Table 5.
Association between measures of endoscopist fatigue and colonoscopic adenoma detection.
| Fatigue measures | Screening exams n=46,297 OR (95% CI) |
Surveillance exams n=30,148 OR (95% CI) |
All exams* n=76,445 OR (95% CI) |
|---|---|---|---|
| Start time: | |||
| Morning Exam | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
| Afternoon Exam | 0.97 (0.93 – 1.02) | 1.02 (0.97 – 1.08) | 0.99 (0.96 – 1.03) |
| Raw fatigue score | |||
| First of the day† | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
| Quartile 1 | 1.09 (1.02 – 1.16) | 0.97 (0.90 – 1.04) | 1.03 (0.99 – 1.09) |
| Quartile 2 | 1.10 (1.02 – 1.19) | 1.05 (0.96 – 1.14) | 1.08 (1.02 – 1.14) |
| Quartile 3 | 1.06 (0.99 – 1.14) | 1.05 (0.97 – 1.14) | 1.05 (1.00 – 1.11) |
| Quartile 4 | 0.99 (0.92 – 1.06) | 1.00 (0.92 – 1.08) | 0.99 (0.94 – 1.04) |
| Consensus fatigue score | |||
| First of the day† | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
| Quartile 1 | 1.08 (1.00 – 1.15) | 0.98 (0.91 – 1.06) | 1.03 (0.98 – 1.09) |
| Quartile 2 | 1.12 (1.05 – 1.20) | 1.01 (0.94 – 1.09) | 1.07 (1.02 – 1.12) |
| Quartile 3 | 1.04 (0.97 – 1.12) | 1.03 (0.95 – 1.12) | 1.04 (0.98 – 1.10) |
| Quartile 4 | 0.99 (0.93 – 1.07) | 1.02 (0.94 – 1.10) | 1.00 (0.95 – 1.05) |
| RVU fatigue score | |||
| First of the day† | 1.00 (referent) | 1.00 (referent) | 1.00 (referent) |
| Quartile 1 | 1.10 (1.03 – 1.18) | 0.99 (0.91 – 1.07) | 1.05 (1.00 – 1.11) |
| Quartile 2 | 1.09 (1.02 – 1.17) | 0.99 (0.92 – 1.07) | 1.04 (0.99 – 1.10) |
| Quartile 3 | 1.06 (0.99 – 1.14) | 1.02 (0.94 – 1.10) | 1.04 (0.99 – 1.09) |
| Quartile 4 | 1.00 (0.93 – 1.07) | 1.04 (0.96 – 1.13) | 1.01 (0.96 – 1.06) |
*
Screening and surveillance examinations combined.
†
The colonoscopy that was the first GI procedure of the day.
OR, odds ratio; n, number; CI, confidence interval; RVU, relative value units.
Raw fatigue score is the sum of the raw weights for the GI procedures performed by the physician before the given colonoscopy; consensus fatigue score is the sum of the consensus weights for the GI procedures performed by the physician before the given colonoscopy; and RVU fatigue score is the sum of the RVU weights for the GI procedures performed by the physician before the given colonoscopy.