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DOI: 10.1055/a-1386-3879
Use of ambient lighting during colonoscopy and its effect on adenoma detection rate and eye fatigue: results of a pilot study
TRIAL REGISTRATION: Non-Randomized, Single Center Clinical Trial NCT04441242 at clinicaltrials.gov
Abstract
Background and study aims Adenoma detection rate (ADR) appears to decrease as the number of consecutive hours performing procedures increases, and eye strain may be a contributing factor. Ambient light may improve symptoms of eye strain, but its effects have yet to be explored in the field of gastroenterology. We aim to determine if using ambient lighting during screening colonoscopy will maintain ADRs and improve eye strain symptoms compared with low lighting.
Methods At a single center, retrospective data were collected on colonoscopies performed under low lighting and compared to prospective data collected on colonoscopies with ambient lighting. Eye fatigue surveys were completed by gastroenterologists. Satisfaction surveys were completed by physicians and staff.
Results Of 498 low light and 611 ambient light cases, 172 and 220 adenomas were detected, respectively (P = 0.611). Under low lighting, the ADR decreased 5.6 % from first to last case of the day (P = 0.2658). With ambient lighting, the ADR increased by 2.80 % (P = 0.5445). The difference in the overall change in ADR between first and last cases with ambient light versus low light was statistically significant (8.40 % total unit change, P = 0.01). The average eye strain scores were 8.12 with low light, and 5.63 with ambient light (P = 0.3341).
Conclusions Performing screening colonoscopies with ambient light may improve the differential change in ADR that occurs from the beginning to the end of the day. This improvement in ADR may be related to improvement in operator fatigue. The effect of ambient light on eye strain is unclear. Further investigation is warranted on the impact of ambient light on symptoms of eye strain and ADR.
Publication History
Received: 29 September 2020
Accepted: 20 January 2021
Article published online:
27 May 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
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References
- 1 Siegel RL, Miller KD, Fuchs HE. et al. Cancer Statistics, 2021. CA Cancer J Clin 2021; 71: 7-33
- 2 Siegel RL, Miller KD, Goding Sauer G. et al. Colorectal cancer statistics, 2020. CA Cancer J Clin 2020; 70: 145-164
- 3 Nishihara R, Wu K, Lochhead P. et al. Long-term colorectal-cancer incidence and mortality after lower endoscopy. N Engl J Med 2013; 369: 1095-1105
- 4 Ran T, Cheng CY, Misselwitz B. Cost-Effectiveness of Colorectal Cancer Screening Strategies-A Systematic Review. Clin Gastroenterol Hepatol 2019; 17: 1969-1981.e15
- 5 Rex DK, Boland CR, Dominitz JA. et al. Colorectal Cancer Screening: Recommendations for Physicians and Patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol 2017; 112: 1016-1030
- 6 Kaminski MF, Wieszczy P, Rupinski M. et al. Increased rate of adenoma detection associates with reduced risk of colorectal cancer and death. Gastroenterology 2017; 153: 98-105
- 7 Almadi MA, Sewitch M, Barkun AN. et al. Adenoma detection rates decline with increasing procedural hours in an endoscopistʼs workload. Can J Gastroenterol Hepatol 2015; 29: 304-308
- 8 Lee CK, Cha JM, Kim WJ. Endoscopist fatigue may contribute to a decline in the effectiveness of screening colonoscopy. J Clin Gastroenterol 2015; 49: e51-e56
- 9 Almario CV, Spiegel BMR. Does endoscopist fatigue impact adenoma detection rate? A review of the evidence to date. Gastrointest Endosc 2017; 85: 611-613
- 10 Teng TY, Khor SN, Kailasam M. et al. Morning colonoscopies are associated with improved adenoma detection rates. Surg Endosc 2016; 30: 1796-1803
- 11 Wu J, Zhao SB, Wang SL. et al. Comparison of efficacy of colonoscopy between the morning and afternoon: A systematic review and meta-analysis. Dig Liver Dis 2018; 50: 661-667
- 12 Lee TJ, Rees CJ, Blanks RG. et al. Colonoscopic factors associated with adenoma detection in a national colorectal cancer screening program. Endoscopy 2014; 46: 203-211
- 13 Zorron Cheng Tao Pu L, Lu K, Ovenden A. et al. Effect of time of day and specialty on polyp detection rates in Australia. J Gastroenterol Hepatol 2019; 34: 899-906
- 14 Gurudu SR, Ratuapli SK, Leighton JA. et al. Adenoma detection rate is not influenced by the timing of colonoscopy when performed in half-day blocks. Am J Gastroenterol 2011; 106: 1466-1471
- 15 Lee A, Jensen CD, Marks AR. et al. Endoscopist fatigue estimates and colonoscopic adenoma detection in a large community-based setting. Gastrointest Endosc 2017; 85: 601-610.e2
- 16 Freedman JS, Harari DY, Bamji ND. et al. The detection of premalignant colon polyps during colonoscopy is stable throughout the workday. Gastrointest Endosc 2011; 73: 1197-1206
- 17 Vertinsky T, Forster B. Prevalence of eye strain among radiologists: influence of viewing variables on symptoms. AJR Am J Roentgenol 2005; 184: 681-686
- 18 Krupinski EA, Berbaum KS, Caldwell RT. et al. Long radiology workdays reduce detection and accommodation accuracy. J Am Coll Radiol 2010; 7: 698-704
- 19 Porcar E, Pons AM, Lorente A. Visual and ocular effects from the use of flat-panel displays. Int J Ophthalmol 2016; 9: 881-885
- 20 Artime Ríos EM, Lasheras FS, Suarez Sánchez A. et al. Prediction of computer vision syndrome in health personnel by means of genetic algorithms and binary regression trees. Sensors (Basel) 2019; 19: 2800
- 21 Schriewer T, Schulze R, Filippi A. et al. The influence of ambient lighting on the detection of small contrast elements in digital dental radiographs. Clin Oral Investig 2013; 17: 1727-1731
- 22 Hellén-Halme K, Petersson A, Warfvinge G. et al. Effect of ambient light and monitor brightness and contrast settings on the detection of approximal caries in digital radiographs: an in vitro study. Dentomaxillofac Radiol 2008; 37: 380-384
- 23 Hellén-Halme K, Lith A. Effect of ambient light level at the monitor surface on digital radiographic evaluation of approximal carious lesions: an in vitro study. Dentomaxillofac Radiol 2012; 41: 192-196
- 24 Ohla H, Dagassan-Berndt D, Payer M. et al. Role of ambient light in the detection of contrast elements in digital dental radiography. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126: 439-443
- 25 Pakkala T, Kuusela L, Ekholm M. et al. Effect of varying displays and room illuminance on caries diagnostic accuracy in digital dental radiographs. Caries Res 2012; 46: 568-574
- 26 Vertinsky T, Forster B. Prevalence of eye strain among radiologists: influence of viewing variables on symptoms. AJR Am J Roentgenol 2005; 184: 681-686
- 27 Liukkonen E, Jartti A, Haapea M. et al. Effect of display type and room illuminance in chest radiographs. Eur Radiol 2016; 26: 3171-3179
- 28 Charwla AS, Ehsan S. Ambient illumination revisited: A new adaptation-based approach for optimizing medical imaging reading environments. Med Physics 2007; 34: 81-90
- 29 Hayes JR, Sheedy JE, Stelmack JA. et al. Computer use, symptoms, and quality of life. Optom Vis Sci 2007; 84: 738-744
- 30 Active Physicians by Sex and Specialty. Physician Specialty Data Report 2018. AAMC; 2022 https://www.aamc.org/data-reports/workforce/data/2018-physician-specialty-data-report-executive-summary
- 31 Sheppard AL, Wolffsohn JS. Digital eye strain: prevalence, measurement and amelioration. BMJ Open Ophthalmol 2018; 3: e000146