Authors
Nascimento de Lima, Pedro, Vardavas, Raffaele, Katragadda, Sai Prathyush, Armour, Philip, Gadwah-Meaden, Catria, Fateh, Baqir, Yi, Stacey, Rojas Aguilera, Javier, Pujol-Mitchell, Toyya, Hernandez, Helin
- Division
- RAND National Security Research Division Personnel, Readiness, and Health Program
- Pages
- 84
- Published in
- United States
- RAND Identifier
- RR-A2188-1
- RAND Type
- report
- Rights
- RAND Corporation
- Series
- Research Reports
- Source
- https://www.rand.org/pubs/research_reports/RRA2188-1.html
Table of Contents
- Cost-Benefit Analysis of Comprehensive Military Eye Examination Policies 1
- About This Report 3
- RAND National Security Research Division 4
- Acknowledgments 4
- Summary 5
- Contents 9
- Figures and Tables 10
- Figures 10
- Tables 11
- Introduction and Background 13
- Comprehensive Eye Examinations and Current Policy 13
- The Burden of Ocular and Visual Dysfunction 15
- Our Analytic Approach 16
- The Organization of This Report 17
- Modeling the Dynamics of Visual Disorders Under Different Eye Examination Policies 18
- Introduction 18
- Simplifying Assumptions 20
- Policy Assumptions and Inputs 21
- General Model Inputs and Parameter Values 21
- Survival or Nonincidence Models 23
- Informing the Survival Function 25
- Treatment Inputs 26
- Performance and Accuracy Inputs of Screening and Comprehensive Eye Exams 27
- Other Fixed Costs 28
- Visual Readiness Value and the Readiness Cost of Ocular and Visual Dysfunction 29
- Informing the Visual Readiness Value Function 33
- Model Parameter Uncertainties 38
- Cost-Effectiveness and Cost-Benefit Analyses 39
- Cost-Benefit Analysis of Alternative Eye Examination Policies 41
- Sensitivity Analysis 41
- The Experimental Design and How Model Outputs Are Presented 43
- The Readiness Cost of Undiagnosed Ocular and Visual Dysfunctions 44
- The Role of Exam Specificity on Readiness Value and Readiness Cost 44
- Total Other Costs of Screening Policies 48
- The Net Monetary Benefit 51
- Varying Readiness Values 55
- Analysis of the Visual Readiness Trajectories of Service Members for Different Examination Policies 57
- Limitations Conclusions and Recommendations 60
- Conclusions and Implications 62
- Tables of Numerical Results 63
- Sensitivity Analysis and Modeling Limitations 66
- Modeling Limitations 67
- Informing the Model 67
- Data Limitations 68
- Sources of Modeling Heterogeneity 68
- Incidence Models 68
- Attrition and Other Health Factors 69
- Correlation of Ocular and Visual Dysfunctions 69
- Population-Level Linearity in the Readiness Value 69
- False Positivity Rates and Exams at Accession 70
- Estimation of Productivity Loss Associated with Onset of Low Vision in the Adult Civilian Population 71
- Input Tables 73
- Abbreviations 78
- References 79
