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Gut instinct: a diagnostic tool?

I Z Iqbal1, N Kara1, C Hartley1

  • 1Otolaryngology Department,Sunderland Royal Infirmary,UK.

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|March 20, 2015
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Summary
This summary is machine-generated.

Clinician instinct positively correlates with head and neck cancer diagnosis. This clinical suspicion is crucial for patient assessment, even if it cannot be precisely quantified.

Keywords:
Investigative Techniques

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Area of Science:

  • Oncology
  • Otorhinolaryngology

Background:

  • Experienced clinicians often develop an unquantifiable ability to suspect malignancy before formal diagnosis.
  • This clinical intuition is recognized but not formally assessed as a diagnostic tool.

Purpose of the Study:

  • To evaluate the association between clinician's instinct (suspicion) and the diagnosis of head and neck cancer.
  • To determine if subjective clinical impression correlates with objective histological findings.

Main Methods:

  • Prospective study of 27 patients undergoing urgent diagnostic procedures for suspected cancer (August-December 2010).
  • Clinician's impression, risk factors, symptoms, and signs were recorded and graded.
  • Correlated clinician's impression with subsequent histology results.

Main Results:

  • 37% of patients were diagnosed with cancer.
  • A significant positive correlation was found between clinical suspicion and cancer diagnosis (Kendall's tau-b = 0.648749).
  • 30% of patients were referred via the two-week pathway; 18.5% had prior head and neck cancer history.

Conclusions:

  • Clinical suspicion is an important factor in diagnosing head and neck cancer.
  • While not quantifiable, clinician's instinct should be considered an integral part of patient assessment.
  • Highlights the value of experienced judgment in the diagnostic pathway.