BACKGROUND: With increasing volumes of endoscopic procedures, endoscopists' workload has had to increase to meet this escalating demand. The aim of this study was to characterize the impact of endoscopist fatigue on quality of endoscopy performance by comparing outcomes based on chronological procedure order. METHODS: Consecutive endoscopic procedures were prospectively observed. Quality indicators of colonoscopy (cecal intubation rate, lesion detection, withdrawal time, insertion time) and esophagogastroduodenoscopy (EGD) duration were compared among procedures based on their chronological sequence. RESULTS: Colonoscopy completion rates declined with successive procedures; completion for 1st to 3rd procedures (90%) was significantly higher than for 4th and subsequent procedures (76%) (P = 0.03). Median insertion times lengthened; times for 1st to 4th procedures [8 min, interquartile range (IQR) 6-11 min] were shorter than for 5th and subsequent procedures (10 min, IQR 7-15 min) (P = 0.06). Lesion detection rates, withdrawal times, and EGD duration remained stable with procedure order. CONCLUSIONS: Colonoscopy cecal intubation rates appear to decline with successive procedures. There also appears to be a trend for insertion times to lengthen. Reassuringly, other quality indicators of colonoscopy (lesion detection and withdrawal time) and EGD duration do not appear to be impacted by repetitive procedures.
BACKGROUND: With increasing volumes of endoscopic procedures, endoscopists' workload has had to increase to meet this escalating demand. The aim of this study was to characterize the impact of endoscopist fatigue on quality of endoscopy performance by comparing outcomes based on chronological procedure order. METHODS: Consecutive endoscopic procedures were prospectively observed. Quality indicators of colonoscopy (cecal intubation rate, lesion detection, withdrawal time, insertion time) and esophagogastroduodenoscopy (EGD) duration were compared among procedures based on their chronological sequence. RESULTS: Colonoscopy completion rates declined with successive procedures; completion for 1st to 3rd procedures (90%) was significantly higher than for 4th and subsequent procedures (76%) (P = 0.03). Median insertion times lengthened; times for 1st to 4th procedures [8 min, interquartile range (IQR) 6-11 min] were shorter than for 5th and subsequent procedures (10 min, IQR 7-15 min) (P = 0.06). Lesion detection rates, withdrawal times, and EGD duration remained stable with procedure order. CONCLUSIONS: Colonoscopy cecal intubation rates appear to decline with successive procedures. There also appears to be a trend for insertion times to lengthen. Reassuringly, other quality indicators of colonoscopy (lesion detection and withdrawal time) and EGD duration do not appear to be impacted by repetitive procedures.
Authors: Douglas K Rex; John L Petrini; Todd H Baron; Amitabh Chak; Jonathan Cohen; Stephen E Deal; Brenda Hoffman; Brian C Jacobson; Klaus Mergener; Bret T Petersen; Michael A Safdi; Douglas O Faigel; Irving M Pike Journal: Am J Gastroenterol Date: 2006-04 Impact factor: 10.864
Authors: D T Simmons; G C Harewood; T H Baron; B T Petersen; K K Wang; F Boyd-Enders; B J Ott Journal: Aliment Pharmacol Ther Date: 2006-09-15 Impact factor: 8.171
Authors: Madhusudhan R Sanaka; Nirav Shah; Kevin D Mullen; D R Ferguson; Charles Thomas; Arthur J McCullough Journal: Am J Gastroenterol Date: 2006-12 Impact factor: 10.864
Authors: Hemant A Shah; Lawrence F Paszat; Refik Saskin; Therese A Stukel; Linda Rabeneck Journal: Gastroenterology Date: 2007-03-21 Impact factor: 22.682
Authors: Alexander Lee; John M Iskander; Nitin Gupta; Brian B Borg; Gary Zuckerman; Bhaskar Banerjee; C Prakash Gyawali Journal: Am J Gastroenterol Date: 2011-03-29 Impact factor: 10.864
Authors: Sreedhar Subramanian; Eftychia E Psarelli; Paul Collins; Neil Haslam; Paul O'Toole; Martin Lombard; Sanchoy Sarkar Journal: Endosc Int Open Date: 2015-08-11
Authors: Tayana Soukup; Benjamin W Lamb; Abigail Morbi; Nisha J Shah; Anish Bali; Viren Asher; Tasha Gandamihardja; Pasquale Giordano; Ara Darzi; James Sa Green; Nick Sevdalis Journal: Cancer Med Date: 2020-08-13 Impact factor: 4.452