Establishing a European research agenda on 'gut feelings' in general practice. A qualitative study using the nominal group technique.
OBJECTIVE
Although 'gut feelings' are perceived as playing a substantial role in the diagnostic reasoning of the general practitioner (GP), there is little evidence about their diagnostic and prognostic value. Consensus on both types of 'gut feelings' (a 'sense of alarm', a 'sense of reassurance') has enabled us to operationalize the concept. As a next step we wanted to identify research questions that are considered relevant to validate the concept of 'gut feelings' and to estimate its usefulness for daily practice and medical education. Moreover, we were interested in the study designs considered appropriate to study these research questions.


METHODS
The nominal group technique (NGT) is a qualitative research method of judgmental decision-making involving four phases: generating ideas, recording them, evaluation and prioritization. Dutch and Belgian academics whose subject is general practice (n = 18), attended one of three meetings during which NGT was used to produce a 'research agenda' on 'gut feelings'.


RESULTS
NGT yielded ten research questions and nine corresponding appropriate designs on four topics, i.e. the diagnostic value of 'gut feelings', the validation of its determinants, the opportunities for integrating 'gut feelings' in medical education and a rest group. The study designs respectively included recording and follow-up of 'gut feelings', video recording of consultations with stimulated recall using simulated and real patients respectively, analysing trainees' consultation stories and videos, linguistic analyses, and vignette studies. Furthermore, two experimental designs were proposed.


CONCLUSIONS
A European research agenda on 'gut feelings' in general practice has been established and could be used in collaborative research.
Stolper
Erik
E
Maastricht University, Faculty of Health, Medicine and Life Sciences, CAPHRI School for Public Health and Primary Care, Department of General Practice, Maastricht, The Netherlands. cf.stolper@hag.unimaas.nl
van Leeuwen
Yvonne
Y
van Royen
Paul
P
van de Wiel
Margaretha
M
van Bokhoven
Marloes
M
Houben
Paul
P
Hobma
Sjoerd
S
van der Weijden
Trudy
T
Dinant
Geert Jan
GJ
D003657:Decision Making; D003933:Diagnosis; D005060:Europe; D005194:Family Practice / Q000379:methods; D006126:Group Processes; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D016544:Patient Simulation; D010821:Physicians, Family / Q000523:psychology*; D012107:Research Design; D014741:Video Recording