Cost-effectiveness of low-astigmatism correction with toric or spherical intraocular lenses combined with corneal incisions: an economic evaluation.

PURPOSE: To assess the cost-effectiveness of the treatment of low corneal astigmatism (≤1.5 D) at the moment of the cataract surgery. SETTING: ("Masked by journal requirement"). DESIGN: Economic Evaluation. METHODS: A decision tree was used to assess the cost-effectiveness of implanting spherical versus toric intraocular lenses (IOLs) or the spherical lens combined with the following corneal incisions: limbal relaxing incisions conducted manually (M-LRI) or assisted by femtosecond laser (F-LRI), arcuate keratotomies conducted manually (M-AK) or assisted by femtosecond (F-AK), and intrastromal arcuate keratotomies (F-iAK). Outcomes of cost were selected from a patient's perspective considering the gross cost of each one of the surgeries at European centers, and the effectiveness variable was the probability of achieving a visual acuity of 20/20 after surgery. A sensitivity analysis was conducted to assess the uncertainty considering the evidence retrieved from the transition probabilities of the model, the effectiveness, and the cost. RESULTS: F-AK or Toric IOLs were the most effective treatments, increasing an 16% or 9%, respectively, in the percentage of eyes attaining 20/20 vision. The M-LRI, F-iAK, and F-LRI procedures were strongly dominated, while the M-AK and toric IOL were weakly dominated by the F-AK. A patient with low corneal astigmatism would need to be willing to pay 360€ [CI 95%: 231-1224] with F-AK and 472€ [CI 95%: 149-4490] with toric IOLs for a 10% increase in the probability of achieving 20/20 vision. CONCLUSIONS: From the patient's perspective, F-AK was generally the most cost-effective treatment, even though toric IOLs can dominate in some countries.

The Syrian refugee crisis: how local governments and NGOs manage their image via social media.

This study, based on situational crisis communication theory and set in the context of the Syrian refugee crisis, seeks first to conduct a comparative analysis of the management of online citizen engagement by local governments and non-governmental organisations (NGOs). Second, it aims to examine the relationship between certain factors pertaining to the types of responses submitted by citizens via the social media of the aforementioned actors. The sample is composed of several Spanish local governments and NGOs belonging to Red de Municipios de Acogida de Refugiados (Local Government Network for Refugee Allocation). The main findings are that NGOs' online engagement with citizens is more than that of local governments. Notably, NGOs are much more active on their Facebook pages than are local governments. The two actors converge, though, in terms of disseminating instructive information and paying less attention to 'basic crisis response options'. Moreover, the factors 'content type', 'reputation', and 'woman' affect the type of response messages sent by citizens.