Health Economics (Workstream D)

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Workstream D: Health Economics

Workstream D of the ISDR study is responsible for all work relating to health economics.

Risk-based screening has the potential to improve outcomes by identifying people with high risk at an earlier stage, making treatment more effective. It also has the potential to reduce unnecessary screening for people who are at low risk of developing sight-threatening diabetic retinopathy, and who could safely be screened less frequently. Moving to a risk-based screening programme therefore has important implications for costs as well as outcomes. The health economics team will consider these together.


The purpose of the project is to evaluate whether or not risk-based screening could be more cost-effective than annual screening. To do this we need to collect information about the effects on people’s health of different intervals of screening. We also need to estimate the costs of screening and of treatments such as laser surgery. Once we have all of this information we can determine whether or not it would be better to move to a policy of risk-based screening instead of annual screening.

To achieve this aim we adopt a number of approaches. We are collecting questionnaires from participants in the trial that enable us to quantify the cost to service users of attending screening, and also their quality of life. We work closely with the other workstreams to obtain data from the study’s Data Warehouse, which stores all data retrieved for the study on screening attendances and treatment. These data are combined using computer simulations to see what might happen over time and which type of screening programme is likely to be the most cost-effective.