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目的:应用成本—效果分析的原理进行评价原发性闭角型青光眼不同筛检试验组成的筛检方案,从中选择出最优方案。方法:根据文献及我们研究的结果建立筛检模型及模型计算所需的参数,然后将手电筒侧照法、前房轴深、周边前房深度及手电筒侧照十周边前房深度串联法这四种筛检方法引入筛检模型的计算机程序进行计算,得出各种筛检方案筛检、诊断和治疗的成本;筛检出的病人多获得的质量调整寿命年。在这个基础上进行各种筛检方案的成本—效果分析。并改变部分参数作灵敏度分析,根据每增加一个质量调整寿命年需要成本最少或节约医疗费用最多为优选原则,选择出最优方案。结果:显示无论哪个年龄组,手电筒侧照十周边前房深度的串联筛检方案是每增加一个质量调整寿命年成本花费最少的方案,故为最优方案,手电筒侧照法作为筛检试验的筛检方案为次优方案。这两个方案对40岁～<70岁人群的原发性闭角型青光眼的筛检不但可以增加质量调整寿命年,而且可以节约医疗费用。灵敏度分析结果:除了当人群中窄房角高危者比例上升或下降到10％时,70岁以上年龄组的串联筛检方案从最优变为次优外,其余均显示手电筒侧照法十周边前房深度测量的串联筛检方案为最优方案。结论:研究显示手电筒侧照十周边前房深度测量的串联筛检方案为最优方?
OBJECTIVE: To evaluate the screening scheme of different screening tests in primary angle-closure glaucoma using the principle of cost-effectiveness analysis, and select the optimal scheme. Methods: Based on the literature and the results of our study, the screening model and the parameters needed for model calculation were established. Then the four methods of flashlight side-view method, anterior chamber depth, surrounding anterior chamber depth and flashlight side view anterior chamber depth series method The screening method was introduced into the screening model of the computer program to calculate the various screening programs were screened, the diagnosis and treatment costs; screening patients get more quality adjustment life years. On this basis for a variety of screening programs cost-effectiveness analysis. And change some of the parameters for sensitivity analysis, according to each additional quality to adjust life years need the least cost or save medical expenses up to the principle of the best, choose the best solution. Results: No matter which age group, flashlight side of the anterior chamber depth of 10 series screening program is to increase the quality of life for each additional cost to spend a minimum program, so the best solution, flashlight side as a screening test method Screening program for the sub-optimal program. Both programs screen primary age-related glaucoma in people aged 40 years to 70 years, not only increasing the quality-adjusted life year but also saving on medical costs. Sensitivity analysis results: Except when the proportion of high risk of narrow angle in the population increased or decreased to 10%, the series screening program in the age group of 70 years or older changed from optimal to suboptimal, and the rest showed that the flashlight lateral radiography ten weeks Anterior chamber depth measurement of the series screening program for the optimal solution. Conclusion: The study shows that flashlight side of the anterior chamber depth measurement of ten series screening program for the best side?