| Is production pressure jeopardizing the quality of colonoscopy? A survey of U.S. endoscopists' practices and perceptions. | |
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MedLine Citation:
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PMID: 22341109 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Fatigue is an underestimated cause of underperformance among physicians. There is evidence that fatigue or other byproducts of production pressure may negatively influence the quality of colonoscopy. OBJECTIVE: To investigate the practices and perceptions of U.S. endoscopists regarding the effect of production pressure on the performance of colonoscopy. DESIGN: We conducted a 40-question online survey to assess endoscopists' practices and perceptions concerning production pressure. SETTING: A total of 5030 U.S. American Society for Gastrointestinal Endoscopy members. MAIN OUTCOME MEASUREMENTS: The proportion of endoscopists responding positively to questions pertaining to the impact of production pressure on colonoscopy practice. RESULTS: Ninety-two percent of respondents indicated that production pressure influenced one or more aspects of their endoscopic practices. Examples of production pressure included (1) postponing polypectomy for a subsequent session (2.8%), (2) reducing the length of time spent inspecting the colon (7.2%), and (3) proceeding with colonoscopy in a patient with an unfavorable risk/benefit ratio (69.2%). Forty-eight percent of respondents reported witnessing the effects of production pressure on a colleague. Respondents working fee-for-service and those with >10 years since completion of fellowship were more likely to describe their weekly workloads as excessive compared with those who were salaried (81.3% vs 71.3%; P = .01) and <10 years out of training (81% vs 72.7%; P = .01). LIMITATIONS: Nonresponse bias due to low response rate (22.3%). CONCLUSION: Production pressure influences the conduct of colonoscopy for many endoscopists and could have an adverse effect on the outcome of colorectal cancer screening. (Clinical trial registration number: RE:GIE D 11-01288R1.) The study was an Internet study and did not involve human subjects. |
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Authors:
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Matthew J Whitson; Carol A Bodian; James Aisenberg; Lawrence B Cohen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Gastrointestinal endoscopy Volume: 75 ISSN: 1097-6779 ISO Abbreviation: Gastrointest. Endosc. Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-02-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0010505 Medline TA: Gastrointest Endosc Country: United States |
Other Details:
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Languages: eng Pagination: 641-648.e8 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Medicine, Division of Gastroenterology, Mount Sinai Medical Center, New York City, New York, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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