Fewer Polyps Detected by Colonoscopy as the Day Progresses at a Veteran's Administration Teaching Hospital

The detection of premalignant colon polyps during colonoscopy is stable throughout the workday

“…The increase in the PMP detection rate in the 1:00 PM to 1:59 PM hour was not seen as noteworthy, especially in light of other studies that demonstrate decreasing colonoscopic polyp detection as the workday progresses. [9][10][11] Our study does not directly test what factors rendered polyp detection rates independent from the time of day. We hypothesize two explanations.…”

“…[9][10][11] The authors of these studies hypothesized that progressive endoscopist fatigue was responsible. If generalizable, this finding has public policy and public health implications.…”

“…[9][10][11] Although the cause for this trend was not studied directly, the authors hypothesized that progressive endoscopist fatigue was responsible. The unprecedented current clinical and economic pressures on endoscopists support this hypothesis.…”

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

“…18 Two recent articles report that PDR also decreases throughout the day, possibly because of endoscopist fatigue. 20,21 Mayo Clinic Rochester (MCR) schedules endoscopists by 3 daily 3-hour shifts (shift 1: morning, 7:30 AM to 10:30 AM; shift 2: midday, 10:30 AM to 1:30 PM; and shift 3: afternoon, 1:30 PM to 4:30 PM) in our largest outpatient endoscopy unit, rather than more-common shift schedules encompassing half or full days. If fatigue accounts for decreasing PDR, it is possible that shorter shifts lead to more stable PDRs.…”

Secondary Prevention of Colorectal Adenomas: Is There an Optimal Follow-up for Colorectal Adenomas?

“…One study has shown no effect of endoscopists' experience on ADR [25]. Adenoma detection is closely linked to a thorough examination, good colonic preparation, cleansing of dirty areas and pooled fluid, adequate inflation, and visualization of proximal folds and other hard-to-reach areas [30]. Researchers on the subject, such as Chen and Rex [31], logically argue that these operator qualities do not necessarily depend on experience but rather on the operator's motivation for conducting a high-quality examination.…”