Evidence map›Paper›PMID 30696671›Full record

ArticleBMJ open2019

Role of intuitive knowledge in the diagnostic reasoning of hospital specialists: a focus group study.

Nydia Van den Brink, Birgit Holbrechts, Paul L P Brand, Erik C F Stolper, Paul Van Royen

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.

  1. Understanding the role of GPs' gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
    Pooled it
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  7. Physicians' appraisal of parental concerns: a qualitative assessment.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
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  8. Evidence-Based Medicine: Past, Present, Future.Journal of clinical medicine · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Nydia Van den BrinkFaculty of Medicine and Health Sciences, Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.
Birgit HolbrechtsFaculty of Medicine and Health Sciences, Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.
Paul L P BrandDepartment of Pediatrics, Isala Hospitals, Zwolle, The Netherlands.
Erik C F StolperFaculty of Medicine and Health Sciences, Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.
Paul Van RoyenCAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands.
Maastricht University · NLUniversity of Antwerp · BEIsala · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveIntuition is an important part of human decision-making and can be explained by the dual-process theory where analytical and non-analytical reasoning processes continually interact. These processes can also be identified in physicians' diagnostic reasoning. The valuable role of intuition, including gut feelings, has been shown among general practitioners and nurses, but less is known about its role among hospital specialists. This study focused on the diagnostic reasoning of hospital specialists, how they value, experience and use intuition. DESIGN AND

participantsTwenty-eight hospital specialists in the Netherlands and Belgium participated in six focus groups. The discussions were recorded, transcribed verbatim and thematically coded. A circular and iterative analysis was applied until data saturation was achieved.

resultsDespite initial reservations regarding the term intuition, all participants agreed that intuition plays an important role in their diagnostic reasoning process. Many agreed that intuition could guide them, but were cautious not to be misguided. They were especially cautious since intuition does not have probative force, for example, in medicolegal situations. 'On-the-job experience' was regarded as a precondition to relying on intuition. Some participants viewed intuition as non-rational and invalid. All participants said that intuitive hunches must be followed by analytical reasoning. Cultural differences were not found. Both the doctor as a person and his/her specialty were seen as important determinants for using intuition.

conclusionsHospital specialists use intuitive elements in their diagnostic reasoning, in line with general human decision-making models. Nevertheless, they appear to disagree more on its role and value than previous research has shown among general practitioners. A better understanding of how to take advantage of intuition, while avoiding pitfalls, and how to develop 'skilled' intuition may improve the quality of hospital specialists' diagnostic reasoning.

Indexed as

Clinical Decision-MakingIntuitionSpecializationAttitude of Health PersonnelBelgiumFocus GroupsHumansNetherlandsProblem Solvingclinical reasoningdecision makinghospital specialistsintuition

Identifiers

PMID30696671
PMCPMC6352845
OpenAlexW2913819189

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.