How useful are gut feelings in medical practice? A scientific debate

Sunday, April 5th, 2015

In Huisarts en Wetenschap (april 2015) staat een wetenschappelijke beschouwing over de betekenis van het pluis/niet-pluis gevoel in het diagnostisch denken van artsen: ‘Hoe pluis is het niet-pluisgevoel’? De eerste resultaten van een onderzoek onder ziekenhuisspecialisten worden vermeld.

Abstract (Huisarts&Wetenschap):

Many GPs use their gut feelings, in terms of a sense of reassurance or a sense of alarm, as a diagnostic compass. It is an initially non-analytical feeling, which can however set in train a process of rationally argued diagnostic management. The feeling is based on knowledge: medical knowledge, experiential knowledge and contextual knowledge. Gut feelings can act as a third track in diagnostic reasoning in addition to the well-known medical decision-making and medical problem-solving tracks, and thus contribute to selecting and processing relevant information in the diagnostic process. Discussing gut feelings in GP training courses provides better insights into the non-analytical aspects of the diagnostic reasoning by trainees. A short, validated questionnaire to assess the presence or absence of gut feelings in the diagnostic reasoning of GPs is available. Hospital-based specialists also acknowledge the value of gut feelings in their reasoning, but emphasize that this always needs to be followed by an analytical step in the diagnostic process. Although evidence and ‘skilled intuition’ may sometimes look like irreconcilable opposites, the combination fits in very well with the concept of evidence-based medicine. Doctors are experts on diagnostics who have become very skilled in intuitively and analytically integrating different types of knowledge.

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