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  • Prevalence and diagnostic value of GPs’ gut feelings for cancer and serious diseases: protocol for a prospective observational study of diagnostic validity

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General practice / Family practice
Protocol
Prevalence and diagnostic value of GPs’ gut feelings for cancer and serious diseases: protocol for a prospective observational study of diagnostic validity
  1. Bernardino Oliva-Fanlo1,2,
  2. Sebastià March1,3,4,
  3. David Medina1,3,4,5,
  4. María Martín-Rabadán1,3,4,6,
  5. Gaspar Tamborero1,7,
  6. Erik Stolper8,9,
  7. Magdalena Esteva1,3,4
  1. 1 Primary Care Research Unit of Mallorca, Balearic Health Services-IbSalut, Palma, Spain
  2. 2 UBS Porreres (CS Ses Roques Llises), Majorca Primary Care Department, Porreres, Spain
  3. 3 Can Misses Primary Health Centre, Balearic Islands Health Research Institute (IdISBa), Palma (I.Baleres), Spain
  4. 4 Preventive Activities and Health Promotion Network, Carlos III Institute of Health (RedIAPP-RETICS), Madrid, Spain
  5. 5 Manacor Primary Health Centre, Majorca Primary Care Department, Manacor, Spain
  6. 6 Can Misses Primary Health Centre, Ibiza and Formentera Health District, Eivissa, Spain
  7. 7 Coll d'en Rabassa Primary Health Centre, Majorca Primary Care Department, Palma, Spain
  8. 8 Department of General Practice, Faculty of Health, Medicine and Life Sciences, Caphri School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands
  9. 9 Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
  1. Correspondence to Dr Bernardino Oliva-Fanlo; boliva{at}ibsalut.caib.es

Abstract

Introduction Cancer diagnosis in primary care is an important challenge for general practitioners (GPs) due to the relatively low frequency of any single type of cancer and the heterogeneous signs and symptoms that can be present. In addition to analytical reasoning, GPs may become aware of gut feelings (GFs) as they suspect that a patient may have cancer or another serious disease. We aimed to investigate the prevalence and the predictive value of GFs for the diagnosis of cancer and serious diseases.

Methods and analysis Prospective observational study of diagnostic validity. Participation will be offered to GPs from Majorca and Zaragoza (Spain). They will recruit all patients with a new reason for encounter during one or two workdays. GPs will complete the Gut Feelings Questionnaire (GFQ). Variables regarding patient, GP and consultation will be collected. Two and 6 months after the first visit, incident diagnoses of cancer or other serious diseases, diagnostic tests performed, referrals and new visits will be recorded. Analysis will include a descriptive analysis of the variables and prevalence of GFs, and the sensitivity, specificity, predictive values and likelihood ratios of the GFs (sense of alarm and sense of reassurance) for diagnosing cancer and other serious diseases, as measured with the GFQ.

Ethics and dissemination The study has obtained approval from the Majorcan Primary Care Research Committee and from the Balearic Islands Ethical Committee, with reference number IB 3210/16 PI. The results may help GPs to make more accurate decisions about which patients need further examinations to rule out or to confirm a diagnosis of cancer or a serious disease, and which ones do not. The results will be published as part of the PhD project of the first author and in open access journals, and will be presented at medical conferences.

  • gut feelings
  • diagnosis
  • cancer
  • intuition
  • general medicine (see internal medicine)

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-032404

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    Footnotes

    • Twitter @c_c_baxter

    • Contributors BO-F, ME, SM and ES conceived the study, participated in its design and coordination, and helped to draft the manuscript. MM-R, DM and GT participated in the design and helped to draft the manuscript. All authors read and approved the final manuscript.

    • Funding This work was supported by grants from the Balearic Cancer League (AECC-Baleares, 2017) and the Institute of Health Research Carlos III (PI18/01492). In addition, the corresponding author received an ‘Isabel Fernandez’ PhD grant in 2016 from the Spanish Society of Family and Community Medicine (semFYC).

    • Competing interests This study is part of the corresponding author’s PhD project.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.