Queue position in the endoscopic schedule impacts effectiveness of colonoscopy
Open accessAbstract
OBJECTIVES: Endoscopist fatigue potentially impacts colonoscopy. Fatigue is difficult to quantitate, but polyp detection rates between non-fatigued and fatigued time periods could represent a surrogate marker. We assessed whether timing variables impacted polyp detection rates at a busy tertiary care endoscopy suite. METHODS: Consecutive patients undergoing colonoscopy were retrospectively identified. Indications, clinical demographics, pre-procedural, and procedural variables were extracted from chart review; colonoscopy findings were determined from the procedure reports. Three separate timing variables were assessed as surrogate markers for endoscopist fatigue: morning vs. afternoon procedures, start times throughout the day, and queue position, a unique variable that takes into account the number of procedures performed before the colonoscopy of interest. Univariate and multivariate analyses were performed to determine whether timing variables and other clinical, pre-procedural, and procedural variables predicted polyp detection. RESULTS: During the 4-month study period, 1,083 outpatient colonoscopy procedures (57.5±0.5 years, 59.5% female) were identified, performed by 28 endoscopists (mean 38.7 procedures/endoscopist), with a mean polyp detection rate of 0.851/colonoscopy. At least, one adenoma was detected in 297 procedures (27.4%). A 12.4% reduction in mean detected polyps was detected between morning and afternoon procedures (0.90±0.06 vs. 0.76±0.06, P=0.15). Using start time on a continuous scale, however, each elapsed hour in the day was associated with a 4.6% reduction in polyp detection (P=0.005). When queue position was assessed, a 5.4% reduction in polyp detection was noted with each increase in queue position (P=0.016). These results remained significant when controlled for each individual endoscopist. CONCLUSIONS: Polyp detection rates decline as time passes during an endoscopist's schedule, potentially from endoscopist fatigue. Queue position may be a novel surrogate measure for operator fatigue.
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The number of endoscopies performed in a day by an endoscopist negatively impacts performance.
“It was found that the number of endoscopies performed in a day by an endoscopist negatively impacted performance [86][87][88] , but the use of CADe eliminates this adverse effect [85] .”
From Enhancing human-AI collaboration: The case of colonoscopy (2024) · cites this paper as [87]
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Enhancing human-AI collaboration: The case of colonoscopy
Introzzi, L., Zonca, J., Cabitza, F., Cherubini, P., & Reverberi, C. (2024) · Digestive and Liver Disease · doi:10.1016/j.dld.2023.10.018 · Cited by 28 · see citing works
- Authors
- Lee, A., Iskander, J. M., Gupta, N., Borg, B. B., Zuckerman, G., Banerjee, B., & Gyawali, P. C.
- Affiliations
- Washington University in St. Louis (US)
- Venue
- American Journal of Gastroenterology
- Published
- 2011-08
- Volume
- 106
- Issue
- 8
- Pages
- 1457-1465
- ISSN
- 0002-9270 (ISSN-L)
- PMC
- PMC4098876
- OpenAlex
- W2020023008
- Cited by
- 66
- References
- 0
- Citations by year
- 2026: 6 · 2023: 4 · 2022: 4 · 2021: 7 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 5 · 2015: 8 · 2014: 5 · 2013: 4 · 2012: 8
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5t32dk007301-35)
- National Institute of Diabetes and Digestive and Kidney Diseases (T32-DK007301, 5-T32-DK07301-35, T32DK007130)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Health Sciences › Health Professions › Emergency Medical Services › Healthcare Operations and Scheduling Optimization
- Keywords
- colonoscopy, polyp detection rate, adenoma detection
- MeSH terms
- Adenoma, Adult, Aged, Analysis of Variance, Appointments and Schedules, Colonic Neoplasms, Colonic Polyps, Colonoscopy, Fatigue, Female, Humans, Male, Middle Aged, Outpatients, Psychomotor Performance, Time Factors, Workload
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