Report of the last COGITA meeting (Tampere, 2019, May 9th)

Monday, May 13th, 2019

We had a very valuable and nice meeting in Tampere (Finland). In the morning, a number of empirical studies were presented as well as an epistemological study about uncertainty. In the afternoon, we extensively discussed a proposal to apply for an EU COST project subsidy.

The participants were from France, Spain, Belgium, Ukraine, Finland, Estonia, Ireland, Poland, Croatia and the Netherlands.

Presentations:

  • The preliminary results of the CORap study (Gut Feelings Prognostic Value in Primary Care) by Bernardino Oliva-Fanlo (Spain)
  • Quantitative and thematic analysis of gut feelings’ text notes, by Bernardino Oliva-Fanlo (Spain)
  • GPs’ sense of alarm is valuable in dyspnoea and chest pain, by Marie Barais (France)
  • The child abuse study: ongoing study, by Erik Stolper (the Netherlands)
  • Gut feelings in the diagnostic reasoning process; the role of uncertainty, by Paul Van Royen (Belgium).

Following the discussion after the presentations:

  • We considered the value of a Likelihood Ratio compared to a Predictive Value (the first one has more significance)
  • The protocol in the chest pain study (Marie Barais) will be repeated in Belgium and we recommend other researchers to do the same in their country. Because of the probable quite high homogeneity of GPs’ diagnostic reasoning processes, we may sum up all results and reach more power and validity.

COST proposal:

In order to make further strategic steps and to reach a higher level of collaboration with more active members and a common research project, one possibility could be to submit a COST-project providing funding for the creation of research networks. These networks offer an open space for collaboration among scientists across Europe (and beyond) and thereby give impetus to research advancements and innovation. Funds are givens for 4 years to cover collaboration activities such as workshops, working group meetings, training schools, dissemination and communication activities – average COST action support is EUR 130.000 per annum for participation.

We discussed a scope, a kind of an overview of key ideas, written by Erik Stolper and Paul Van Royen. Here you find some of the remarks made during the discussion:

  • A COST project is not aimed for funding research but for bringing together researchers from all over Europe to develop collaboration on a clear scientific area, in our case, the whole diagnostic reasoning process (DR) of GPs including the role of the patient. In fact, we then are opening up our research to a broader field where experts in other domains might contribute to a better understanding of DR. Our topic of research upon till now, gut feelings in DR, keeps an important element but in the wholeness of the consultation
  • We then should focus on many interfacing elements of DR and take a more holistic approach, discerning the building blocks but still not loosening their connectedness in a possible complex network. Therefore we need experts from other domains but have to keep central the medical point of view, the reason for encounter
  • Indicating clear outcome indicators is a main component of the proposal including a number of lectures, publications, workshops about e.g. using measures, and research ideas
  • The subsection in the scope about the enablement of the patient is a major item but should be extended. Teresa Pawlikovska will add more elements to this subsection.
  • Implementing the final results of the network in medical education -the valorisation of the outcomes- is one of our aims of a research network but medical education as a major topic deserves more attention in the scope
  • A COST network enables its members to compose full proposals applying for European funds for common research projects
  • We discussed items such as complexity thinking approach, uncertainty, the importance of interprofessional dialogues, decision support tools, artificial intelligence and the interaction in the physician-patient relationship.

Decision

In the end, we decided to start up a COST project application. The next call will be closed 5-th September (2019). About 4 weeks we will decide to go for this call or for the next one in 2020.Paul Van Royen, Erik Stolper, Magdalena Esteva, Marie Barais, Teresa Pawlikovska and Norbert Donner-Banzhoff belong to the core team. Within 4 weeks (half June) all additions and improvements have to be sent to Paul Van Royen (paul.vanroyen@uantwerpen.be), who will will be the lead applicant.

Next COGITA meeting

The next meeting will be in Gothenburg (Sweden), 2020 May 7th, the day before the EGPRN conference. Please save the date in your diary.