title: Gut instinct: a diagnostic tool?
abstract: OBJECTIVE
  It is generally accepted that with experience clinicians develop the ability to identify patients who present with malignancy prior to a formal diagnosis. This ability cannot be quantified, nor is it a plausible substitute for investigation. This study aimed to evaluate the association between instinct and head and neck cancer diagnosis.
  
  
  METHODS
  A prospective study of patients requiring urgent diagnostic procedures for suspected cancer between August and December 2010 was performed. Risk factors, symptoms, signs and the clinician's impression were recorded. These were graded and subsequently correlated with histology findings.
  
  
  RESULTS
  Twenty-seven patients, with a mean age of 62.2 years, underwent a diagnostic procedure. Thirty per cent of patients were referred under the two-week pathway and 18.5 per cent had a previous history of head and neck cancer. A diagnosis of cancer was made in 37 per cent of patients. There was a positive correlation between clinical suspicion and cancer diagnosis (Kendall's tau-b = 0.648749).
  
  
  CONCLUSIONS
  This study highlights the importance of clinical suspicion in cancer diagnosis. Although clinical suspicion cannot be quantified, it should be regarded as an integral part of patient assessment.
authors: Otolaryngology Department,Sunderland Royal Infirmary,UK.
authors: I Z
authors: IZ
authors: Iqbal
authors: Otolaryngology Department,Sunderland Royal Infirmary,UK.
authors: N
authors: N
authors: Kara
authors: Otolaryngology Department,Sunderland Royal Infirmary,UK.
authors: C
authors: C
authors: Hartley
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D019545:Intuition; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Investigative Techniques