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Pay attention to gut feelings about cancer in patients
Question clinique
How reliable are general practitioners' gut feelings in diagnosing cancer in their patients?
L’Essentiel
In this systematic review, clinicians' gut feelings of a potential cancer diagnosis in their patients are associated with higher odds of cancer. It also finds, not surprisingly, that clinicians often act on their gut feelings. 2a-
Référence
Plan de l'etude: Systematic review
Financement: Government
Cadre: Outpatient (primary care)
Sommaire
These authors searched multiple databases, websites, and reference lists of included papers to identify studies that evaluated general practitioners' use of gut feelings (and a variety of potential synonyms) for a potential cancer diagnosis. They used reasonable methods in selecting articles, extracting data, and assessing the methodologic quality of the included studies. They identified 12 articles and 4 online resources; 6 papers were qualitative. Although the authors rated the methodologic quality of the qualitative studies as reasonable, they had significant qualms about the other studies. Not surprisingly, many clinicians had difficulty in specifying what their guts were saying; ie, that their suspicion was that the patient was "unwell" as opposed to specifically having cancer. When gut feelings were present, clinicians generally acted on them, either through referral or through careful follow-up. Among 4 studies with 17,420 patients of whom 448 had a cancer diagnosed, the authors report that when the general practitioner had "a gut feeling" the odds of the patient having cancer was 4.24 (95% CI 2.26 - 7.94), but the data were heterogeneous.
Reviewer
Henry C. Barry, MD, MS
Professor
Michigan State University
East Lansing, MI
Commentaires
gut feelings
There is a good description of this in Malcolm Gladwell's book; "Blink"
“Gut feelings”
What are “gut feelings”? I think it is just another term we use to describe that sensation that we know something but we really can’t describe how we know it. “Psychic” is another term for it. I’m not deriding listening to your gut; I use it all the time. Over the years I think most of us have learned that we must listen to our gut on a lot of things. I think we are just observing abnormalities about the patient that we cannot adequately describe, but that our brain has associated with cancer or other ill health. Perhaps it is a subtle skin colour change, or scent on the breath or body. Something that flies below our conscious mind, but still informs us. If we pay attention. We are trained observers, after all.
Gut feeling on cancer
A common phenomenon in family docs certainly and often proves valid!
Evidence Based Intuition
Great to have some empirical evidence to back up what many of us already know, that clinical intuition and gut feelings are a critical aspect of being a physician.
gut feelings about cancer in a patient
I believe that good practitioners practice the "art of medicine" which involves "gut feelings" that something is wrong and needs to be investigated
Gut Feeling
Gut Feeling is our body's way of communicating its assessment of the situation apart from our logical brain. The way the body communicates its feeling of fear, hunger, anxiety etc are by feeling (emotions mediated by chemicals) not words and sentences. We favour the supposedly more objective analytic thoughtful approach rather than encouraging the subjective emotional thinking process of our body. Brain and Body have different ways of assessing the World and coping with problems.