Research program

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 Maastricht-Antwerp research group 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-Antwerp 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.

Tutorials on clinical reasoning in GP traineeship (Maastricht-Antwerp) has been analysed focused on the role of gut feelings.

A study of the role of gut feelings in the hospital specialists’ domain (Zwolle-Antwerp) has been rounded off.

A glossary of gut feelings’ related wordings in our research domain has been composed.

The gut feelings questionnaire has been translated into French, German and Polish.

Current research:

  • What is the role of gut feelings in recognition by GPs of child abuse?
  • A feasibility study of the gut feelings questionnaire in France, Belgium, the Netherlands and Germany.
  • The interaction between gut feelings and other elements of clinical reasoning such as context information and experience has been studied in an experimental study design. A publication is in process.
  • PhD project: the significance of gut feelings in clinical reasoning in recognition of pulmonary embolism (French GPs, Brest).
  • PhD project: the correlation between gut feelings and the diagnosis cancer (Spanish GPs, Mallorca).
  • Do patients have gut feelings too? What expressions and words do they use according to GPs, practice-nurses and triagistes? And how do these primary caregivers deal with this gut feelings? What is the view of medical disciplinary tribunals in the Netherlands about the significance of patients’ gut feelings in the diagnostic reasoning process of their GPs? And last but not least, what do patients themselves tell us about this topic? After all, are we able to determine a patient’s gut feeling in the waiting room using a validated questionnaire? If yes, we would be able to count the correlation between gut feelings of patients, gut feelings of GPs and the outcome of a referral or non-referral after three months.