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Prior studies have suggested that the adenoma detection rate (ADR) decreases as the number of colonoscopies performed per day increases or that it is lower in afternoon versus morning procedures (NEJM JW Gastroenterol Nov 2011 and Am J Gastroenterol 2011; 106:1457; NEJM JW Gastroenterol Nov 2009 and Am J Gastroenterol 2009; 104:1659). However, most studies included small numbers of colonoscopies and relatively few endoscopists.
Investigators have now conducted a large, retrospective, cross-sectional study involving 259,064 colonoscopies performed by 126 gastroenterologists in a community-based practice. The researchers assessed endoscopist fatigue by time of day (afternoon vs. morning) and by several measures of how much work had already bee…