- Colonoscopy quality is reduced in afternoon when the endoscopist works a full-day, but not half-day, block shift, according to a meta-analysis.
Why this matters
- A half-day shift may prevent endoscopist fatigue.
- Meta-analysis of 16 studies (n=38,063) that met inclusion criteria after search of MEDLINE, Web of Science, EMBASE, and the Cochrane Library.
- Quality of colonoscopy was defined by adenoma detection rate (ADR), which was the primary outcome, or by polyp detection rate and cecal intubation rate (CIR), which were secondary outcomes.
- When endoscopists worked half-day block shifts, no difference was seen in ADR between morning and afternoon (relative risk [RR], 1.08; 95% CI, 1.00-1.17) and CIR (RR, 1.01; 95% CI, 1.00-1.02).
- When endoscopists worked full-day shifts, a significant reduction was seen in afternoon (vs morning) ADR (RR, 1.18; 95% CI, 1.09-1.28) and CIR (RR, 1.08; 95% CI, 1.02-1.13) in subgroup analysis.
- When inferior bowel preparation was performed, a significant reduction was seen in afternoon (vs morning) ADR (RR, 1.12; 95% CI, 1.01-1.24) and CIR (RR, 1.02; 95% CI, 1.01-1.03) in subgroup analysis.
- Each of the studies was performed at a single center.
- Heterogeneity across studies.