Fejleh M Phillip, Shen Ching-Chieh, Chen Jacqueline, Bushong Joseph A, Dieckgraefe Brian K, Sayuk Gregory S
M. Phillip Fejleh is a gastroenterology fellow at the University of California at Los Angeles. At Washington University in St. Louis, Mo., Ching-Chieh Shen is an internal medicine resident and Jacqueline Chen is a gastroenterology fellow. Joseph A. Bushong is a PA endoscopist at the St. Louis (Mo.) Veterans Affairs Medical Center. Brian K. Dieckgraefe is an associate professor of medicine at Washington University and practices at St. Louis Veterans Affairs Medical Center. Gregory S. Sayuk is an associate professor of medicine and psychiatry at Washington University and practices at St. Louis Veterans Affairs Medical Center. The authors have disclosed no potential conflicts of interest, financial or otherwise.
JAAPA. 2020 Apr;33(4):43-48. doi: 10.1097/01.JAA.0000657192.96190.ab.
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.
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.
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.
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.
许多社区面临合格内镜医师短缺的问题。培训医师助理（PA）进行结肠镜检查可扩大结直肠癌筛查的可及性。本研究调查了胃肠病学家、受监督的医师助理和胃肠病学住院医师的筛查结肠镜检查指标和质量指标。
接受平均风险筛查结肠镜检查的连续患者按内镜医师类型分为三组之一。审查了操作和病理报告以评估提供者的技术操作和质量指标。
医师助理在技术操作和质量指标方面与胃肠病学家表现相当，并且其盲肠插管率高于胃肠病学同事。按经验年限分组的主治医师和医师助理的比较在操作方面也未显示出显著差异。
在受监督的实践中，医师助理在既定的结肠镜检查质量指标方面与胃肠病学同事表现相当。经过适当培训后，医师助理可受聘进行筛查结肠镜检查。
