Abstract:
BACKGROUND:Recent studies have shown that colonoscopic polyp detection decreases as the workday progresses. This may reflect time-dependent factors such as colonoscopist fatigue and decreased colon cleanliness, which can be addressed through adaptations in colonoscopy practice. OBJECTIVE:To test for time-of-day differences in adenomatous polyp (AP) and sessile serrated polyp (SSP) detection in a practice that uses split-dose bowel preparation and moderated daily colonoscopist procedure loads. DESIGN:Retrospective chart review. SETTING:Community-based, group gastroenterology practice. PATIENTS:This study involved 2439 patients undergoing surveillance or screening colonoscopy. INTERVENTION:Colonoscopy. MAIN OUTCOME MEASUREMENTS:Detection rate of all premalignant polyps (PMPs), and of APs and SSPs, individually. RESULTS:A total of 1183 PMPs were identified in 1486 eligible patients (mean PMP/colonoscopy = 0.80; PMP detection rate = 47%). In univariate and multivariate analyses, PMP detection as well as detection of APs or SSPs individually did not vary significantly in relation to the hour of the day. In a binary comparison of morning (am) versus afternoon (pm) procedures, the total polyp detection rate was 67% and 66%, respectively. For PMPs, APs, SSPs, and hyperplastic polyps (HPs), the am and pm detection rates were 46% and 47%, 41% and 44%, 8% and 8%, and 27% and 24%, respectively. Bowel preparation quality was independent of time of day and was rated excellent or good in 86% to 87% of cases. LIMITATIONS:Retrospective, nonrandomized study. CONCLUSION:Stable PMP, AP, SSP, and HP detection rates throughout the workday occur under certain practice conditions, including the use of split-dose bowel preparation and/or moderated daily colonoscopist procedure loads.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Freedman JS,Harari DY,Bamji ND,Bodian CA,Kornacki S,Cohen LB,Miller KM,Aisenberg Jdoi
10.1016/j.gie.2011.01.019subject
Has Abstractpub_date
2011-06-01 00:00:00pages
1197-206issue
6eissn
0016-5107issn
1097-6779pii
S0016-5107(11)00021-6journal_volume
73pub_type
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pub_type: 杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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