Document Detail

Is production pressure jeopardizing the quality of colonoscopy? A survey of U.S. endoscopists' practices and perceptions.
MedLine Citation:
PMID:  22341109     Owner:  NLM     Status:  In-Data-Review    
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.
Matthew J Whitson; Carol A Bodian; James Aisenberg; Lawrence B Cohen
Related Documents :
17174079 - Formation of filopodia in earthworm (lumbricus terrestris) coelomocytes in response to ...
16137719 - A simple method for measuring interstitial fluid pressure in cancer tissues.
16311279 - Effect of fluid loading with saline or colloids on pulmonary permeability, oedema and l...
1745549 - Culture characteristics of trypanosoma catostomi and trypanosoma phaleri from north ame...
3392669 - Filtration coefficient and osmotic reflection coefficient to albumin in rabbit submandi...
19464689 - The role of interstitial fluid pressurization in articular cartilage lubrication.
2364179 - Identification of a coronary-prone profile for business managers: comparison of three a...
2548959 - Central alpha-adrenoceptor influence over the cardiovascular reflexes activated by vera...
19179809 - The diagnosis and treatment of hypertensive crises.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  75     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  641-648.e8     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Department of Medicine, Division of Gastroenterology, Mount Sinai Medical Center, New York City, New York, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Assessing the realism of colonoscopy simulation: the development of an instrument and systematic com...
Next Document:  New closure technique for large mucosal defects after endoscopic submucosal dissection of colorectal...