Morning colonoscopies are associated with improved adenoma detection rates

Teng, Tze Yeong; Khor, Shao Nan; Kailasam, Manimegalai; Cheah, Wei-Keat; Lau, Cheryl C.

doi:10.1007/s00464-015-4448-7

Cited by 31 publications

(27 citation statements)

References 34 publications

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“…Prolonged duty hours and sleep deprivation have been associated with increased medical errors among interns [ 9 10 11 12 13 ]. For example, even during work days, adenoma detection rate was significantly higher in morning colonoscopies than in afternoon colonoscopies [ 14 15 16 ]. Patients anesthetized at different time of the day may have different clinical outcomes [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Operation start time and long-term outcome of hepatocellular carcinoma after curative hepatic resection

Liu

Zhang

et al. 2020

Ann Surg Treat Res

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Purpose The objective of the current study was to examine the potential effects of surgery start times (morning vs. afternoon) on the long-term prognosis of patients after hepatic resection (HR) for hepatocellular carcinoma (HCC). Methods All eligible patients were divided into 2 groups according to the start time of surgery: group M (morning surgery, 8 AM–1 PM) and group A (afternoon surgery, 1 PM–6 PM). Clinicopathologic and surgical parameters, as well as oncologic outcomes were compared between the 2 groups. Results In total, 231 patients were included in the study. There was no difference in age, body mass index, comorbidities, tumor size, tumor location, tumor stages, surgical procedures, or surgical margin between morning and afternoon surgery (all P > 0.05). In contrast, patients in group M experienced longer operation duration than those in group A (median, 240 minutes vs. 195 minutes, P = 0.004). However, no differences of overall survival were observed between morning and afternoon surgery groups in the whole cohort or stratified by surgical margin (all P > 0.05). Conclusion Surgery start times during the work day have no measurable influence on patient outcome following curative HR for HCC, indicating good self-regulation and professional judgment of surgeons for progressive fatigue during surgery.

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Section: Introductionmentioning

confidence: 99%

Operation start time and long-term outcome of hepatocellular carcinoma after curative hepatic resection

Liu

Zhang

et al. 2020

Ann Surg Treat Res

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“…Several studies in the USA have concluded that scheduling does not affect ADR . Conversely, other studies in the USA, Singapore, and Canada found that colonoscopies performed later in the day had a less favorable ADR. There had previously been no such studies in Australia.…”

Section: Discussionmentioning

confidence: 98%

Effect of time of day and specialty on polyp detection rates in Australia

Ovenden

et al. 2019

J of Gastro and Hepatol

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Background and Aim Adenoma detection rate (ADR) is an important quality metric in colonoscopy. However, there is conflicting evidence around factors that influence ADR. This study aims to investigate the effect of time of day and endoscopist background on ADR and sessile serrated adenoma/polyp detection rate (SSA/P‐DR) for screening colonoscopies. Methods Consecutive patients undergoing colonoscopy in 2016 were retrospectively evaluated. Primary outcome was the effect of time of day and endoscopist specialty on screening ADR. Secondary outcomes included evaluation of the same factors on SSA/P‐DR and other metrics and collinearity of ADR and SSA/P‐DR. Linear regression models were used for association between ADR, time of day, and endoscopist background. Bowel preparation, endoscopist, session, patient age, and gender were adjusted for. Linear regression model was also used for comparing ADR and SSA/P‐DR. Chi‐square was used for difference of proportions. Results Two thousand six hundred fifty‐seven colonoscopies, of which 558 were screening colonoscopies, were performed. The adjusted mean ADR (screening) was 36.8% in the morning compared with 30.5% in the afternoon (P < 0.0001) and was 36.8% for gastroenterologists compared with 30.4% for surgeons (P < 0.0001). For every 1‐h delay in commencing the procedure, there was a reduction in mean ADR by 3.4%. Using a linear regression model, a statistically significant positive association was found between ADR and SSA/P‐DR (P < 0.0001). Conclusions Morning and afternoon sessions and gastroenterologists and surgeons achieved the minimum standards recommended for ADR. Afternoon lists and surgeons were associated with a lower ADR compared with morning and gastroenterologists, respectively. Additionally, SSA/P‐DR showed collinearity with ADR.

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“…On the other hand, our observed variability in proximal and distal adenoma detection is consistent with what has been previously observed [ 14 ]. Second, we were unable to examine certain procedural factors that have been previously associated with ADR such as withdrawal time [ 27 ] and time of day [ 28 , 29 ]. The influence of colonoscopy queue position during the day, insertion time, and withdrawal time on proximal and distal adenoma detection warrant further study.…”

Section: Discussionmentioning

confidence: 99%

Variable Endoscopist performance in proximal and distal adenoma detection during colonoscopy: a retrospective cohort study

James

Hegagi

et al. 2018

BMC Gastroenterol

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BackgroundAdenoma Detection Rate (ADR) is a validated colonoscopy quality indicator. In addition to overall ADR, Distal and Proximal Adenoma Detection Rates may provide important colonoscopy quality information. The goal of this study is to determine the association between distal and proximal adenoma detection (AD) and to identify factors contributing to overall, distal, and proximal AD.MethodsThis is a retrospective cohort study of patients with a noted family history of CRC or positive fecal occult blood test who underwent a screening colonoscopy at a regional colorectal cancer (CRC) screening center between May 2009 and December 2011. Data regarding patient demographics, procedure details, endoscopist characteristics and polyp histology were captured. The main outcomes measured were overall, distal, and proximal AD.Results1907 patients were included. The median age was 60 years and 42% were male. Endoscopist median overall ADR was 25% (30% male, 21% female). Endoscopist distal ADR was only modestly associated with their proximal ADR (Spearman Rank: 0.51 p = 0.11). Highest overall ADR (29 to 45%) was found for endoscopists whose distal and proximal ADRs were above the group median. In multivariate analysis, factors associated with overall, distal, and proximal AD included age, sex, and endoscopist practicing experience.ConclusionInclusion of distal and proximal ADRs, in addition to overall ADR, in colonoscopy quality assessment provides the more accurate feedback on endoscopist performance.

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Morning colonoscopies are associated with improved adenoma detection rates

Cited by 31 publications

References 34 publications

Operation start time and long-term outcome of hepatocellular carcinoma after curative hepatic resection

Operation start time and long-term outcome of hepatocellular carcinoma after curative hepatic resection

Effect of time of day and specialty on polyp detection rates in Australia

Variable Endoscopist performance in proximal and distal adenoma detection during colonoscopy: a retrospective cohort study

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