{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T21:11:24Z","timestamp":1793221884179,"version":"4.5.0"},"reference-count":21,"publisher":"BMJ","issue":"10","funder":[{"name":"Balearic Cancer League","award":["2017"],"award-info":[{"award-number":["2017"]}]},{"name":"Institute of Health Research Carlos III","award":["PI18\/01492"],"award-info":[{"award-number":["PI18\/01492"]}]},{"name":"Sociedad Espa\u00f1ola de Medicina Familiar y Comunitaria","award":["Isabel Fern\u00e1ndez 2016"],"award-info":[{"award-number":["Isabel Fern\u00e1ndez 2016"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,9,17]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cancer diagnosis in primary care is an important challenge for general practitioners (GPs) due to the relatively low frequency of any single type of cancer and the heterogeneous signs and symptoms that can be present. In addition to analytical reasoning, GPs may become aware of gut feelings (GFs) as they suspect that a patient may have cancer or another serious disease. We aimed to investigate the prevalence and the predictive value of GFs for the diagnosis of cancer and serious diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Prospective observational study of diagnostic validity. Participation will be offered to GPs from Majorca and Zaragoza (Spain). They will recruit all patients with a new reason for encounter during one or two workdays. GPs will complete the Gut Feelings Questionnaire (GFQ). Variables regarding patient, GP and consultation will be collected. Two and 6\u2009months after the first visit, incident diagnoses of cancer or other serious diseases, diagnostic tests performed, referrals and new visits will be recorded. Analysis will include a descriptive analysis of the variables and prevalence of GFs, and the sensitivity, specificity, predictive values and likelihood ratios of the GFs (sense of alarm and sense of reassurance) for diagnosing cancer and other serious diseases, as measured with the GFQ.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has obtained approval from the Majorcan Primary Care Research Committee and from the Balearic Islands Ethical Committee, with reference number IB 3210\/16 PI. The results may help GPs to make more accurate decisions about which patients need further examinations to rule out or to confirm a diagnosis of cancer or a serious disease, and which ones do not. The results will be published as part of the PhD project of the first author and in open access journals, and will be presented at medical conferences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-032404","type":"journal-article","created":{"date-parts":[[2019,10,29]],"date-time":"2019-10-29T07:02:03Z","timestamp":1572332523000},"page":"e032404","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence and diagnostic value of GPs\u2019 gut feelings for cancer and serious diseases: protocol for a prospective observational study of diagnostic validity"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7861-1168","authenticated-orcid":false,"given":"Bernardino","family":"Oliva-Fanlo","sequence":"first","affiliation":[{"name":"Primary Care Research Unit of Mallorca, Balearic Health Services-IbSalut, Palma, Spain"},{"name":"UBS Porreres (CS Ses Roques Llises), Majorca Primary Care Department, Porreres, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebasti\u00e0","family":"March","sequence":"additional","affiliation":[{"name":"Primary Care Research Unit of Mallorca, Balearic Health Services-IbSalut, Palma, Spain"},{"name":"Can Misses Primary Health Centre, Balearic Islands Health Research Institute (IdISBa), Palma (I.Baleres), Spain"},{"name":"Preventive Activities and Health Promotion Network, Carlos III Institute of Health (RedIAPP-RETICS), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Medina","sequence":"additional","affiliation":[{"name":"Primary Care Research Unit of Mallorca, Balearic Health Services-IbSalut, Palma, Spain"},{"name":"Can Misses Primary Health Centre, Balearic Islands Health Research Institute (IdISBa), Palma (I.Baleres), Spain"},{"name":"Preventive Activities and Health Promotion Network, Carlos III Institute of Health (RedIAPP-RETICS), Madrid, Spain"},{"name":"Manacor Primary Health Centre, Majorca Primary Care Department, Manacor, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Mart\u00edn-Rabad\u00e1n","sequence":"additional","affiliation":[{"name":"Primary Care Research Unit of Mallorca, Balearic Health Services-IbSalut, Palma, Spain"},{"name":"Can Misses Primary Health Centre, Balearic Islands Health Research Institute (IdISBa), Palma (I.Baleres), Spain"},{"name":"Preventive Activities and Health Promotion Network, Carlos III Institute of Health (RedIAPP-RETICS), Madrid, Spain"},{"name":"Can Misses Primary Health Centre, Ibiza and Formentera Health District, Eivissa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaspar","family":"Tamborero","sequence":"additional","affiliation":[{"name":"Primary Care Research Unit of Mallorca, Balearic Health Services-IbSalut, Palma, Spain"},{"name":"Coll d'en Rabassa Primary Health Centre, Majorca Primary Care Department, Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Stolper","sequence":"additional","affiliation":[{"name":"Department of General Practice, Faculty of Health, Medicine and Life Sciences, Caphri School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands"},{"name":"Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Esteva","sequence":"additional","affiliation":[{"name":"Primary Care Research Unit of Mallorca, Balearic Health Services-IbSalut, Palma, Spain"},{"name":"Can Misses Primary Health Centre, Balearic Islands Health Research Institute (IdISBa), Palma (I.Baleres), Spain"},{"name":"Preventive Activities and Health Promotion Network, Carlos III Institute of Health (RedIAPP-RETICS), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,28]]},"reference":[{"key":"2025121508123687000_9.10.e032404.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00205-3"},{"key":"2025121508123687000_9.10.e032404.2","doi-asserted-by":"crossref","first-page":"366","DOI":"10.3399\/bjgp10X515412","article-title":"Positive predictive values of \u22655% in primary care for cancer: systematic review","volume":"60","author":"Shapley","year":"2010","journal-title":"Br J Gen Pract"},{"key":"2025121508123687000_9.10.e032404.3","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.30"},{"key":"2025121508123687000_9.10.e032404.4","doi-asserted-by":"publisher","DOI":"10.3109\/02813432.2012.688701"},{"key":"2025121508123687000_9.10.e032404.5","doi-asserted-by":"crossref","unstructured":"Hull FM . The consultation process. In: Sheldon M , Brooke J , Rector A , eds. Decision making in general practice. London: MacMillan, 1985: 13\u201326.","DOI":"10.1007\/978-1-349-07159-3_2"},{"key":"2025121508123687000_9.10.e032404.6","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2296-10-17","article-title":"The diagnostic role of gut feelings in general practice a focus group study of the concept and its determinants","volume":"10","author":"Stolper","year":"2009","journal-title":"BMC Fam Pract"},{"key":"2025121508123687000_9.10.e032404.7","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2296-10-66","article-title":"Consensus on gut feelings in general practice","volume":"10","author":"Stolper","year":"2009","journal-title":"BMC Fam Pract"},{"key":"2025121508123687000_9.10.e032404.8","doi-asserted-by":"crossref","first-page":"237","DOI":"10.3109\/13814788.2013.779662","article-title":"The transculturality of \u2018gut feelings\u2019. Results from a French Delphi consensus survey","volume":"19","author":"Le Reste","year":"2013","journal-title":"Eur J Gen Pract"},{"key":"2025121508123687000_9.10.e032404.9","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-012847","article-title":"Gut feelings in the diagnostic process of Spanish GPs: a focus group study","volume":"6","author":"Oliva","year":"2016","journal-title":"BMJ Open"},{"key":"2025121508123687000_9.10.e032404.10","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2296-14-1","article-title":"Family physicians\u2019 diagnostic gut feelings are measurable: construct validation of a questionnaire","volume":"14","author":"Stolper","year":"2013","journal-title":"BMC Fam Pract"},{"key":"2025121508123687000_9.10.e032404.11","doi-asserted-by":"crossref","DOI":"10.1186\/s12875-017-0626-0","article-title":"The linguistic validation of the gut feelings questionnaire in three European languages","volume":"18","author":"Barais","year":"2017","journal-title":"BMC Fam Pract"},{"key":"2025121508123687000_9.10.e032404.12","first-page":"1","article-title":"Cross-cultural translation and validation of the \u2018 gut feelings \u2019 questionnaire into Spanish and Catalan","volume":"0","author":"Oliva-Fanlo","year":"2018","journal-title":"Eur J Gen Pract"},{"key":"2025121508123687000_9.10.e032404.13","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1038\/bjc.2015.41","article-title":"Cancer detection in primary care: insights from general practitioners","volume":"112","author":"Green","year":"2015","journal-title":"Br J Cancer"},{"key":"2025121508123687000_9.10.e032404.14","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp14X680125"},{"key":"2025121508123687000_9.10.e032404.15","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1186\/s12885-015-1424-5","article-title":"The Danish cancer pathway for patients with serious non-specific symptoms and signs of cancer\u2013a cross-sectional study of patient characteristics and cancer probability","volume":"15","author":"Ingeman","year":"2015","journal-title":"BMC Cancer"},{"key":"2025121508123687000_9.10.e032404.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-012511","article-title":"Determinants of general practitioner's cancer-related gut feelings-a prospective cohort study","volume":"6","author":"Donker","year":"2016","journal-title":"BMJ Open"},{"key":"2025121508123687000_9.10.e032404.17","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cms065"},{"key":"2025121508123687000_9.10.e032404.18","unstructured":"Mart\u00ednez-Ca\u00f1avate L\u00f3pez-Montes T . MODELO MULTINIVEL EXPLICATIVO de la UTILIZACI\u00d3N de las CONSULTAS de ATENCI\u00d3N PRIMARIA en ANDALUC\u00cdA, 2007. Available: http:\/\/hera.ugr.es\/tesisugr\/16905234.pdf"},{"key":"2025121508123687000_9.10.e032404.19","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.76.6.972"},{"key":"2025121508123687000_9.10.e032404.20","doi-asserted-by":"publisher","DOI":"10.1027\/1015-5759.25.1.39"},{"key":"2025121508123687000_9.10.e032404.21","doi-asserted-by":"publisher","DOI":"10.1002\/ejsp.401"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-032404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T16:12:42Z","timestamp":1765815162000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-032404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10]]},"references-count":21,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2019,10,28]]},"published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1136\/bmjopen-2019-032404"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-032404","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10]]}}}