September 21, 2009

Gut feelings: Usually alarm or reassurance

So-called gut feelings play a substantial role in primary physicians' diagnostic reasoning, but in combination with analytical reasoning, Dutch researchers say.

Erik Stolper of Maastricht University, The Netherlands, worked with a team of 27 medical opinion leaders to define gut feelings closely and allow future research to evaluate the effectiveness of the gut-compass.

The panel concluded a sense of alarm means a primary care physician perceives an uneasy feeling, indicating concern about a possible adverse outcome. A physician might not have found any specific indications but have a sense there's something wrong here, Stolper said.

A sense of alarm activates the diagnostic process by stimulating a doctor to formulate and weigh up working hypotheses that might involve a serious outcome, Stolper said.

The sense of reassurance means a physician feels secure about the further management and course of a patient's problem, even though he or she may not be certain about the diagnosis.

Our next step will be to construct and validate a questionnaire as a tool to evaluate gut feelings as well as the diagnostic work-up and the contribution of major potential determinants like experience and contextual knowledge, Stolper said in a statement.

The findings are published in the journal BMC Family Practice.