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    Time of day variation in polyp detection rate for colonoscopies performed on a 3-hour shift schedule.

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    Authors
    Munson, Gregory W
    Harewood, Gavin C
    Francis, Dawn L
    Affiliation
    Department of Gastroenterology, Mayo Clinic, Rochester, MN 55905, USA.
    Issue Date
    2011-03
    
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    Citation
    Time of day variation in polyp detection rate for colonoscopies performed on a 3-hour shift schedule. 2011, 73 (3):467-75 Gastrointest. Endosc.
    Journal
    Gastrointestinal endoscopy
    URI
    http://hdl.handle.net/10147/127688
    DOI
    10.1016/j.gie.2010.07.025
    PubMed ID
    20933230
    Abstract
    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.
    To examine PDR variation with the MCR shift schedule.
    Retrospective cohort.
    Outpatient tertiary-care center.
    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.
    None.
    PDR (colonoscopies with ≥1 polyp divided by total number of colonoscopies) by shift of day.
    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.
    Retrospective study.
    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.
    Item Type
    Article
    Language
    en
    ISSN
    1097-6779
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.gie.2010.07.025
    Scopus Count
    Collections
    Beaumont Hospital

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