SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2020
Understanding the role of GPs' gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 6 of them syntheses that pooled it.
What it found
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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.
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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.
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Who cites it
49 citing papers in PubMed, 6 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Identification and Management of Binge-Eating Disorder and Bulimia Nervosa in Primary Care Settings: A Qualitative Systematic Review of Healthcare Professionals' and Patients' Perceptions.The International journal of eating disorders · 2026Pooled it
- Predictive accuracy of surgeon gestalt for adverse postoperative outcomes: systematic review.The British journal of surgery · 2025Pooled it
- Gut feeling for the diagnosis of cancer in general practice: a diagnostic accuracy review.BMJ open · 2023Pooled it
- Pooled it
- Pooled it
- Factors shaping the implementation and use of Clinical Cancer Decision Tools by GPs in primary care: a qualitative framework synthesis.BMJ open · 2021Pooled it
- Article
- Physicians' appraisal of parental concerns: a qualitative assessment.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Dr AI will see you now: could artificial intelligence replace general practitioners?Irish journal of medical science · 2025Article
- Article
- A UK population-based case-control study of blood tests before cancer diagnosis in patients with non-specific abdominal symptoms.British journal of cancer · 2025Article
- Prevalence and characteristics of the 'bad feeling' among healthcare professionals in the context of emergency situations: A Bi-Hospital Survey.Journal of clinical nursing · 2025Article
- Article
- Signs and symptoms of serious illness in adults with acute abdominal pain presenting to ambulatory care: a systematic review.BJGP open · 2024Article
- Hidden systems in primary care cancer detection: an embedded qualitative intervention development study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Personal and organisational health literacy in the non-specific symptom pathway for cancer: An ethnographic study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Understanding GPs' referral decisions for younger patients with symptoms of cancer: a qualitative interview study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- The impact of variation in out-of-hours doctors' referral practices: a Norwegian registry-based observational study.Family practice · 2023Observational
- The linguistic validation of the gut feelings questionnaire in Turkish.The European journal of general practice · 2023Article
- Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundGrowing evidence for the role of GPs' gut feelings in cancer diagnosis raises questions about their origin and role in clinical practice.
aimTo explore the origins of GPs' gut feelings for cancer, their use, and their diagnostic utility. DESIGN AND
settingSystematic review and meta-analysis of international research on GPs' gut feelings in primary care.
methodSix databases were searched from inception to July 2019, and internet searches were conducted. A segregated method was used to analyse, then combine, quantitative and qualitative findings.
resultsTwelve articles and four online resources were included that described varied conceptualisations of gut feelings. Gut feelings were often initially associated with patients being unwell, rather than with a suspicion of cancer, and were commonly experienced in response to symptoms and non-verbal cues. The pooled odds of a cancer diagnosis were four times higher when gut feelings were recorded (OR 4.24, 95% confidence interval = 2.26 to 7.94); they became more predictive of cancer as clinical experience and familiarity with the patient increased. Despite being included in some clinical guidelines, GPs had varying experiences of acting on gut feelings as some specialists questioned their diagnostic value. Consequently, some GPs ignored or omitted gut feelings from referral letters, or chose investigations that did not require specialist approval.
conclusionGPs' gut feelings for cancer were conceptualised as a rapid summing up of multiple verbal and non-verbal patient cues in the context of the GPs' clinical knowledge and experience. Triggers of gut feelings not included in referral guidance deserve further investigation as predictors of cancer. Non-verbal cues that trigger gut feelings appear to be reliant on continuity of care and clinical experience; they tend to remain poorly recorded and are, therefore, inaccessible to researchers.
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Registered trials
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.