BACKGROUND: Recent research suggests that the colonoscopy polyp detection rate (PDR) varies by time of day, possibly because of endoscopist fatigue. Mayo Clinic Rochester (MCR) schedules colonoscopies on 3-hour shifts, which should minimize fatigue. OBJECTIVE: To examine PDR variation with the MCR shift schedule. DESIGN: Retrospective cohort. SETTING: Outpatient tertiary-care center. PATIENTS: This study involved completed outpatient colonoscopies in 2008. Procedures were excluded for lack of withdrawal time stamps, indications other than average-risk screening, inadequate bowel preparation, fellow participation, or performance by endoscopists with a low number of endoscopies performed. INTERVENTION: None. MAIN OUTCOME MEASUREMENTS: PDR (colonoscopies with ≥1 polyp divided by total number of colonoscopies) by shift of day. RESULTS: We analyzed 3846 colonoscopies. PDR varied significantly by shift (P = .008) on univariate analysis; results for shifts 1 and 3 were similar (39.0% vs 38.7%, respectively) whereas shift 2 had the highest PDR (44.7%). Mean withdrawal times were stable (P = .92). PDR also varied significantly (P < .0001) by month of year on univariate analysis. On multivariate analysis, patient age (P < .0001), patient gender (P < .0001), endoscopist mean withdrawal time (P < .0001), month of year (P = .0002), endoscopist experience (P = .04), and shift of day (P = .048) significantly predicted PDR. LIMITATIONS: Retrospective study. CONCLUSION: MCR's 3-hour shift schedule does not show a decrease in PDR as the day progresses, as seen in other recent studies. Intervention trials at other institutions could determine whether alterations in shift length lead to PDR improvements.
BACKGROUND: Recent research suggests that the colonoscopy polyp detection rate (PDR) varies by time of day, possibly because of endoscopist fatigue. Mayo Clinic Rochester (MCR) schedules colonoscopies on 3-hour shifts, which should minimize fatigue. OBJECTIVE: To examine PDR variation with the MCR shift schedule. DESIGN: Retrospective cohort. SETTING:Outpatient tertiary-care center. PATIENTS: This study involved completed outpatient colonoscopies in 2008. Procedures were excluded for lack of withdrawal time stamps, indications other than average-risk screening, inadequate bowel preparation, fellow participation, or performance by endoscopists with a low number of endoscopies performed. INTERVENTION: None. MAIN OUTCOME MEASUREMENTS: PDR (colonoscopies with ≥1 polyp divided by total number of colonoscopies) by shift of day. RESULTS: We analyzed 3846 colonoscopies. PDR varied significantly by shift (P = .008) on univariate analysis; results for shifts 1 and 3 were similar (39.0% vs 38.7%, respectively) whereas shift 2 had the highest PDR (44.7%). Mean withdrawal times were stable (P = .92). PDR also varied significantly (P < .0001) by month of year on univariate analysis. On multivariate analysis, patient age (P < .0001), patient gender (P < .0001), endoscopist mean withdrawal time (P < .0001), month of year (P = .0002), endoscopist experience (P = .04), and shift of day (P = .048) significantly predicted PDR. LIMITATIONS: Retrospective study. CONCLUSION: MCR's 3-hour shift schedule does not show a decrease in PDR as the day progresses, as seen in other recent studies. Intervention trials at other institutions could determine whether alterations in shift length lead to PDR improvements.
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: Alexander Lee; Christopher D Jensen; Amy R Marks; Wei K Zhao; Chyke A Doubeni; Ann G Zauber; Virginia P Quinn; Theodore R Levin; Douglas A Corley Journal: Gastrointest Endosc Date: 2016-10-01 Impact factor: 9.427
Authors: Lynn Butterly; Christina M Robinson; Joseph C Anderson; Julia E Weiss; Martha Goodrich; Tracy L Onega; Christopher I Amos; Michael L Beach Journal: Am J Gastroenterol Date: 2014-01-07 Impact factor: 10.864
Authors: Dilhana S Badurdeen; Nisser A Umar; Rehana Begum; Andrew K Sanderson; Momodu Jack; Getachew Mekasha; John Kwagyan; Duane T Smoot; Adeyinka O Laiyemo Journal: Ann Epidemiol Date: 2012-05-08 Impact factor: 3.797