Quality metrics of screening colonoscopies performed by PAs

JAAPA. 2020 Apr;33(4):43-48. doi: 10.1097/01.JAA.0000657192.96190.ab.

Abstract

Background: Many communities face a shortage of qualified endoscopists. Training physician assistants (PAs) to perform colonoscopies can expand the availability of colorectal cancer screening. This study examined screening colonoscopy metrics and quality indicators among gastroenterologists, supervised PAs, and gastroenterology fellows.

Methods: Consecutive patients undergoing average-risk screening colonoscopy were stratified into one of three groups by endoscopist type. Procedure and pathology reports were reviewed for the technical performance and quality metrics of the providers.

Results: PAs performed comparably to gastroenterologists in technical performance and quality metrics, and demonstrated higher cecal intubation rates than their gastroenterologist colleagues. Comparisons of attending physicians and PAs grouped by years of experience also did not show notable differences in performance.

Conclusions: In a supervised practice, PAs performed on par with their gastroenterology colleagues on established colonoscopy quality indicators. Following proper training, PAs can be employed in the provision of screening colonoscopy.

MeSH terms

  • Clinical Competence*
  • Colonoscopy / education*
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / prevention & control*
  • Early Detection of Cancer / methods*
  • Female
  • Gastroenterologists
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Physician Assistants / education*
  • Quality Assurance, Health Care*