General practitioners (GPs) sometimes base clinical decisions entirely on gut feelings, even though there is little evidence about the diagnostic and prognostic value of such feelings, e.i. the “sense of alarm” and the “sense of reassurance”, in daily practice. An e-mail survey among GPs in all countries allied to the European General Practitioners Research Network (EGPRN) has shown that one form of gut feelings, the sense of alarm, is quite commonly perceived by general practitioners in Europe. The research group at Maastricht has developed a definition of gut feelings and identified their main determinants, with the help of qualitative research techniques (focus groups and a Delphi consensus procedure). This research has also resulted in a consensus on the meaning of the sense of alarm and the sense of reassurance. A group of French researchers has participated in this research by comparing the results of the Dutch focus group research with the opinions of French GPs, using a Delphi consensus procedure.

With the help of a nominal group technique, a research agenda has been established to validate the concept of gut feelings and to estimate their value for daily practice and medical education. This agenda can be used for collaborative research in several European countries.

The Maastricht group also studied how Dutch disciplinary tribunals have dealt with the phenomenon of gut feelings in their considerations and have searched for information in databases with decisions of disciplinary tribunals in other European countries.

The literature on diagnostic reasoning has been reviewed and a theoretical framework was composed to understand how gut feelings arise in a GP’s diagnostic reasoning and how they function.

The consensus on a definition of gut feelings enabled the Maastricht group to operationalise the gut feelings’ concept by designing a questionnaire to record (the use of) gut feelings. The construct validity of this questionnaire was found to be good.

Current research:

• Analysing tutorials on clinical reasoning in GP traineeship (Maastricht-Antwerp).
• The interaction between gut feelings and other elements of clinical reasoning (Maastricht-Antwerp).
• The significance of the determinant experience related to gut feelings (Maastricht-Antwerp).
• Initiating gut feelings research in the hospital specialist’ domain (Maastricht-Antwerp-Groningen).
• PhD project: the significance of gut feelings in clinical reasoning of French GPs (Brest).
• Linguistic validation of the questionnaire (Poland).
• Composing a glossary of gut feelings’ related wording in the research domain (Cogita).