Adenoma detection rate is not influenced by full-day blocks, time, or modified queue position

Lurix, Einar; Hernandez, Adrián V.; Thoma, Matthew N.; Castro, Fernando

doi:10.1016/j.gie.2011.12.008

Cited by 35 publications

(27 citation statements)

References 21 publications

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“…18 In contrast, 4 studies evaluated hours elapsed in the day, morning versus afternoon procedure time, and/or queue position and found no or minimal differences in adenoma detection. 11,20–22 …”

Section: Discussionmentioning

confidence: 99%

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Endoscopist fatigue estimates and colonoscopic adenoma detection in a large community-based setting

Lee

Jensen

Marks

et al. 2017

Gastrointestinal Endoscopy

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Background and Aims Endoscopist fatigue may impact colonoscopy quality, but prior studies conflict, and minimal data exist from community-based practices where most colonoscopies are performed. Methods Within a large, community-based integrated healthcare system, we evaluated the associations among 4 measures of endoscopist fatigue and colonoscopic adenoma detection during the years 2010 to 2013. Fatigue measures included afternoon versus morning colonoscopy and the number of GI procedures performed before a given colonoscopy, including consideration of prior procedure complexity. Analyses were adjusted for potential confounders using multivariate logistic regression. Results We identified 126 gastroenterologists who performed 259,064 total GI procedures (median: 6/day, range: 1–24), including 76,445 screening and surveillance colonoscopies. Compared with morning examinations, colonoscopies in the afternoon were not associated with lower adenoma detection for screening examinations, surveillance examinations, or their combination (odds ratio (OR) for combination 0.99; 95% confidence interval (CI), 0.96–1.03). The number of procedures performed before a given colonoscopy, with or without consideration of prior procedure complexity, was also not inversely associated with adenoma detection (OR for adenoma detection for colonoscopies in the fourth quartile of fatigue based on the number of prior procedures performed versus colonoscopies performed as the first procedure of the day 0.99; 95% CI, 0.94–1.04). Conclusions In a large community-based setting, adenoma detection for screening and surveillance colonoscopies was not associated with either time of day or the number of prior procedures performed by the endoscopist, within the range of procedure volumes evaluated. The lack of association persisted after accounting for prior procedure complexity.

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Section: Discussionmentioning

confidence: 99%

“…Consensus weights reflect procedure complexity based on published studies, 11 and ranged from 0.5 to 1.5 (Table 1). …”

Section: Methodsmentioning

confidence: 99%

Endoscopist fatigue estimates and colonoscopic adenoma detection in a large community-based setting

Lee

Jensen

Marks

et al. 2017

Gastrointestinal Endoscopy

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“…Some studies found that ADR tended to be lower for afternoon procedures compared with morning procedures 45,46 and also lower toward the end of a shift irrespective of the length of the shift 47 ; however, others report that these factors did not significantly impact ADR. 48,49 CONCLUSIONS ADR is an important and widely-accepted measure of quality in colonoscopy. There are many factors that influence ADR, including the age and sex of the patient, as well as the indication for colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

Adenoma Detection Rate in Colonoscopy

Yang

Wong

2016

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Saad et al found that in 1502 consecutive colonoscopies, rectal retroflexion was successful in 94%, but resulted in the detection of an additional seven polyps of which six were hyperplastic and one a 4 mm adenoma [14]. Attempts to retrovert the colonoscope at the caecum and ascending colon has had mixed results.…”

Section: Bowel Preparationmentioning

confidence: 99%

Screening colonoscopy: should we focus more on technique and less on technology?

Mohammed

Subramanian

2013

F1000Prime Rep

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Several large studies have confirmed that high quality colonoscopic surveillance can improve outcomes with substantial reduction in colorectal cancer rates. In order to improve outcomes from screening colonoscopy and help detect adenomas, the emphasis has been mainly on improvements in technology like high-resolution scopes, computerized as well as dye-based chromoendoscopy and wide-angle endoscopes. In addition to the equipment and technological innovation in the equipment used, a number of other factors like experience of the endoscopist, optimal withdrawal techniques, position changes during colonoscopy and bowel preparation can all influence adenoma detection and thereby the quality of colonoscopic surveillance. In this review we will focus on recent studies investigating these aspects of colonoscopy and their impact on adenoma or polyp detection.

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Adenoma detection rate is not influenced by full-day blocks, time, or modified queue position

Cited by 35 publications

References 21 publications

Endoscopist fatigue estimates and colonoscopic adenoma detection in a large community-based setting

Endoscopist fatigue estimates and colonoscopic adenoma detection in a large community-based setting

Adenoma Detection Rate in Colonoscopy

Screening colonoscopy: should we focus more on technique and less on technology?

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