Quality metrics of screening colonoscopies performed by PAs

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.
Source: Journal of the American Academy of Physician Assistants - Category: Primary Care Tags: Original Research Source Type: research

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This article reviews alternative colorectal cancer (CRC) screening tests, including flexible sigmoidoscopy (FS), computed tomography (CT) colonography, and colon capsule endoscopy. FS has abundant and convincing evidence supporting its use for CRC screening and is a commonly used CRC test worldwide. CT colonography has demonstrated convincing results for CRC screening, but concerns regarding cost, accuracy for flat or sessile neoplasia, reproducibility, extracolonic findings, and lack of coverage have limited its use and development. Colon capsule endoscopy has demonstrated encouraging results for polyp detection in averag...
Source: Clinical Colorectal Cancer - Category: Cancer & Oncology Authors: Tags: Gastrointest Endosc Clin N Am Source Type: research
Abstract After 2 screen-setting studies showing high sensitivity for colorectal cancer and advanced precancerous lesions, multitarget stool DNA testing was endorsed by the US Preventative Services Task Force as a first-line colorectal cancer screening test. Uptake has increased exponentially since approval by the US Food and Drug Administration and Centers for Medicare and Medicaid Services. Adherence to testing is approximately 70%. Patients with positive results have high diagnostic colonoscopy completion rates in single-center studies. The positive predictive value for colorectal neoplasia in postapproval studi...
Source: Clinical Colorectal Cancer - Category: Cancer & Oncology Authors: Tags: Gastrointest Endosc Clin N Am Source Type: research
Abstract The goal of colorectal cancer (CRC) screening with colonoscopy is to minimize CRC with minimal risk and cost. In order to continuously improve the quality of colonoscopy, different outcomes must be measured. For this topic, the priority indicators to be measured are (1) frequency of scheduling colonoscopy at appropriate interval based on current guidelines; (2) frequency of identifying adenomas in average-risk individuals undergoing their first screening colonoscopy; and, (3) providing guideline-consistent recommendations for repeat colonoscopy after the procedure. PMID: 32439087 [PubMed - in process]
Source: Clinical Colorectal Cancer - Category: Cancer & Oncology Authors: Tags: Gastrointest Endosc Clin N Am Source Type: research
Abstract Most colorectal cancer screening in the United States occurs in the opportunistic setting, where screening is initiated by a patient-provider interaction. Colonoscopy provides the longest-interval protection, and high-quality colonoscopy is ideally suited to the opportunistic setting. Both detection and colonoscopic resection have improved as a result of intense scientific investigation. Further improvements in detection are expected with the introduction of artificial intelligence programs into colonoscopy platforms. We may expect recommended intervals or colonoscopy after negative examinations performed...
Source: Clinical Colorectal Cancer - Category: Cancer & Oncology Authors: Tags: Gastrointest Endosc Clin N Am Source Type: research
Source: Gastroenterology - Category: Gastroenterology Authors: Source Type: research
Authors: He L, Guo L, Hu C Abstract Data regarding Computed Tomography colonography, standard optical colonoscopy, and enhanced colonoscopy/histopathology at 1-year after surgery and at 6-month intervals for the next 2 years of 345 patients who faced curative surgery for colorectal cancer were included in the analysis. Computed Tomography colonography and standard optical colonoscopy both detected 298 polyps as suspicious. With reference to enhanced colonoscopy/histopathology, sensitivities for the detection of any polyps for Computed Tomography colonography and standard optical colonoscopy were 0.952 and 0.906. Wh...
Source: Cancer Investigation - Category: Cancer & Oncology Tags: Cancer Invest Source Type: research
Among the many remarkable things that have happened since the COVID-19 pandemic began is that a lot of our usual medical care has simply stopped. According to a recent study, routine testing for cervical cancer, cholesterol, and blood sugar is down nearly 70% across the country. Elective surgeries, routine physical examinations, and other screening tests have been canceled or rescheduled so that people can stay at home, avoid being around others who might be sick, and avoid unknowingly spreading the virus. Many clinics, hospitals, and doctors’ offices have been closed for weeks except for emergencies. Even if these f...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Health care Healthy Aging Men's Health Women's Health Source Type: blogs
Colonoscopy is the reference standard for the detection of colorectal cancer but it is an invasive technique and has the risk of bowel perforation and bleeding. Unlike colonoscopy, sedation is not required in ...
Source: BMC Medical Imaging - Category: Radiology Authors: Tags: Research article Source Type: research
Condition:   Colorectal Neoplasms Intervention:   Sponsor:   VA Office of Research and Development Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
This article summarizes the clinical questions and bottom-line answers from the top 20 POEMs of 2019. Taking blood pressure medications at night results in a large mortality reduction over six years compared with morning dosing. Automated devices are the best way to measure blood pressure. Nonfasting lipid profiles are preferred over fasting lipid profiles, and nonfasting and fasting lipid profiles are equally effective at predicting risk. The benefit of statins for primary prevention in people 75 years and older is uncertain at best. Aspirin has no net benefit for primary prevention of cardiovascular disease and has no ef...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
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