title: Colonoscopy scheduling influences adenoma and polyp detection rates.
abstract: OBJECTIVE
  Because colonoscopy can be a technically challenging procedure, endoscopist fatigue, which usually increases as day progresses, may impact procedural performance. The aim of this study was to determine the influence of colonoscopy scheduling on adenoma and polyp detection rates (ADR and PDR, respectively).
  
  
  METHODS
  This was a retrospective study of data prospectively collected on 1,293 consecutive, asymptomatic, average-risk patients. Three separate timing variables were assessed, as follows: morning vs. afternoon procedures; start times throughout the day; and four groups by matching each subsequent passing hour in the morning and afternoon sessions.
  
  
  RESULTS
  420 (32%) were performed in the morning and 881 (68%) were performed in the afternoon. There was a significantly higher ADR and PDR in the morning colonoscopies compared to the afternoon colonoscopies (42.3% vs. 34.7% [po=0.008] and 52.5% vs. 46.3% [p=0.038], respectively). Based on multivariable analysis, afternoon colonoscopies and colonoscopies performed during 4th hour of session were significantly associated with a decreased ADR (OR, 0.739 [0.576-0.949], p=0.018; and OR, 0.651 [0.443-0.975], p=0.029).
  
  
  CONCLUSIONS
  Colonoscopies scheduled in the morning have a significantly higher ADR and PDR as compared to colonoscopies scheduled in the afternoon. Also,colonoscopies performed during 4th hour of the session were associated with decreased ADR.
authors.forename: Kyung Hyun
authors.initials: KH
authors.lastname: Paeck
authors.forename: Woon Je
authors.initials: WJ
authors.lastname: Heo
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Kim
authors.forename: Suck-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Chang Kyun
authors.initials: CK
authors.lastname: Lee
authors.forename: Chang Soo
authors.initials: CS
authors.lastname: Eun
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Han
mesh_terms: D000236:Adenoma / Q000473:pathology*; D000368:Aged; D001071:Appointments and Schedules; D016009:Chi-Square Distribution; D002940:Circadian Rhythm; D002983:Clinical Competence; D003110:Colonic Neoplasms / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010561:Personnel Staffing and Scheduling; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D016526:Workload