{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:47:36Z","timestamp":1761630456995},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2007,6,8]],"date-time":"2007-06-08T00:00:00Z","timestamp":1181260800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2007,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Many factors impacting cecal intubation rates have been examined in detail; however, little information exists regarding the effect of the timing of the procedure. We sought to examine any difference in cecal intubation rates between morning and afternoon colonoscopies and identify factors contributing to a discrepancy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Retrospective, single-center study comparing cecal intubation rates for colonoscopies performed in the morning (begun prior to 12 noon) and colonoscopies performed in the afternoon (begun after 12 noon) over an approximately 12 month period. Univariate and multivariate analyses were performed evaluating patient demographics, procedure indication(s), endoscopist, bowel preparation type and quality, and participation by a gastroenterology fellow.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>6087 colonoscopies were evaluated in this study. Colonoscopies (n = 3729) performed in the morning were compared to colonoscopies performed in the afternoon (n = 2358). The crude completion rate to the cecum was 95.0% in the morning group while the completion rate to the cecum was 93.6% of the afternoon exams (p = 0.02). The morning colonoscopies had better bowel preparation quality (p &lt; 0.001). The multivariate analyses demonstrated that gender, age, and bowel preparation quality impacted completion rates. After correcting for these factors, there was no significant difference in completion rates in the morning versus afternoon.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Uncorrected cecal intubation rates were lower in the afternoon compared to the morning in outpatients undergoing colonoscopy. Bowel preparation quality was worse in the afternoon compared with the morning. Efforts at improving afternoon bowel preparation may improve the outcome of afternoon colonoscopies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-230x-7-19","type":"journal-article","created":{"date-parts":[[2007,6,8]],"date-time":"2007-06-08T18:14:37Z","timestamp":1181326477000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Comparison of morning versus afternoon cecal intubation rates"],"prefix":"10.1186","volume":"7","author":[{"given":"Christopher D","family":"Wells","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell I","family":"Heigh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virender K","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D","family":"Crowell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suryakanth R","family":"Gurudu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan A","family":"Leighton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora","family":"Mattek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David E","family":"Fleischer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2007,6,8]]},"reference":[{"key":"19_CR1","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1056\/NEJM200007203430301","volume":"343","author":"DA Lieberman","year":"2000","unstructured":"Lieberman DA, Weiss DG, Bond JH, Ahnen DJ, Garewal H, Chejfec G, et al: Use of colonoscopy to screen asymptomatic adults for colorectal cancer. N Engl J Med. 2000, 343: 162-8. 10.1056\/NEJM200007203430301.","journal-title":"N Engl J Med"},{"key":"19_CR2","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/S0016-5107(91)70674-3","volume":"37","author":"JD Waye","year":"1991","unstructured":"Waye JD, Bashkoff E: Total Colonosocpy: is it always possible?. Gastrointest Endosc. 1991, 37: 152-4.","journal-title":"Gastrointest Endosc"},{"issue":"4","key":"19_CR3","first-page":"556","volume":"89","author":"JM Church","year":"1994","unstructured":"Church JM: Complete colonoscopy: how often? And if not, why?. Am J Gastroenterol. 1994, 89 (4): 556-60.","journal-title":"Am J Gastroenterol"},{"key":"19_CR4","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1007\/BF02049733","volume":"38","author":"WC Cirocco","year":"1995","unstructured":"Cirocco WC, Rusin LC: Factors that predict incomplete colonoscopy. Dis Col Rect. 1995, 38: 964-8. 10.1007\/BF02049733.","journal-title":"Dis Col Rect"},{"key":"19_CR5","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/S0016-5107(06)80113-6","volume":"43","author":"BP Saunders","year":"1996","unstructured":"Saunders BP, Fukumoto M, Halligan S, Jobling C, Moussa ME, Bartram CI, et al: Why is colonosocpy more difficult in women?. Gastrointest Endosc. 1996, 43: 124-6. 10.1016\/S0016-5107(96)70317-6.","journal-title":"Gastrointest Endosc"},{"key":"19_CR6","doi-asserted-by":"publisher","first-page":"2784","DOI":"10.1111\/j.1572-0241.2000.03186.x","volume":"95","author":"JC Anderson","year":"2000","unstructured":"Anderson JC, Gonzalez JD, Messina CR, Pollack BJ: Factors that predict colonoscopy: thinner is not always better. Am J Gastroenterol. 2000, 95: 2784-7. 10.1111\/j.1572-0241.2000.03186.x.","journal-title":"Am J Gastroenterol"},{"key":"19_CR7","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.dld.2004.09.015","volume":"37","author":"G Dafnis","year":"2005","unstructured":"Dafnis G, Granath F, Pahlman L, Ekbom A, Blomqvist P: Patient factors influencing the completion rate in colonoscopies. Dig Liv Dis. 2005, 37: 113-8. 10.1016\/j.dld.2004.09.015.","journal-title":"Dig Liv Dis"},{"key":"19_CR8","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/S0016-5107(96)70229-8","volume":"44","author":"A Chak","year":"1996","unstructured":"Chak A, Cooper GS, Blades EW, Canto M, Sivak MV: Prospective assessment of colonoscopic intubation skills in trainees. Gastrointest Endosc. 1996, 44: 54-7. 10.1016\/S0016-5107(96)70229-8.","journal-title":"Gastrointest Endosc"},{"key":"19_CR9","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s004640080147","volume":"15","author":"SD Wexner","year":"2001","unstructured":"Wexner SD, Garbus JE, Singh JJ: A prospective analysis of 13,580 colonoscopies: reevaluation of credentialing guidelines. Surg Endosc. 2001, 15: 251-61. 10.1007\/s004640080147.","journal-title":"Surg Endosc"},{"key":"19_CR10","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1007\/s10620-005-1276-y","volume":"50","author":"GC Harewood","year":"2005","unstructured":"Harewood GC: Relationship of colonscopy completion rates and endoscopist features. Dig Dis Sci. 2005, 50: 47-51. 10.1007\/s10620-005-1276-y.","journal-title":"Dig Dis Sci"},{"key":"19_CR11","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1067\/mge.2000.109802","volume":"52","author":"WH Kim","year":"2000","unstructured":"Kim WH, Cho YJ, Park JY, Min PK, Kand JK, Park IS: Factors affecting insertion time and patient discomfort during colonosocpy. Gastrointest Endosc. 2000, 52: 600-5. 10.1067\/mge.2000.109802.","journal-title":"Gastrointest Endosc"},{"key":"19_CR12","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/S0016-5107(04)02461-7","volume":"61","author":"C Bernstein","year":"2005","unstructured":"Bernstein C, Thorn M, Monsees K, Spell R, O'Connor JB: A prospective study of factors that determine cecal intubation time at colonoscopy. Gastrointest Endosc. 2005, 61: 72-5. 10.1016\/S0016-5107(04)02461-7.","journal-title":"Gastrointest Endosc"},{"key":"19_CR13","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1136\/bmj.329.7467.665","volume":"329","author":"JE Ball","year":"2004","unstructured":"Ball JE, Osbourne J, Jowett S, Pellen M, Welfare MR: Quality improvement programme to achieve acceptable colonoscopy completion rates: prospective before and after study. BMJ. 2004, 329: 665-7. 10.1136\/bmj.329.7467.665.","journal-title":"BMJ"},{"key":"19_CR14","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1016\/S0016-5107(93)70162-5","volume":"39","author":"JB Marshall","year":"1993","unstructured":"Marshall JB, Barthel JS: The frequency of total colonoscopy and ileal intubation in the 1990's. Gastrointest Endosc. 1993, 39: 518-20.","journal-title":"Gastrointest Endosc"},{"key":"19_CR15","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.1111\/j.1572-0241.2002.05812.x","volume":"97","author":"DK Rex","year":"2002","unstructured":"Rex DK, Bond JH, Winawer S, Levin TR, Burt RW, Johnson DA, et al: Quality in the technical performance of colonoscopy and the continuous quality improvement process for colonoscopy: recommendations of the U.S. Multi-Society Task Force on Colorectal Cancer. Am J Gastroenterol. 2002, 97: 1296-1308. 10.1111\/j.1572-0241.2002.05812.x.","journal-title":"Am J Gastroenterol"},{"key":"19_CR16","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1067\/mge.2003.121","volume":"57","author":"PB Cotton","year":"2003","unstructured":"Cotton PB, Connor P, McGee D, Jorwell P, Nickl N, Schutz S, et al: Colonoscopy: practice variation among 69 hospital-based endoscopists. Gastrointest Endosc. 2003, 57: 352-7. 10.1067\/mge.2003.121.","journal-title":"Gastrointest Endosc"},{"key":"19_CR17","doi-asserted-by":"publisher","first-page":"2726","DOI":"10.1111\/j.1572-0241.2006.00887.x","volume":"101","author":"MR Sanaka","year":"2006","unstructured":"Sanaka MR, Shah N, Mullen KD, Ferguson DR, Thomas C, McCullough AJ: Afternoon Colonoscopies Have Higher Failure Rates Compared to Morning Colonoscopies. Am J Gastroenterol. 2006, 101: 2726-30. 10.1111\/j.1572-0241.2006.00887.x.","journal-title":"Am J Gastroenterol"},{"key":"19_CR18","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/S0016-5107(05)00371-8","volume":"62","author":"E Aoun","year":"2005","unstructured":"Aoun E, Abdul-Baki H, Azar C, Mourad F, Barada K, Berro Z, et al: A randomized single-blind trial of split-dose PEG-electrolyte solution without dietary restriction compared with whole dose PEG-electrolyte solution with dietary restriction for colonoscopy preparation. Gastrointest Endosc. 2005, 62: 213-8. 10.1016\/S0016-5107(05)00371-8.","journal-title":"Gastrointest Endosc"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-230X-7-19.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-230X-7-19\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-230X-7-19","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-230X-7-19.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T21:44:44Z","timestamp":1630446284000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/1471-230X-7-19"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,6,8]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2007,12]]}},"alternative-id":["19"],"URL":"https:\/\/doi.org\/10.1186\/1471-230x-7-19","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,6,8]]},"assertion":[{"value":"18 December 2006","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2007","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2007","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"19"}}