A Hybrid Cohort Individual Sampling Natural History Model of Age-Related Macular Degeneration: Assessing the Cost-Effectiveness of Screening Using Probabilistic Calibration. Med Decis Making 2009

Background. Age-related macular degeneration (AMD) is a leading cause of visual impairment and blindness. It is likely that treatment of AMD at earlier stages is more effec-tive than later treatment; thus, screening for AMD should be considered. The aim of this study was to develop a natural history model of AMD to estimate the cost-effectiveness of screening. Methods. A hybrid cohort/individual sampling decision analytic model was developed. Primary data sets, expert elicitation, and data from the literature were used to populate the model. To incorporate joint parameter uncertainty, and to populate unobservable parameters, an innovative form of probabilistic calibration was applied to a range of output parameters. Results. In the reference case, annual screening from age 60 y is the most cost-effective option, although this is subject to high level