{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T07:48:06Z","timestamp":1781596086501,"version":"3.54.5"},"reference-count":39,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,10,1]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Retinopathy of prematurity (ROP) is a leading cause of adverse visual outcomes in premature infants. Both laser photocoagulation and cryotherapy have been demonstrated in clinical trials to be efficacious in reducing the incidence of visual loss occurring secondary to threshold ROP. Visual data recently have become available concerning the long-term clinical efficacy of both treatments, as have data concerning the utility value of visual states in general. Accordingly, we undertook an analysis to ascertain the cost-effectiveness of laser photocoagulation and cryotherapy in the treatment of threshold ROP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design.<\/jats:title><jats:p>A computer simulation economic model is presented to evaluate the cost-effectiveness of cryotherapy and laser photocoagulation therapy, compared with the natural course of the disease, for treating premature infants with threshold ROP. The model applies long-term visual data from previous clinical trials, utility analysis, decision analysis, and economic principles, such as present value analysis, to account for the time value of money to arrive at a cost per quality-adjusted life-year (QALY) gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome Measures.<\/jats:title><jats:p>Cost per QALY gained from laser therapy and cryotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Laser photocoagulation therapy for threshold ROP costs $678 1998 US dollars (at a 3% discount rate to account for the time value of money) for each QALY gained from treatment. Cryotherapy for the same disease costs $1801 per QALY at a similar discount rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions.<\/jats:title><jats:p>From the point of view of cost-effectiveness, laser therapy seems to have an advantage over cryotherapy for the treatment of threshold ROP.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.104.4.e47","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:45:45Z","timestamp":1092440745000},"page":"e47-e47","source":"Crossref","is-referenced-by-count":83,"title":["Cost-Effectiveness of Treatment for Threshold Retinopathy of Prematurity"],"prefix":"10.1542","volume":"104","author":[{"given":"Gary C.","family":"Brown","sequence":"first","affiliation":[{"name":"From the Center for Evidence-Based Healthcare, Flourtown, Pennsylvania; the"},{"name":"Retina Service and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa M.","family":"Brown","sequence":"additional","affiliation":[{"name":"From the Center for Evidence-Based Healthcare, Flourtown, Pennsylvania; the"},{"name":"Cataract and Primary Eye Care Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Sharma","sequence":"additional","affiliation":[{"name":"From the Center for Evidence-Based Healthcare, Flourtown, Pennsylvania; the"},{"name":"Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Tasman","sequence":"additional","affiliation":[{"name":"Retina Service and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi C.","family":"Brown","sequence":"additional","affiliation":[{"name":"From the Center for Evidence-Based Healthcare, Flourtown, Pennsylvania; the"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1999,10,1]]},"reference":[{"key":"2021121002564346400_B1"},{"key":"2021121002564346400_B2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1001\/archopht.1990.01070040047029","article-title":"Multicenter trial of cryotherapy for retinopathy of prematurity: three month outcome.","volume":"108","author":"Cryotherapy for Retinopathy of Prematurity Cooperative Study Group","year":"1990","journal-title":"Arch Ophthalmol"},{"key":"2021121002564346400_B3","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1001\/archopht.1993.01090030057039","article-title":"Multicenter trial of cryotherapy for retinopathy of prematurity: 3\u00bd-year outcome\u2014structure and function.","volume":"111","author":"Cryotherapy for Retinopathy of Prematurity Cooperative Group","year":"1993","journal-title":"Arch Ophthalmol"},{"key":"2021121002564346400_B4","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1001\/archopht.1994.01090140028007","article-title":"Laser therapy for retinopathy of prematurity.","volume":"112","author":"The Laser ROP Study Group","year":"1994","journal-title":"Arch Ophthalmol"},{"key":"2021121002564346400_B5","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3928\/0191-3913-19970301-06","article-title":"Randomized comparison of diode laser photocoagulation versus cryotherapy for threshold retinopathy of prematurity: 3-year outcome.","volume":"34","author":"White","year":"1997","journal-title":"J Pediatr Ophthalmol Strabismus"},{"key":"2021121002564346400_B6","doi-asserted-by":"crossref","first-page":"1628","DOI":"10.1016\/S0161-6420(98)99029-7","article-title":"A comparison of laser photocoagulation with trans-scleral cryotherapy in the treatment of threshold retinopathy of prematurity.","volume":"105","author":"Connolly","year":"1998","journal-title":"Ophthalmology"},{"key":"2021121002564346400_B7","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1001\/archopht.1996.01100130413008","article-title":"Multicenter trial for retinopathy of prematurity: Snellen visual acuity and structural outcome at 5\u00bd years after randomization.","volume":"114","author":"Cryotherapy for Retinopathy of Prematurity Cooperative Group","year":"1996","journal-title":"Arch Ophthalmol"},{"key":"2021121002564346400_B8","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1016\/S0161-6420(90)32491-0","article-title":"Systemic complications associated with retinal cryoablation for retinopathy of prematurity.","volume":"97","author":"Brown","year":"1990","journal-title":"Ophthalmology"},{"key":"2021121002564346400_B9","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1016\/S0161-6420(97)30034-7","article-title":"Early treatment of posterior retinopathy of prematurity: a controlled clinical trial.","volume":"104","author":"Vander","year":"1997","journal-title":"Ophthalmology"},{"key":"2021121002564346400_B10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0167-6296(86)90020-2","article-title":"Measurement of health state utilities for economic appraisal. A review.","volume":"5","author":"Torrance","year":"1986","journal-title":"J Health Econ"},{"key":"2021121002564346400_B11","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/0021-9681(87)90019-1","article-title":"Utility approach to measuring health-related quality of life.","volume":"40","author":"Torrance","year":"1987","journal-title":"J Chron Dis"},{"key":"2021121002564346400_B12","doi-asserted-by":"crossref","first-page":"337","DOI":"10.7326\/0003-4819-126-5-199703010-00001","article-title":"Cost-effectiveness of screening for carotid stenosis in asymptomatic patients.","volume":"126","author":"Lee","year":"1997","journal-title":"Ann Intern Med."},{"key":"2021121002564346400_B13"},{"key":"2021121002564346400_B14"},{"key":"2021121002564346400_B15"},{"key":"2021121002564346400_B16","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/S0161-6420(91)32247-4","article-title":"Laser photocoagulation for stage 3+ retinopathy of prematurity.","volume":"98","author":"McNamara","year":"1991","journal-title":"Ophthalmology"},{"key":"2021121002564346400_B17"},{"key":"2021121002564346400_B18"},{"key":"2021121002564346400_B19"},{"key":"2021121002564346400_B20","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1056\/NEJM197703312961304","article-title":"Foundations of cost-effectiveness analysis for health and medical practices.","volume":"296","author":"Weinstein","year":"1977","journal-title":"N Engl J Med"},{"key":"2021121002564346400_B21"},{"key":"2021121002564346400_B22"},{"key":"2021121002564346400_B23"},{"key":"2021121002564346400_B24"},{"key":"2021121002564346400_B25","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1001\/jama.1996.03540160061034","article-title":"Panel on cost-effectiveness in health and medicine.","volume":"276","author":"Siegel","year":"1996","journal-title":"JAMA"},{"key":"2021121002564346400_B26","first-page":"271","article-title":"A clinician's guide to utility measurement.","volume":"22","author":"Redelmeier","year":"1995","journal-title":"Med Decis Making"},{"key":"2021121002564346400_B27","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/00055735-199906000-00012","article-title":"Evidence-based medicine, utilities and quality of life.","volume":"10","author":"Brown","year":"1999","journal-title":"Curr Opin Ophthalmol"},{"key":"2021121002564346400_B28","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1177\/0272989X9501500212","article-title":"Explaining distortions in utility elicitation through the rank-dependent model for risky choices.","volume":"15","author":"Wakker","year":"1995","journal-title":"Med Decis Making"},{"key":"2021121002564346400_B29","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/0277-9536(94)90162-7","article-title":"Cost utility analysis: what should be measured?","volume":"39","author":"Richardson","year":"1994","journal-title":"Soc Sci Med"},{"key":"2021121002564346400_B30","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1017\/S0266462300008461","article-title":"Utilities and quality-adjusted life years.","volume":"2","author":"Torrance","year":"1989","journal-title":"Int J Technol Assess Health Care"},{"key":"2021121002564346400_B31","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1056\/NEJM198304143081511","article-title":"Adding insult to injury: usurping patients' prerogatives.","volume":"308","author":"Kassirer","year":"1983","journal-title":"N Engl J Med"},{"key":"2021121002564346400_B32","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1056\/NEJM198405243102111","article-title":"Patients' preferences in randomized clinical trials.","volume":"310","author":"Angell","year":"1984","journal-title":"N Engl J Med"},{"key":"2021121002564346400_B33","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1056\/NEJM199406303302611","article-title":"Incorporating patients' preferences into medical decisions.","volume":"330","author":"Kassirer","year":"1994","journal-title":"N Engl J Med"},{"key":"2021121002564346400_B34","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/S0161-6420(88)33063-0","article-title":"Economic aspects of cataract.","volume":"95","author":"Drummond","year":"1988","journal-title":"Ophthalmology"},{"key":"2021121002564346400_B35","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1001\/jama.1989.03430130071037","article-title":"Are clinical trials a cost-effective investment?","volume":"262","author":"Detsky","year":"1989","journal-title":"JAMA"},{"key":"2021121002564346400_B36","first-page":"473","article-title":"How attractive does a new technology have to be to warrant adoption and utilization: tentative guidelines for using clinical and economic evaluation.","volume":"146","author":"Laupacis","year":"1992","journal-title":"Can Med Assoc J"},{"key":"2021121002564346400_B37","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1542\/peds.91.5.859","article-title":"Cost-effectiveness of screening and cryotherapy for threshold retinopathy of prematurity.","volume":"91","author":"Javitt","year":"1993","journal-title":"Pediatrics"},{"key":"2021121002564346400_B38","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1542\/peds.91.5.961","article-title":"Infants less than 1250 grams birth weight at Groote Schuur Hospital: outcome at 1 and 2 years of age.","volume":"91","author":"Thompson","year":"1993","journal-title":"Pediatrics"},{"key":"2021121002564346400_B39","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1177\/0272989X9301300409","article-title":"Markov models in medical decision making: a practical guide.","volume":"13","author":"Sonnenberg","year":"1993","journal-title":"Med Decis Making"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/104\/4\/e47\/842408\/e47.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/104\/4\/e47\/842408\/e47.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T05:31:18Z","timestamp":1682746278000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/104\/4\/e47\/62408\/Cost-Effectiveness-of-Treatment-for-Threshold"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,10,1]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1999,10,1]]},"published-print":{"date-parts":[[1999,10,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.104.4.e47","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[1999,10,1]]}}}