Adenoma detection rate is not influenced by the timing of colonoscopy when performed in half-day blocks

Suryakanth R. Gurudu, Shiva K. Ratuapli, Jonathan A Leighton, Russell I. Heigh, Michael D. Crowell

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objectives: Afternoon colonoscopies have recently been reported to be associated with lower adenoma detection rate (ADR), which was attributed to physician fatigue resulting from the same endoscopist performing procedures throughout the day. The aim of our study was to assess ADR in morning compared with afternoon colonoscopy performed in half-day blocks with different physicians. We evaluated the primary hypothesis that morning and afternoon ADRs would not differ significantly when performed in half-day blocks by different endoscopists. Methods: Data on all colonoscopies performed between January 2009 and December 2009 were obtained from our endoscopy database. All patients who underwent colonoscopies in 2009 for screening, surveillance, and family history of colon cancer/polyps were included in the study. Morning colonoscopies were defined as those that were performed from 0800 to 1200 hours. Afternoon colonoscopies were defined as those that were performed from 1300 to 1700 hours. Colonoscopies in each block were performed either by different endoscopists working in half-day (morning or afternoon) block schedules or by the same endoscopist working a full-day schedule. Results: A total of 4,665 patients were included in the study. For endoscopists working the full-day, the afternoon ADR was significantly lower than the morning ADR (21 vs. 26.1%; odds ratio (OR)=0.75; 95% confidence interval (CI) 0.59, 0.96; P=0.02). Conversely, in the half-day group, there was no significant difference in ADR between afternoon and morning (27.6 vs. 26.6%; OR=1.05; 95% CI 0.88, 1.26; P=0.56). Conclusions: Performing colonoscopies in half-day blocks by different endoscopists increases the detection of adenomas in afternoon procedures, probably by reducing physician fatigue.

Original languageEnglish (US)
Pages (from-to)1466-1471
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume106
Issue number8
DOIs
StatePublished - 2011

Fingerprint

Colonoscopy
Adenoma
Physicians
Fatigue
Appointments and Schedules
Odds Ratio
Confidence Intervals
Polyps
Colonic Neoplasms
Endoscopy
Databases

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Adenoma detection rate is not influenced by the timing of colonoscopy when performed in half-day blocks. / Gurudu, Suryakanth R.; Ratuapli, Shiva K.; Leighton, Jonathan A; Heigh, Russell I.; Crowell, Michael D.

In: American Journal of Gastroenterology, Vol. 106, No. 8, 2011, p. 1466-1471.

Research output: Contribution to journalArticle

Gurudu, Suryakanth R. ; Ratuapli, Shiva K. ; Leighton, Jonathan A ; Heigh, Russell I. ; Crowell, Michael D. / Adenoma detection rate is not influenced by the timing of colonoscopy when performed in half-day blocks. In: American Journal of Gastroenterology. 2011 ; Vol. 106, No. 8. pp. 1466-1471.
@article{286c22084b144a93959a5843134932e6,
title = "Adenoma detection rate is not influenced by the timing of colonoscopy when performed in half-day blocks",
abstract = "Objectives: Afternoon colonoscopies have recently been reported to be associated with lower adenoma detection rate (ADR), which was attributed to physician fatigue resulting from the same endoscopist performing procedures throughout the day. The aim of our study was to assess ADR in morning compared with afternoon colonoscopy performed in half-day blocks with different physicians. We evaluated the primary hypothesis that morning and afternoon ADRs would not differ significantly when performed in half-day blocks by different endoscopists. Methods: Data on all colonoscopies performed between January 2009 and December 2009 were obtained from our endoscopy database. All patients who underwent colonoscopies in 2009 for screening, surveillance, and family history of colon cancer/polyps were included in the study. Morning colonoscopies were defined as those that were performed from 0800 to 1200 hours. Afternoon colonoscopies were defined as those that were performed from 1300 to 1700 hours. Colonoscopies in each block were performed either by different endoscopists working in half-day (morning or afternoon) block schedules or by the same endoscopist working a full-day schedule. Results: A total of 4,665 patients were included in the study. For endoscopists working the full-day, the afternoon ADR was significantly lower than the morning ADR (21 vs. 26.1{\%}; odds ratio (OR)=0.75; 95{\%} confidence interval (CI) 0.59, 0.96; P=0.02). Conversely, in the half-day group, there was no significant difference in ADR between afternoon and morning (27.6 vs. 26.6{\%}; OR=1.05; 95{\%} CI 0.88, 1.26; P=0.56). Conclusions: Performing colonoscopies in half-day blocks by different endoscopists increases the detection of adenomas in afternoon procedures, probably by reducing physician fatigue.",
author = "Gurudu, {Suryakanth R.} and Ratuapli, {Shiva K.} and Leighton, {Jonathan A} and Heigh, {Russell I.} and Crowell, {Michael D.}",
year = "2011",
doi = "10.1038/ajg.2011.125",
language = "English (US)",
volume = "106",
pages = "1466--1471",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "8",

}

TY - JOUR

T1 - Adenoma detection rate is not influenced by the timing of colonoscopy when performed in half-day blocks

AU - Gurudu, Suryakanth R.

AU - Ratuapli, Shiva K.

AU - Leighton, Jonathan A

AU - Heigh, Russell I.

AU - Crowell, Michael D.

PY - 2011

Y1 - 2011

N2 - Objectives: Afternoon colonoscopies have recently been reported to be associated with lower adenoma detection rate (ADR), which was attributed to physician fatigue resulting from the same endoscopist performing procedures throughout the day. The aim of our study was to assess ADR in morning compared with afternoon colonoscopy performed in half-day blocks with different physicians. We evaluated the primary hypothesis that morning and afternoon ADRs would not differ significantly when performed in half-day blocks by different endoscopists. Methods: Data on all colonoscopies performed between January 2009 and December 2009 were obtained from our endoscopy database. All patients who underwent colonoscopies in 2009 for screening, surveillance, and family history of colon cancer/polyps were included in the study. Morning colonoscopies were defined as those that were performed from 0800 to 1200 hours. Afternoon colonoscopies were defined as those that were performed from 1300 to 1700 hours. Colonoscopies in each block were performed either by different endoscopists working in half-day (morning or afternoon) block schedules or by the same endoscopist working a full-day schedule. Results: A total of 4,665 patients were included in the study. For endoscopists working the full-day, the afternoon ADR was significantly lower than the morning ADR (21 vs. 26.1%; odds ratio (OR)=0.75; 95% confidence interval (CI) 0.59, 0.96; P=0.02). Conversely, in the half-day group, there was no significant difference in ADR between afternoon and morning (27.6 vs. 26.6%; OR=1.05; 95% CI 0.88, 1.26; P=0.56). Conclusions: Performing colonoscopies in half-day blocks by different endoscopists increases the detection of adenomas in afternoon procedures, probably by reducing physician fatigue.

AB - Objectives: Afternoon colonoscopies have recently been reported to be associated with lower adenoma detection rate (ADR), which was attributed to physician fatigue resulting from the same endoscopist performing procedures throughout the day. The aim of our study was to assess ADR in morning compared with afternoon colonoscopy performed in half-day blocks with different physicians. We evaluated the primary hypothesis that morning and afternoon ADRs would not differ significantly when performed in half-day blocks by different endoscopists. Methods: Data on all colonoscopies performed between January 2009 and December 2009 were obtained from our endoscopy database. All patients who underwent colonoscopies in 2009 for screening, surveillance, and family history of colon cancer/polyps were included in the study. Morning colonoscopies were defined as those that were performed from 0800 to 1200 hours. Afternoon colonoscopies were defined as those that were performed from 1300 to 1700 hours. Colonoscopies in each block were performed either by different endoscopists working in half-day (morning or afternoon) block schedules or by the same endoscopist working a full-day schedule. Results: A total of 4,665 patients were included in the study. For endoscopists working the full-day, the afternoon ADR was significantly lower than the morning ADR (21 vs. 26.1%; odds ratio (OR)=0.75; 95% confidence interval (CI) 0.59, 0.96; P=0.02). Conversely, in the half-day group, there was no significant difference in ADR between afternoon and morning (27.6 vs. 26.6%; OR=1.05; 95% CI 0.88, 1.26; P=0.56). Conclusions: Performing colonoscopies in half-day blocks by different endoscopists increases the detection of adenomas in afternoon procedures, probably by reducing physician fatigue.

UR - http://www.scopus.com/inward/record.url?scp=85027937542&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027937542&partnerID=8YFLogxK

U2 - 10.1038/ajg.2011.125

DO - 10.1038/ajg.2011.125

M3 - Article

AN - SCOPUS:85027937542

VL - 106

SP - 1466

EP - 1471

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 8

ER -