eye 20/200. Conclusion: Cost-effectiveness analysis is a new perspective method evaluating
successfulness of medical procedure comparing the final effect with the financial
costs. In evaluation of effectiveness of individual procedures, three main aspects
are considered: subjective feeling of influence of the disease on the patient’s life,
objective results of clinical examination and financial costs of the procedure.
According to this method, the cataract surgery, as well as procedures in the
pediatric ophthalmology belong to the most effective surgical methods.
Key words:
evidence based medicine, utility value, cost-effectiveness, cataract
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