How much should doctors trust parental intuition?

A "smart mother" often makes a "better diagnosis than a poor doctor": medical students are often given this century-old advice from pioneering German surgeon Dr August Bier – and a new study has confirmed just how seriously they should take it.

Parental intuition is better than medical tests at predicting the deterioration of an unwell child, researchers have found – strengthening the case for parents' concerns to be taken more seriously in hospital settings, including giving parents the right to ask for a second opinion.

'Permission to speak up'

The study, published in the Lancet Child & Adolescent Health, analysed data from nearly 190,000 A&E visits by children to a hospital in Melbourne, Australia. The carer of each child was asked, "Are you worried your child is getting worse?" The researchers found that "caregiver concern for clinical deterioration" was "significantly associated" with a need for ICU admission and mechanical ventilation, with children four times more likely to need ICU care if their caregiver had voiced these concerns.

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In fact, caregiver concern was "more strongly associated" with ICU admission than "any abnormal vital sign", including abnormal heart rate, abnormal breathing or blood pressure changes. Overall, the researchers found, children of caregivers who had said they were concerned that their child was deteriorating, were "more unwell, more likely to be admitted to an inpatient ward, and stayed in hospital almost three times as long".

These are findings "we cannot ignore", said lead study author Erin Mills, of Monash University, Melbourne. Parents should be treated "as part of the care team. We want every hospital to recognise that, and give parents the permission, and power, to speak up."

Gut feelings

Intuition, sometimes known as a gut feeling, is "the idea of making decisions without analytical reasoning", said Parents.com. Emotions play a key role in this sort of decision-making and, some neuroscientists believe, "past emotional experiences" can create "future gut feelings".

Added to that, parents – particularly mothers – can be more susceptible or sensitive to cues from their child. "The rise and fall of gestational hormones over the course of her pregnancy, along with the surge of oxytocin during labour and birth, prime mothers for responsiveness," anthropologist Sarah Hrdy, author of "Mother Nature", told the parenting site. "A new mother's top priority is often to make sure her baby is safe, and she will have a low threshold for sensing anything amiss."

But it can sometimes it can be hard to distinguish intuition from anxiety and fear – hence some medics' reluctance to place too much emphasis on parental concern.

A boost for Martha's Rule

The study findings will boost support for Martha's Rule, a new scheme rolling out in NHS hospitals that gives patients and their families the right to an urgent second medical opinion on the condition of a seriously ill patient.

The scheme is named after Martha Mills, who died of sepsis in a London hospital: her parents "repeatedly raised concerns" about her deterioration but were "dismissed" by doctors, said The Times.

MPs were told in March that thousands of patients or their loved ones have already sought a second opinion about their NHS care under the trial.