Table 1. Probabilities, Costs, and Outcomes Modeled and Sensitivity Analysis Ranges.
| Factor | Estimate | Sensitivity analysis range | Distribution modeled | Source |
|---|---|---|---|---|
| Probabilities | ||||
| Treatment-requiring ROP incidence | 0.05 | 0.01-0.20 | Beta | Quinn et al,23 2018; Mitsiakos and Papageorgiou,24 2018 |
| Sensitivity of ophthalmoscopy | 0.9 | 0.75-0.999 | Beta | Biten et al,28 2018 |
| Specificity of ophthalmoscopy | 0.99 | 0.75-0.999 | Beta | Biten et al,28 2018 |
| Sensitivity of telemedicine | 0.9 | 0.75-0.999 | Beta | Biten et al,28 2018; Cheng et al,29 2019; Chiang et al,30 2006 |
| Specificity of telemedicine | 0.85 | 0.60-0.99 | Beta | Biten et al,28 2018; Cheng et al,29 2019; Chiang et al,30 2006 |
| Sensitivity of AI | 0.9 | 0.75-0.999 | Beta | Brown et al,15 2018; Redd et al,33 2018; Greenwald et al,38 2020 |
| Specificity of AI | 0.85 | 0.60-0.99 | Beta | Brown et al,15 2018; Redd et al,33 2018; Greenwald et al,38 2020 |
| Image readability | 0.95 | 0.75-0.999 | Beta | Coyner et al,39 2018 |
| Costs | ||||
| Ophthalmoscopy initial evaluation, $ | 136.08 | 108.86-163.30 | Gamma | US Centers for Medicare & Medicaid Services35 |
| Ophthalmoscopy follow-up evaluation, $ | 71.88 | 57.50-86.25 | Gamma | US Centers for Medicare & Medicaid Services35 |
| Extended ophthalmoscopy, $ | 49.90 | 39.93-59.88 | Gamma | US Centers for Medicare & Medicaid Services35 |
| Ophthalmoscopy examination time, min | 30 | 15-45 | Gamma | NA |
| No. of ophthalmoscopy examinations | 4 | 3-8 | Gamma | NA |
| Telemedicine initial evaluation, $a | 16.05 | 12.84-19.26 | Gamma | US Centers for Medicare & Medicaid Services35 |
| Telemedicine follow-up evaluation, $a | 31.06 | 24.85-37.27 | Gamma | US Centers for Medicare & Medicaid Services35 |
| Telemedicine read time, min | 5 | 3-10 | Gamma | NA |
| No. of telemedicine examinations | 6 | 2-8 | Gamma | NA |
| AI cost, $a | 30 | 5-100 | Gamma | NA |
| AI review time, min | 1 | 0.5-5 | Gamma | NA |
| No. of AI examinations | 6 | 4-8 | Gamma | NA |
| Hours worked/wk | 50 | 60-80 | Gamma | NA |
| Weeks worked/y | 48 | 44-52 | Gamma | NA |
| Salary, $ | 250 000 | 125 000-400 000 | Gamma | NA |
| Laser coagulation treatment, $ | 1167.52 | 500-5000 | Gamma | US Centers for Medicare & Medicaid Services35 |
| Societal cost, $ | ||||
| Treatment needed | 24 554 | 19 643-29 465 | Gamma | Brown et al,37 2016 |
| No treatment needed | 14 056 | 11 245-16 867 | Gamma | Brown et al,37 2016 |
| Outcomes | ||||
| Timely treatment utility | 0.628 | 0.618-0.748 | Beta | Methods section |
| Correctly untreated utility | 0.748 | 0.7-0.8 | Beta | Methods section |
| Late treatment utility | 0.618 | 0.6-0.7 | Beta | Methods section |
| Life expectancy | 78.7 | 50-90 | Gamma | US Centers for Disease Control and Prevention40 |
| Discount rate | 0.03 | 0.01-0.05 | Beta | Sanders et al,22 2016 |
Abbreviations: AI, artificial intelligence; NA, not applicable; ROP, retinopathy of prematurity.
a
Professional fees and technical fees are considered together and include photographer costs.