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Aim

GPs sometimes describe getting an uneasy feeling called a gut feeling that makes them think that their patient could be seriously unwell, even if the patient has no other obvious symptoms that would point to a serious illness. This study aims to understand how General Practitioners (GPs) develop and use their gut feelings when making decisions about how to treat patients who they suspect may have cancer, including decisions about whether to refer them to specialist services for further testing. It will also explore patient experiences of being referred to services based on their GP’s gut feeling. Finally, this study aims to establish how good a GP’s gut feeling is at predicting whether their patient has cancer. Doing this will provide information to the organisations who make guidelines for GPs so that GPs might be taught how to recognise and respond to their own gut feelings.

Why is this important?

GPs regularly use their gut feelings to help identify patients who may have cancer. Previous research has suggested that they are an effective tool in identifying patients, however, there are also concerns that GPs’ gut feelings may be too subjective and prone to error. As a result, no guidelines currently recommend that GPs should refer patients for further investigations based on this criterion and a discussion of these is not included in GP education. This project aims to better understand how gut feelings work and how useful they are in helping to identify patients who have cancer in primary care.

Methods

This study will be conducted in four stages:

  1. Studies that have explored the use of gut feelings in the diagnosis of cancer will be identified and combined to provide us with information about what is already known on the topic.
  2. 20 – 25 interviews will be conducted with GPs who have referred patients to the SCAN Pathway, a new cancer pathway in Oxfordshire, which allows GPs to refer patients for investigations based on a gut feeling. Interviews will explore how these gut feelings develop, how they influence GPs’ decisions about how to treat patients.
  3. 20 – 25 interviews will be conducted with patients who have been referred to the SCAN Pathway based on their GPs’ gut feelings. Interviews will examine their views on being referred based on this criterion. They will also explore the role of their own gut feelings in making decisions about whether to visit their GP.
  4. Anonymised data of patients who have been referred to the SCAN Pathway based on their GPs’ gut feelings will be used to calculate how effective they are in predicting whether a patient has cancer. The data will also be used to see if there is a relationship between how at risk of cancer GPs think their patients are and the patients’ actual cancer risk.

How could this benefit patients?

This work will contribute to an understanding of GPs’ gut feelings and their role in cancer diagnosis. Study findings will provide valuable information to GPs and their professional bodies about how useful gut feeling is in identifying a patient that has cancer. Information may be used to inform clinical guidelines, training for GPs and information for patients.

Further information:

External collaborators:

  • Eric Stolper

Funders:

Cancer Research UK

Links:

Suspected CANcer (SCAN) Diagnostic Pathway

Contact for further information:

Claire Friedemann Smith