Addressing the structural challenges of insufficient and unevenly distributed ophthalmic healthcare resources, Professor Lin Haotian's team at Sun Yat-sen Eye Center, Sun Yat-sen University, collaborated with Associate Professor Pan Rong's team at the School of Computer Science, Sun Yat-sen University. They validated, from a health economics perspective, the cost-effectiveness of the "new three-tier diagnosis and treatment" model based on the previously developed digital intelligent technology of "home self-screening - community screening - hospital referral." The study confirmed the cost-effectiveness of the new model in both urban and rural areas in China, with optimal screening cost-effectiveness annually. The related findings were published online on April 30th in "Nature Communications."
Illustration of the "New Three-tier Diagnosis and Treatment Model". Image provided by the research team.
"This study combines the current situation in China to recommend the optimal cataract screening strategy for the Chinese population from urban and rural perspectives, providing new ideas for the economic and efficient screening of common blinding eye diseases, and offering a basis for government departments to formulate public health strategies for eye disease prevention and control." Lin Haotian, the co-corresponding author of the paper, stated that as a top domestic institution of higher learning, Sun Yat-sen University actively explores the interdisciplinary development model of "Medicine + X" and is committed to promoting innovation in medical research and practice.
With the global trend of aging populations, chronic non-communicable diseases such as blinding eye diseases occupy a major position in the disease spectrum. Early diagnosis and timely management are crucial for improving patients' quality of life and reducing the burden on healthcare. Taking cataracts, the leading cause of blindness worldwide, as an example, it is estimated that by 2050, there will be 20 million cases of cataract-induced blindness in China. However, the current structural challenges of limited high-quality medical resources and inadequate primary healthcare service capabilities in China directly hinder the effective implementation of widespread screening for blinding eye diseases like cataracts.
The "New Three-tier Diagnosis and Treatment Model" relies on digital intelligent technologies such as artificial intelligence, big data, 5G, Internet of Things, and cloud computing. It consists of three steps: first, residents use smart mobile devices at home to take photos of their eyes for initial screening by AI; second, suspicious patients are guided to community health service centers for AI examination and assessment; third, patients requiring referral are transferred to tertiary specialized hospitals for treatment. This model significantly reduces screening costs, avoids wastage of medical resources due to unnecessary referrals, enhances the efficient utilization of high-quality medical resources, and guides the efficient implementation of large-scale cataract screening based on populations.
By constructing a Markov model, this study simulated the natural development process of cataracts in urban and rural scenarios for 100,000 person-times in China, achieving cost-effectiveness and cost-utility analyses of cataract diagnosis and treatment under different screening strategies. The results indicate that compared to no screening, remote screening, and traditional AI screening models, the "New Three-tier Diagnosis and Treatment Model" has the highest health economic value in both urban and rural China. Additionally, conducting the new three-tier screening annually helps in early patient detection and timely referral, making it the most cost-effective solution, reducing total costs by 6.24%, increasing quality-adjusted life years by 1.78% for the population, and avoiding 15.50% of blind years.
It was reported that in recent years, Lin Haotian's team has collaborated with various interdisciplinary strengths within the university to establish a medical artificial intelligence interdisciplinary talent team, create an intelligent screening technology system for blinding eye diseases, lead global intelligent medical development, develop ophthalmic surgery intelligent navigation systems and robots to enhance surgical predictability, precision, and stability, establish an intelligent three-tier diagnosis and treatment technology application platform, innovate blinding eye disease prevention and control models and efficacy. Their research achievements have been applied in numerous institutions nationwide and along the "Belt and Road" initiative, expanding the availability of high-quality medical resources.
For more information on the related paper: https://doi.org/10.1038/s41467-024-47211-w
