The ‘sense of alarm’ (‘gut feeling’) in clinical practice. A survey among European general practitioners on recognition and expression

Figures & data

Table I. Questionnaire.

Every Dutch-speaking GP probably knows that special sense in some consultations: ‘There's something wrong with this patient but I don't know exactly what. I have to do something for this patient because waiting longer might be bad for him or her’. It is a non-specific sense, non-analytical but important to be recognised. Something vague in the patient's story or in the presentation triggers the doctor's attention and alerts him or her. It has something to do with prognosis.

In the Netherlands and Flanders (Belgium), we use a typical expression for this sense, viz. ‘niet-pluis’. We recently started research to examine the value of this feeling, i.e. its diagnostic properties. Unfortunately, the literature offers almost nothing about this topic.

We would, therefore, like you to answer the following questions, if possible:1. Do you recognise this special sense?2. Do you have an expression or descriptive phrase for this feeling in your language? If yes, please write it down below. How would you translate this in English?

Table II ‘Sense of alarm’ and comparable expressions in Europe.

Country	Recognition	Expression/description
Bulgaria	Yes	No specific expression.
Bulgaria	Yes	Intuition.
Croatia	Yes	Intuition, sixth sense.
Denmark	Yes	Min sjette sans sagde mig = My sixth sense tells me something is wrong.Noget i min mave fortalte mig = something in my stomach told me or my gut feeling told me.Et eller andet sagde mig at noget er galt = something tells me something is wrong.
France	Yes	Sentiment d'ėtrangetė = a sense of something strange.
France	Yes	Peut-être intuition ou intime conviction = one's innermost conviction.
France	Yes	Mauvais presentiment ou mauvaise premonition = ominous feeling or a bad premonition.
Germany	Yes	Alarmgefűhl = sense of alarm.
Germany	Yes	Hier stimmt was nicht = there's something wrong here.
Germany	Yes	Ahnung. Gefűhl = suspicion, feeling.
Greece	Yes	K = there is something I don't like.K = something ‘smells’ here.K = there is something that does not ‘stick’ here.
Greece	Yes	K = something will come to me or happen to me or something is coming.
Hungary	Yes	Megmagyarazkatatlan allapotromlas = unexplained detoriation. Valami nem tetstik = something dislike.
Israel	Yes	Gut feeling, abdominal sensations.
Israel	Yes	No expression in Hebrew; sixth sense.
Italy	Yes	No.
Italy	Yes	Brutto presentimento = an uneasy premonition.
Italy	Yes	No specific expression.
Malta	Yes	Ixxomm xi haga = something ‘smells’.
Norway	Yes	Magefølelse = feeling in my stomach.Noe som ikke stemmer = something that doesn't fit in.Pasienten virker syk = patient seems ill.
Norway	Yes	Dårlig magefǿlelse = bad feeling in the stomach.
Portugal	Yes	sexto sentido = sixth sense.
Romania	Yes	No specific expression.
South Africa	Yes	Gut feel. Instinct.
Serbia/Montenegro	Yes	Neobjasnjivo zdravstveno stanje = unexplained health condition.Svestan opasnosti = alert to danger.Potencijalno opasno zdravstveno stanje = potential dangerous health condition.
Switzerland	Yes	Mon petit doigt me dit, intuition = my little finger says.
Turkey	Yes	Koku var = this has a smell, this case ‘smells’.
UK	Yes	Gut feeling.Uncertain feeling but needing to do something.
UK	Yes	I have a feeling in my bones.
UK	Yes	Clinical hunch or sixth sense that something serious is going on or clinical intuition.