{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:15:32Z","timestamp":1780964132864,"version":"3.54.1"},"reference-count":43,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T00:00:00Z","timestamp":1581984000000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Agence R\u00e9gionale de Sant\u00e9 ARS Bretagne","award":["This funding source had no role in the design of t"],"award-info":[{"award-number":["This funding source had no role in the design of t"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,1,27]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Dyspnoea and chest pain are symptoms shared with multiple pathologies ranging from the benign to life-threatening diseases. A Gut Feelings Questionnaire (GFQ) has been validated to measure the general practitioner\u2019s (GPs) sense of alarm or sense of reassurance. The aim of the study was to estimate the diagnostic test accuracy of GPs\u2019 sense of alarm when confronted with dyspnoea and chest pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and settings<\/jats:title>\n                    <jats:p>Prospective observational study in general practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients aged between 18 and 80 years, consulting their GP for dyspnoea and\/or chest pain, were considered for enrolment. These GPs had to complete the GFQ immediately after the consultation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>Life-threatening and non-life-threatening diseases have previously been defined according to the pathologies or symptoms in the International Classification of Primary Care (ICPC)-2 classification. The index test was the sense of alarm and the reference standard was the final diagnosis at 4 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>25 GPs filled in 235 GFQ questionnaires. The positive likelihood ratio for the sense of alarm was 2.12 (95% CI 1.49 to 2.82), the negative likelihood ratio was 0.55 (95% CI 0.37 to 0.77).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Where the physician experienced a sense of alarm when a patient consulted him\/her for dyspnoea and\/or chest pain, the post-test odds that this patient had, in fact, a life-threatening disease was about twice as high as the pretest odds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial results\" xlink:href=\"NCT02932982\">NCT02932982<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-034348","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T04:27:29Z","timestamp":1582086449000},"page":"e034348","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Accuracy of the general practitioner\u2019s sense of alarm when confronted with dyspnoea and\/or chest pain: a prospective observational study"],"prefix":"10.1136","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct02932982","registry":"10.18810\/clinical-trials-gov","type":"results"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0535-8258","authenticated-orcid":false,"given":"Marie","family":"Barais","sequence":"first","affiliation":[{"name":"Department of General Practice, EA 7479 SPURBO, Facult\u00e9 de M\u00e9decine et des Sciences de la Sant\u00e9, Universit\u00e9 de Bretagne Occidentale, Brest, Bretagne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Fossard","sequence":"additional","affiliation":[{"name":"Department of General Practice, EA 7479 SPURBO, Facult\u00e9 de M\u00e9decine et des Sciences de la Sant\u00e9, Universit\u00e9 de Bretagne Occidentale, Brest, Bretagne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Dany","sequence":"additional","affiliation":[{"name":"Department of Public Health, EA 7479 SPURBO, Facult\u00e9 de M\u00e9decine et des Sciences de la Sant\u00e9, Universit\u00e9 de Bretagne Occidentale, Brest, Bretagne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristan","family":"Montier","sequence":"additional","affiliation":[{"name":"Inserm UMR1078, Facult\u00e9 de M\u00e9decine et des Sciences de la Sant\u00e9, Universit\u00e9 de Bretagne Occidentale, Brest, Bretagne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Stolper","sequence":"additional","affiliation":[{"name":"CAPHRI School for Public Health and Primary Care, University of Maastricht, Maastricht, The Netherlands"},{"name":"Department of Primary and Interdisciplinary Care, University of Antwerp Faculty of Medicine and Health Sciences, Wilrijk, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9554-1680","authenticated-orcid":false,"given":"Paul","family":"Van Royen","sequence":"additional","affiliation":[{"name":"Department of Primary and Interdisciplinary Care, University of Antwerp Faculty of Medicine and Health Sciences, Wilrijk, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,2,18]]},"reference":[{"key":"2025121513591468000_10.2.e034348.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200106283442611"},{"key":"2025121513591468000_10.2.e034348.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12875-015-0373-z","article-title":"Studies of the symptom dyspnoea: a systematic review","volume":"16","author":"Viniol","year":"2015","journal-title":"BMC Fam Pract"},{"key":"2025121513591468000_10.2.e034348.3","unstructured":"Letrilliart L , Supper I , Schuers M , et al . 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