[Cervical smears taken by physicians' assistants are of lesser quality than smears taken by family physicians, but almost as good as the national average].
OBJECTIVE
To compare the quality of cervical smears taken by practice assistants with the quality of smears taken by general practitioners.


METHODS
Retrospective.


METHODS
Data were collected on the 1672 smears taken as part of the population screening for cervical cancer and recorded 13 general practices in Limburg in the year 1997. The results of smears taken by practice assistants were compared with those made by general practitioners with regard to the quality indicators 'presence of endocervical cells' and 'absence of Pap-o'.


RESULTS
In 12.3% of the 481 cervical smears taken by the 17 practice assistants endocervical cells were absent. This is statistically significantly more than to the results (7.2%) in 1191 smears taken by the 22 general practitioners (relative risk: 1.70: 95% confidence interval: 1.23-2.70). Similar differences, but not statistically significant, were found with regard to Pap-o results and pathological findings. Most of the practice assistants had 1-2 years' experience. The proportion of smears made by practice assistants in which endocervical cells were lacking was reasonable compared with the average of 10% for the Netherlands as a whole.


CONCLUSIONS
The cervical smears taken by practice assistants were of lower quality than those taken by the general practitioners but almost as good as the nationwide mean.
Voordijk-van der Ben
M H
MH
Universiteit Maastricht, vakgroep Huisartsgeneeskunde.
Buntinx
F
F
D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D009426:Netherlands / Q000453:epidemiology; D010823:Physician Assistants / Q000592:standards / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears / Q000592:standards*