TableA.8 Cost effectiveness of GI services: summary of articles examined for the role of nurses in GI services

AuthorsResearch setting and year of studyStudy designSample sizeTopic of documentResults and conclusionsComments
Maule758UK (1994)Prospective cohort study1881 Patients (examined by nurses) and 730 (examined by physiciansScreening of colorectal cancer by nurse endoscopistsNurses can carry out screening by flexible sigmoidoscopy as accurately and safely as experienced gastroenterologistsThe paper did not include a proper economic evaluation
Melleney and Willoughby759UK (England) (1999–2000)Case series study100 PatientsTo audit a nurse endoscopist based one stop clinicThe system was popular with patients as most of them (70%) were dealt with at a single hospital attendance. However, the one stop clinic as currently formulated is open to the criticism that its productivity is low, and moreover, the overload of minor disorders increased the waiting timeThe study does not include a proper economic evaluation
Smale et al712UK (2000)Retrospective and prospective cohort study3009 Patients (retrospectively) 480 (prospectively)To determine the effectiveness, patient comfort, and attitude towards future development of endoscopy performed by nursesExperienced nurses perform routine diagnostic gastroscopy safely and as with as little discomfort for patients and as much patient satisfaction as medical staffA good study, but it did not include any economic evaluation
Burnett et al757UK (1998–2000)RCT102 PatientsTo evaluate the effectiveness of a nurse led clinic (NLC) compared with a consultant led paediatric GI clinic (PGL) in the management of chronic constipationResults suggest that an NLC can significantly improve follow-up of children with intractable constipation, and highlight the important role for clinic nurse specialist in management of children with GI diseaseThe study suffers from small numbers and it did not include any economic evaluation