Cost-effectiveness of digital cataract assessment

Purpose: The aim of this study was to compare costs of digital photograph grading with that of film-based, human grading of the lens in epidemiological studies involving cataract assessment. Methods: Cost-effectiveness was measured by establishing the number of participants with ungradeable images and incorporating these lost data into the overall cost per participant for each study. Results: The digital grading system cost was A$105 000 with operating costs of $2.81 per participant, with 99.4% effectiveness. The film-based, human grading set-up costs were $43 000 with operating costs of $18.49 per participant and 90% effectiveness. After examining 3500 people the use of the digital equipment becomes cost-beneficial. Conclusions: The high costs of setting up a digital cataract grading system are offset by the low running costs, less ungradeable images and greater accuracy over the duration of a large scale ophthalmic epidemiological study.