Abstract accepted for poster presentation at the EGPRN-conference (Tampere, Finland, 2019)

Bernardino Oliva-Fanlo, Sebastià March, Cristina Gadea, Erik Stolper, Magdalena Esteva

Background: GPs use gut feelings (GF) during a patient visit to pace their decisions. A ‘sense of alarm’ (SA) means that intervention seems necessary to prevent imminent serious health problems, and a ‘sense of reassurance’ (SR) implies that a GP feels secure about whether and what therapy needs to be started. We don’t know how these senses are captured in patient’s electronic clinical records (ECR).

Research Question: Are there differences regarding the extent of the text and the subjects treated when the physician has a SA and when the physician has a SR?

Method: Review of text notes of 73 patients included in a broader study about GF. Presence of SA or SR was determined using the GF Questionnaire. We collected number of words used by the GPs in their annotations: complete annotation and its parts (anamnesis, examination, action plan).Thematic analysis: Two different researchers read separately the text notes, coded the expressions used and assigned the codes to categories. They met and agreed with the codes and categories selected.

Results: 29 SA, 44 SR.

• GPs tend to use more words when having a SA than when having a SR in all the sections of text notes, although differences are bigger in anamnesis and examination.
• GPs write more details about examination and investigations requested when there is a SA.
• GPs report more data about treatment when they feel a SR.

Conclusion: When having a SA GPs suspect possible serious consequences. So they try to gather more data from clinical interview and physical examination. Or same data are actually collected but GPs need to leave record of their actions more frequently when having a SA. GPs with a SA tend to perform broader patient’s examinations (physical and vital signs), to request more diagnostic procedures (tests, investigations or referrals), and to propose fewer treatments.