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Questions: In children with acute illness (patient) does gut feeling (test) rule in or rule out serious infections (outcome)?
Methods
Design: Prospective cohort study of children 0–16 years.
Setting: Primary care, general practitioners or community paediatricians. Flanders, Belgium.
Patients The study included 3890 children aged 0–16 years, presenting with an acute illness of less than 5 days duration.
Diagnostic strategy
At the initial consultation the following were recorded:
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A list of clinical features was made, on which an objective clinical impression was based.
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The clinician also recorded their gut feeling, defined as an intuitive feeling that something was wrong even if the clinician was unsure why.
Subsequently a panel, blinded to the initial clinical evaluation, made the final diagnosis of serious infection, based on hospital records and clinicians’ follow-up information. Association of gut feeling with specific clinical features or with clinician experience was analysed using logistic regression.
Outcomes
Of 3890 children, …
Correspondence to Dr Ian D Wacogne, General Paediatrics, Birmingham Childrens Hospital, Steelhouse Lane, Birmingham B4 6NH, UK; ian.wacogne{at}bch.nhs.uk
Footnotes
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Funding None.
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Competing interests None.
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Provenance and peer review Not commissioned; internally peer reviewed.