Evidence map›Paper›PMID 27560179›Full record

Observational studyPloS one2016

Physician Associate and General Practitioner Consultations: A Comparative Observational Video Study.

Simon de Lusignan, Andrew P McGovern, Mohammad Aumran Tahir, Simon Hassan, Simon Jones, Mary Halter, Louise Joly, Vari M Drennan

Abstract readComparative StudyObservational Study
In one paragraph

Observational study in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Review
  6. Review
  7. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Simon de LusignanDepartment of Clinical and Experimental Medicine University of Surrey, Guildford, GU2 7XH, United Kingdom.
Andrew P McGovernDepartment of Clinical and Experimental Medicine University of Surrey, Guildford, GU2 7XH, United Kingdom.
Mohammad Aumran TahirDepartment of Clinical and Experimental Medicine University of Surrey, Guildford, GU2 7XH, United Kingdom.
Simon HassanDepartment of Clinical and Experimental Medicine University of Surrey, Guildford, GU2 7XH, United Kingdom.
Simon JonesDepartment of Clinical and Experimental Medicine University of Surrey, Guildford, GU2 7XH, United Kingdom.
Mary HalterFaculty of Health, Social Care & Education, Kingston University & St. George's University of London, London, United Kingdom.
Louise JolySocial Care Workforce Research Unit King's College London, Strand, London, WC2R 2LS, United Kingdom.
Vari M DrennanFaculty of Health, Social Care & Education, Kingston University & St. George's University of London, London, United Kingdom.

Funding

Department of Health 09/1801/1066
6 · The paper itself

Abstract

backgroundPhysician associates, known internationally as physician assistants, are a mid-level practitioner, well established in the United States of America but new to the United Kingdom. A small number work in primary care under the supervision of general practitioners, where they most commonly see patients requesting same day appointments for new problems. As an adjunct to larger study, we investigated the quality of the patient consultation of physician associates in comparison to that of general practitioners.

methodWe conducted a comparative observational study using video recordings of consultations by volunteer physician associates and general practitioners with consenting patients in single surgery sessions. Recordings were assessed by experienced general practitioners, blinded to the type of the consulting practitioner, using the Leicester Assessment Package. Assessors were asked to comment on the safety of the recorded consultations and to attempt to identify the type of practitioner. Ratings were compared across practitioner type, alongside the number of presenting complaints discussed in each consultation and the number of these which were acute, minor, or regarding a chronic condition.

resultsWe assessed 62 consultations (41 general practitioner and 21 physician associates) from five general practitioners and four physician associates. All consultations were assessed as safe; but general practitioners were rated higher than PAs in all elements of consultation. The general practitioners were more likely than physician associates to see people with multiple presenting complaints (p<0.0001) and with chronic disease related complaints (p = 0.008). Assessors correctly identified general practitioner consultations but not physician associates. The Leicester Assessment Package had limited inter-rater and intra-rater reliability.

conclusionsThe physician associate consultations were with a less complex patient group. They were judged as competent and safe, although general practitioner consultations, unsurprisingly, were rated as more competent. Physician associates offer a complementary addition to the medical workforce in general practice.

Indexed as

Physician-Patient RelationsFemaleGeneral PractitionersHumansMalePhysician AssistantsPrimary Health CareReferral and ConsultationReproducibility of ResultsUnited KingdomVideo Recording

Identifiers

PMID27560179
PMCPMC4999215

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.