How Deliciously Unscientific!
Modern Medicine Embraces Intuition
SOURCE: MedPage Today ~ Sept. 25, 2012
By Nancy Walsh, Staff Writer
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston
This new MedPage review advises medical doctors that: Physicians should pay attention to their “gut feeling” that something may be seriously wrong when assessing a child with an infectious disease — even if the clinical appearance is reassuring. 
Among 3,369 children whose primary care evaluation did not suggest a serious illness, six (0.2%) ultimately were admitted to the hospital with a severe infection, according to Ann Van den Bruel, MD, PhD, of the Radcliffe Observatory Quarter in Oxford, England, and colleagues.
The clinician’s gut feeling that the child was seriously ill considerably increased the chance that a severe infection was present, with a likelihood ratio of 25.5 (95% CI 7.9 to 82), and heeding the feeling might have prevented two cases from being overlooked (33%, 95% CI 0.95 to 1.75), the researchers reported online in BMJ.
Considerable research has focused on developing tools for clinical prediction in acutely ill children, including symptoms, vital signs, and laboratory tests, but primary care physicians often see children before the full clinical picture has developed — and sometimes report relying on intuition that a potentially serious problem exists even though they’re unsure why.
Moreover, a systematic review recently determined that such a gut feeling had considerable diagnostic significance. 
The most remarkable findings in this study were: (more…)