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published_or_final_version / abstract / Clinical Psychology / Master / Master of Social Sciences

OBJECTIVE To determine whether grading for AMD during a diabetic retinopathy (DR) screening program would be cost-effective in Hong Kong. METHODS A cost-effectiveness analysis based on a Markov model with six mutually exclusive health states was undertaken. It included grading for AMD and treatment with vitamin therapy for those with intermediate AMD. The outcome of the model was cost per quality-adjusted life year (QALY) gained. A public provider perspective was used. The measures of effectiveness were mostly taken from a local DR screening project except the transition probabilities and the utility values which were taken from overseas data. Costs were mainly taken from the Hospital Authority and salary scale 2009. The main assumptions and estimates were tested in sensitivity analyses. In this model, only subjects with non-sight threatening diabetic retinopathy were included and the possibility of disease regression and treatment benefit for those with advanced AMD were not considered. Both costs and benefits were discounted at 3%. RESULTS The cost per QALY gained through grading for AMD at the time of DR screening and treatment with vitamins of appropriate cases was HK$47,397 after discounting. This would be considered highly cost-effective based on the World Health Organization’s threshold of willingness-to-pay (WTP) for a QALY, e.g. less than the annual per capita GDP HK$300,000. One way sensitivity analyses revealed that the cost per QALY was most sensitive to utility value, discount rate, progression rate from intermediate to advanced AMD, and compliance rate for the treatment. The cost-effectiveness acceptability curve showed that at a WTP for a QALY of $100,000 or more, this AMD screening programme has over 90% of probability of being cost-effective compared with no screening. CONCLUSION Our cost-effectiveness analysis demonstrated that grading for AMD at the time of DR screening among diabetic patients would probably be cost-effective in a Hong Kong public hospital setting. / published_or_final_version / Public Health / Master / Master of Public Health

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There is no abstract available for this thesis. / Department of Physiology and Health Science

Thesis (M.S.)--University of Wisconsin--Madison, 1984. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 28-29).

Prospective memory refers to remembering to carry out an intended or planned action, such as keeping a doctor's appointment or telling a friend about an upcoming party. Despite its importance in everyday life, prospective memory has received little empirical or theoretical attention. Rather, much of the literature has focused on retrospective memory, that is, memory for information learnt in the past. The current literature on prospective memory addresses five aspects that are necessary for carrying out an intended action. These are (a) formulating the plan; (b) having the knowledge necessary to carry out the plan; (c) remembering the plan at the appropriate time; (d) carrying out the plan; and (e) remembering that the plan has been performed. The literature also raises three fundamental questions. Namely, whether prospective and retrospective memory involve different processes, whether self-report and behavioral measures of prospective memory are correlated, and whether prospective memory performance varies as a function of age. These questions were the focus of the exploratory studies presented in this dissertation. The first three studies involved the development of a memory diary, a memory questionnaire, and a metamemory questionnaire, respectively. These instruments were used in the fourth and fifth studies. Studies 4 and 5 also included behavioral measures of prospective memory and objective measures of retrospective memory. The fourth study examined how community-dwelling adults feel about, and use, their memory on a daily basis. In accordance with previous research, no age differences were observed on the behavioral measures of prospective memory. Moreover, performance on the self-report measures did not differ as a function of age. As hypothesized, age was correlated with performance on a retrospective memory task. The fifth study involved an extension and replication of Study 4, with the major addition being the use of several standard laboratory tests to assess retrospective memory. This study revealed several interesting findings. First, in contrast to previous studies, performance on some retrospective memory tasks was related to performance on some prospective memory tasks. Second, by and large, self-report and behavioral measures of prospective memory were not correlated. Third, performance on the prospective memory tasks (both self-report and behavioral) did not vary as a function of age, although performance ' on the retrospective memory tasks was clearly age related. The implications of this research are discussed. / Arts, Faculty of / Psychology, Department of / Graduate