Screening colonoscopy by mid-level practitioners
Adams E
Record ID 32005000278
English
Authors' objectives:
This study aims to provide a bibliographic list of completed health technology assessments and relevant literature on screening colonoscopy by mid-level practitioners.
Authors' results and conclusions:
VATAP uncovered no completed studies in the published, peer-reviewed literature or ongoing trials comparing the use of physicians to mid-level practitioners for screening colonoscopy, nor did VATAP uncover any available practice guidelines on the subject by the major professional societies in the United States. Currently, CMS Medicare reimbursement for screening colonoscopy is limited to procedures performed by a doctor of medicine or osteopathy.
A survey of experienced advanced practice registered nurses (APRNs) provides some insight into the professional interest in this topic. It found a willingness among many APRNs to perform colonoscopy for either diagnostic and possibly therapeutic procedures, but lack of education, limited training opportunities, lack of physician support, and lack of policies were common barriers to their performing colonoscopy. The author advocated developing policies and establishing acceptable training guidelines and competency rates in performing GI endoscopic procedures.
Authors' recommendations:
Given the lack of conclusive evidence comparing mid-level practitioners to physician specialists for screening colonoscopy, well-designed clinical trials with outcomes monitoring are warranted to ensure quality and cost-effective patient care. This is a rapidly evolving area. The QUERI-CRC projects, such as developing a data system for informing, monitoring and assessing outcomes of screening-promotion projects, should help inform decisions about the best approaches to improving colorectal cancer screening and follow up in VA.
Authors' methods:
Bibliography
Details
Project Status:
Completed
Year Published:
2004
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Colonoscopy
- Mass Screening
- Colorectal Neoplasms
Contact
Organisation Name:
VA Technology Assessment Program
Contact Address:
Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;
Contact Name:
elizabeth.adams@med.va.gov
Contact Email:
elizabeth.adams@med.va.gov
Copyright:
Technology Assessment Unit, Office of Patient Care Services, US Department of Veterans Affairs (VATAP)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.