Prospective Observational Study on the Prevalence and Diagnostic Value of General Practitionersâ€™ Gut Feelings for Cancer and Serious Diseases
Abstract Background General practitioners (GPs) have recognized the presence of gut feelings in their diagnostic process. However, little is known about the frequency or determinants of gut feelings or the diagnostic value of gut feelings for cancer and other serious diseases. Objective To assess the prevalence of gut feelings in general practice, examine their determinants… read more
De Augeo magazine special voor de huisartsenzorgÂ â€˜Kindermishandeling; zo signaleer je en werk je samenâ€™ staat online (link).
General practitionersâ€™ recognition and management of child abuse: what is going well and what could be improved?
In the Netherlands, child abuse affects about 100.000 children resulting in at least 17 child fatalities a year. General practitionersâ€™ (GPs) health care position is of vital importance for recognising and managing child abuse. In this Clinical Lesson, using three illustrating cases, we discuss how GPsâ€™ suspicion of child abuse may arise including the role… read more
Building the case for the use of gut-feelings in cancer referrals: perspectives of patients referred to a non-specific symptoms pathway
Abstract Background: Gut-feelings may be useful when dealing with uncertainty that is ubiquitous in primary care. Both patients and GPs experience this uncertainty but patientsâ€™ views on gut-feelings in the consultation have not been explored. Aim: To explore patientsâ€™ perceptions of gut-feelings in decision-making, and compare these perceptions to those of GPs. Design and setting:… read more
Cultivating Doctorsâ€™ Gut Feeling: Experience, Temporality and Politics of Gut Feelings in Family Medicine
Abstract For the past decade, within family medicine there has been a focus on cultivating doctors gut feelings as â€˜a way of knowingâ€™ in cancer diagnostics. In this paper, building on interviews with family doctors in Oxford shire, UK we explore the embodied and temporal dimensions of clinical reasoning and how the cultivation of doctorsâ€™… read more
Abstract accepted for presentation (workshop Clinical Decision Making, 2021 April) Background Research indicated that patientsâ€™ feelings of worriedness play a role in their physiciansâ€™ clinical reasoning and judgment of clinical tribunals. Interviews with primary care workers and patients showed how these feelings are expressed. Based on these expressions we developed a questionnaire to measure gut… read more
Abstract accepted for presentation (workshop Clinical Decision Making 2021 April) Background: General practitionersâ€™ diagnostic gut feelings (GF) proved to be valuable. But what about patientsâ€™ GF? Dutch medical tribunals consider patientsâ€™ worry useful for doctorsâ€™ diagnostics. Research showed that patientsâ€™ GF contribute to their physiciansâ€™ clinical reasoning but how this happens is unclear. Research questions… read more
BackgroundÂ The use of gut feelings to guide clinical decision making in primary care has been frequently described but is not considered a legitimate reason for cancer referral. AimÂ To explore the role that gut feeling plays in clinical decision making in primary care. Design and settingÂ Qualitative interview study with 19 GPs in Oxfordshire, UK. MethodÂ GPs who… read more
Understanding the role of GPsâ€™ gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence
Background Growing evidence for the role of GPsâ€™ gut feelings in cancer diagnosis raises questions about their origin and role in clinical practice. Aim To explore the origins of GPsâ€™ gut feelings for cancer, their use, and their diagnostic utility. Design and setting Systematic review and meta-analysis of international research on GPsâ€™ gut feelings in… read more
Embracing complexity with systems thinking in general practitioners’ clinical reasoning helps handling uncertainty
Clinical reasoning in general practice is increasingly challenging because of the rise in the number of patients with multimorbidity. This creates uncertainty because of unpredictable interactions between the symptoms from multiple medical problems and the patient’s personality, psychosocial context and life history. Case analysis may then be more appropriately managed by systems thinking than by… read more