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Determinants of general practitioner’s cancer related gut feelings – a prospective cohort study
Donker, G., Wiersma, E., Heins, M. Determinants of general practitioner’s cancer related gut feelings – a prospective cohort study European Journal of Public Health: 2016, 26(suppl. 1) . Abstract: 9th European Public Health Conference All for Health, Health for All Vienna, Austria 9–12 November 2016
Background
General practitioners (GPs) use gut feelings to diagnose cancer in an early stage, but little is known about the predictive value of gut feelings and how this is influenced by patient and GP characteristics.
Methods
Prospective cohort study of patients in 44 general practices throughout the Netherlands, from January 2010 till December 2013. GPs completed a questionnaire regarding gut feelings, patient and GP characteristics, if they noticed a cancer-related gut feeling during patient consultation. Follow-up questionnaires were sent 3 months later requesting information about the patient’s diagnosis. Chi-square, uni- and multivariate logistic regression and multilevel analyses were performed.
Results
A gut feeling (N = 366) is most often triggered by weight loss (24%, N = 85) and rare GP visits (22%, N = 76), but none of the triggers were predictive of cancer in a multivariate analysis except for patient’s (P = 0.01) and doctor’s age (P = 0.04). Most GPs (95%) acted immediately on the gut feeling, either referring to a specialist or by performing additional medical tests. The average positive predictive value of cancer related gut feeling was 35%. This increases with 2% for every year a patient becomes older, and with 3% for every year a GP becomes older.
Conclusions
GP’s gut feeling for cancer proves to be a useful tool in diagnosing cancer and its relative high predicting value increases if the GP is older or more experienced and when the patient is older. The value of GP’s gut feeling needs more attention in guidelines and medical training concerning cancer.
Key messages:
•Profesional experience enhances development of cancer related gut feelings
•The value of GP’s gut feeling needs more attention in guidelines and medical training concerning cancer
General practitioners (GPs) use gut feelings to diagnose cancer in an early stage, but little is known about the predictive value of gut feelings and how this is influenced by patient and GP characteristics.
Methods
Prospective cohort study of patients in 44 general practices throughout the Netherlands, from January 2010 till December 2013. GPs completed a questionnaire regarding gut feelings, patient and GP characteristics, if they noticed a cancer-related gut feeling during patient consultation. Follow-up questionnaires were sent 3 months later requesting information about the patient’s diagnosis. Chi-square, uni- and multivariate logistic regression and multilevel analyses were performed.
Results
A gut feeling (N = 366) is most often triggered by weight loss (24%, N = 85) and rare GP visits (22%, N = 76), but none of the triggers were predictive of cancer in a multivariate analysis except for patient’s (P = 0.01) and doctor’s age (P = 0.04). Most GPs (95%) acted immediately on the gut feeling, either referring to a specialist or by performing additional medical tests. The average positive predictive value of cancer related gut feeling was 35%. This increases with 2% for every year a patient becomes older, and with 3% for every year a GP becomes older.
Conclusions
GP’s gut feeling for cancer proves to be a useful tool in diagnosing cancer and its relative high predicting value increases if the GP is older or more experienced and when the patient is older. The value of GP’s gut feeling needs more attention in guidelines and medical training concerning cancer.
Key messages:
•Profesional experience enhances development of cancer related gut feelings
•The value of GP’s gut feeling needs more attention in guidelines and medical training concerning cancer