Goal: 

The goal of this study is to determine the significance of day of the work week and its contribution to endoscopist performance using adenoma detection rate (ADR) and proposed surrogate quality measures.

Background: 

Nearly a quarter of adenomas are missed on routine screening colonoscopy which contributes to between 50% and 60% of interval colorectal cancer.

Materials and Methods: 

Adult patients who underwent outpatient screening colonoscopy between January 2015 and April 2020 were included. Measurement of ADR and proposed quality metrics were analyzed for each day of the work week. Secondary outcomes included rates of good or excellent bowel preparation, trainee fellow participation, performance quartile of individual endoscopists, and patient demographic data. A generalized linear mixed model was used to analyze predictors of ADR.

Results: 

A total of 1884 screening procedures were included in our analysis. ADR on Friday (35.6%) was significantly lower than all other days of the work week (P<0.001). When compared with Friday, all days were found to be independent predictors of increased ADR. Male gender [95% confidence interval (CI): 1.12-1.65, P=0.002], good rather than excellent bowel preparation (95% CI: 1.22-2.28, P=0.001) and colonoscopy withdrawal time (CWT) (95% CI: 1.02-1.03, P<0.001) were all found to be predictors of increased ADR. Proposed quality indicators were all well correlated with ADR (r>0.811, P≤0.001) apart from CWT (r=0.28, P=0.379).

Conclusions: 

The data suggests there is a decline in endoscopist performance on Friday when compared with all other days of the work week. ADR correlates well with many proposed quality parameters, however, CWT may be of additional value as a quality metric.

中文翻译：

---

胃肠病学家有“虚弱”的一天吗？星期几对门诊结肠镜检查质量的影响

目标： 

本研究的目的是使用腺瘤检出率 (ADR) 和建议的替代质量指标来确定工作日的重要性及其对内窥镜医师表现的贡献。

背景： 

近四分之一的腺瘤在常规筛查结肠镜检查中被遗漏，这导致了 50% 至 60% 的间期结直肠癌。

材料和方法： 

纳入了在 2015 年 1 月至 2020 年 4 月期间接受门诊筛查结肠镜检查的成年患者。针对工作周的每一天分析 ADR 的测量和建议的质量指标。次要结果包括良好或极佳的肠道准备率、受训人员参与度、个体内窥镜医师的表现四分位数和患者人口统计数据。使用广义线性混合模型来分析 ADR 的预测因子。

结果： 

我们的分析中包括总共 1884 个筛查程序。周五的 ADR (35.6%) 明显低于工作周的所有其他日子 ( P <0.001)。与周五相比，所有日子都被发现是增加 ADR 的独立预测因素。男性 [95% 置信区间 (CI)：1.12-1.65，P =0.002]，良好而非极好的肠道准备 (95% CI：1.22-2.28，P =0.001) 和结肠镜检查退出时间 (CWT) (95% CI : 1.02-1.03, P <0.001) 都被发现是 ADR 增加的预测因素。除 CWT（ r =0.28 ， P = 0.379）外，提出的质量指标均与 ADR（ r >0.811 ， P ≤0.001）相关。

结论： 

数据表明，与工作周的所有其他日子相比，内窥镜医师周五的表现有所下降。ADR 与许多建议的质量参数密切相关，但是，CWT 作为质量度量可能具有附加值。