Evid Based Med doi:10.1136/eb-2012-101099
  • Prognosis
  • Cohort study

Physicians’ gut feeling is useful in diagnosing serious infection in children

  1. Manoj K Mittal
  1. Division of Emergency Medicine, The Children's Hospital of Philadelphia, Pennsylvania, USA
  1. Correspondence to: Manoj K Mittal
    Division of Emergency Medicine—CTRB, The Children's Hospital of Philadelphia, 9th Floor, 3501 Civic Center Blvd., Philadelphia, PA 19104, USA; mittal{at}

Commentary on: Van den Bruel A, Thompson M, Buntinx F, et al. Clinicians’ gut feeling about serious infections in children: observational study. BMJ 2012;345:e6144.


With the advent of effective vaccinations, serious infections (SI) have become rare among children presenting to primary care settings, yet when not diagnosed promptly, such infections, especially meningitis and septic shock, can cause substantial morbidity and mortality. Hence, researchers continue to search for new diagnostic methods; the present study by Van den Bruel and colleagues investigates the basis and value of gut feeling or intuition in addition to clinical assessment for diagnosing SI in children.


This is a secondary analysis of a prospective, observational study that enrolled 3890 children aged 0–16 years old presenting to general practitioners or community paediatricians in Flanders, Belgium. ‘Gut feeling’ is defined as a positive response to the statement, ‘something is wrong’.1 Clinical impression is defined as a subjective impression …

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