P0334 - Do Adenoma Detection Rates Decline Before Holidays and During Major News Events?

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Has Audio

Presenting Author(s)

Arence Paasewe, MD

New York-Presbyterian Columbia
New York, NY

Arence Paasewe, MD¹, Anna Krigel, MD¹, Daniel Freedberg, MD², Benjamin Lebwohl, MD, MS¹
¹New York-Presbyterian Columbia, New York, NY; ²New York Presbyterian-Columbia, New York, NY

Introduction: Variations in colonoscopy adenoma detection rate (ADR) may be due to a number of factors; for example, lower ADR has been observed in afternoon sessions compared to morning sessions. However, provider distraction is a factor that has not been thoroughly investigated. We aimed to determine if increased external distraction from looming holidays or major news events would negatively effect ADR.

Methods: Using our institution’s endoscopy record, we performed a retrospective study of colonoscopies performed between 7/31/16 and 7/31/21 on patients ≥ age 50. The primary comparison was the difference in ADR during time periods of increased distraction compared to baseline. Time periods of increased distraction were divided into 2 categories: holiday eves, i.e. the Fridays before a 3 day weekend, and news events, i.e. the 24 hours after a notable national news story, as defined by a composite of year-end top news headlines from media companies including CBS, US News, and Newsweek. We compared the ADR on holiday eves to Fridays not preceding a holiday. We compared the ADR during major news events to that of colonoscopies done on other weekdays. We examined the independent associations of holiday eves and major new events with ADR after adjusting for age, gender, race, ethnicity, FHx of colon cancer, indication for colonoscopy, adequacy of preparation and presence of a fellow using multivariate logistic regression.

Results: We identified 9,999 colonoscopies performed during the study period (69% screening, 31% surveillance), including 169 that occurred on a holiday eve and 176 that occurred during a news event. The ADR during news events was 33%, which was not significantly different to other colonoscopies (37%, p = 0.3). The ADR on holiday eves was 36%, which was not significantly different compared to other Friday colonoscopies (35%, p = 0.8). Multivariate analysis showed age, gender, colonoscopy preparation quality and surveillance colonoscopies were each independent predictors of ADR, but that holiday eves (OR 1.04; 95% CI 0.74-1.46) and news events (OR 0.85; 95% CI 0.61-1.16) were not. The presence of a fellow was associated with adenoma detection in the model that evaluated news events (see table).

Discussion: Time periods of increased distraction were not associated with a significant decrease in ADR. Further studies should determine the strategies used to maintain attention during holiday eves and news events and incorporate them to combat periods of known decreased ADR such as afternoons.

Multivariate Analysis of ADR on Holiday Eve Fridays vs Regular Fridays (n=2,070)					Multivariate Analysis of ADR in the 24hrs After News Events vs Regular Days (n=9,999)
Variable		OR	95% CI	p value	Variable		OR	95% CI	p value
Holiday Eve	No			0.8	News Event	No			0.3
Holiday Eve	Yes	1.04	0.74-1.46	0.8	News Event	Yes	0.85	0.61-1.16	0.3
Age Range	50-59			< 0.001	Age Range	50-59			< 0.001
	60-69	1.27	1.03-1.58			60-69	1.25	1.13-1.38
	70-79	1.56	1.20-2.03			70-79	1.69	1.51-1.90
	80+	2.86	1.63-5.12			80+	2.44	1.90-3.14
Gender	Female			< 0.001	Gender	Female			< 0.001
Gender	Male	1.51	1.25-1.82	< 0.001	Gender	Male	1.54	1.41-1.67	< 0.001
Race	White			0.9	Race	White			0.5
	African American/Black	0.92	0.65-1.29			African American/Black	1.03	0.88-1.21
	Unknown or Other	0.99	0.80-1.23			Unknown or Other	1.06	0.96-1.16
Ethnicity	Non Hispanic or Latino			< 0.001	Ethnicity	Non Hispanic or Latino			< 0.001
	Hispanic or Latino	1.62	1.24-2.11			Hispanic or Latino	1.26	1.12-1.42
	Unknown	2.23	0.90-5.43			Unknown	1.88	1.14-3.07
Family Hx of Cancer	No			0.7	Family Hx of Cancer	No			>0.9
Family Hx of Cancer	Yes	0.92	0.62-1.35	0.7	Family Hx of Cancer	Yes	1	0.86-1.18	>0.9
Colonoscopy Indication	Screening			< 0.001	Colonoscopy Indication	Screening			< 0.001
Colonoscopy Indication	Surveillance	1.63	1.32-2.01	< 0.001	Colonoscopy Indication	Surveillance	1.5	1.37-1.65	< 0.001
Adequate Preparation	No			< 0.001	Adequate Preparation	No			< 0.001
Adequate Preparation	Yes	2.85	1.67-5.17	< 0.001	Adequate Preparation	Yes	1.64	1.31-2.07	< 0.001
Fellow Presence	No			0.2	Fellow Presence	No			< 0.001
Fellow Presence	Yes	1.16	0.92-1.47	0.2	Fellow Presence	Yes	1.33	1.2-1.47	< 0.001

Table: Holiday eve analysis compared colonoscopies performed on Fridays. News event analysis compared colonoscopies performed on all weekdays. Logistic regression modeling used to obtain odds ratios (ORs) and confidence intervals (CI).

Disclosures:

Arence Paasewe indicated no relevant financial relationships.

Anna Krigel indicated no relevant financial relationships.

Daniel Freedberg indicated no relevant financial relationships.

Benjamin Lebwohl indicated no relevant financial relationships.

Arence Paasewe, MD¹, Anna Krigel, MD¹, Daniel Freedberg, MD², Benjamin Lebwohl, MD, MS¹. P0334 - Do Adenoma Detection Rates Decline Before Holidays and During Major News Events?, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.