How Do Family Physicians Perceive their Gut Feeling?

DOI: 10.3238/zfa.2020.0463-0466

german translation / full article

Johannes Hauswaldt, Erik C. F. Stolper

Keywords: clinical decision making cognitive science intuition potentially dangerous outcome sense of alarm

SummaryFamily physicians (FPs) care for patients with both benign and serious diseases sometimes presented with the same vague symptoms. In these situations, FPs occasionally experience an uncomfortable feeling that something is not quite right in a patient’s clinical presentation. It alerts the doctor, occasionally activates the diagnostic process and may trigger specific action to avert an immediately serious outcome. Results are presented from European co-operative research on physician’s non-analytical cognitive processes in clinical decision making. The initial qualitative approach with semi structured interviews on the opinion of German FPs about gut feelings, and what their colleagues all over Europe said, was followed by systematic studies in the Netherlands, Flanders and France according to an agreed research agenda. The European research group COGITA generated a glossary of terms on topics of physician’s gut feelings. Its members developed a short questionnaire, which was translated into six languages, validated, and tested by FPs in three countries for application feasibility during consultation hours. In a prospective observational study on the accuracy of their gut feelings, French FPs found a positive Likelihood-Ratio of 2.12 (95% CI 1.49 to 2.82) and a negative Likelihood-Ratio of 0.55 (95% CI 0.37 to 0.77).Though by no means always reliable, emerging gut feelings should be considered by physicians during clinical encounter and decision making.Keywordsclinical decision making; potentially dangerous outcome; sense of alarm; intuition; cognitive science

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