Cost comparison—ophthalmic grader pathway and standard care pathway
| Sensitivity | Specificity | Cost per 100 patients | Cost saving compared with standard care* | |
| Standard care pathway †† | Assumed 100% | Assumed 100% | £5800.00 | – |
| Ophthalmic grader evaluating seven-field ETDRS images* | 85% | 48% | £5339.00 | £461.00‡ |
| Ophthalmic grader evaluating UWF images* | 83% | 54% | £4611.00 | £1189.00§ |
*The analysis from which the sensitivity and specificity values are derived in this table are based on either eye being active and referrals to ophthalmologist. *=Grader referral for PDR = ‘active’ + ‘unsure’ + ‘ungradable’. The cost will not be increased if both eyes show active PDR.
†Standard care pathway=ophthalmologist face-to-face examination for active PDR in either eye.
‡Calculated as (time of taking ETDRS photos+costs of ophthalmic grader reading ETDRS photos) x100 +(52 × standard of care costs). Because of the specificity, 52% of patients will be referred to the ophthalmologist.
§Calculated as (time of taking UWF fundus images+costs of ophthalmic grader reading UWF images)*100 +(46 * standard of care costs). Because of the specificity, 46% of patients will be referred to the ophthalmologist.
ETDRS, Early Treatment for Diabetic Retinopathy Study; PDR, proliferative diabetic retinopath; UWF, ultrawide field.