Stakeholder perspectives on contributors to delayed and inaccurate diagnosis of cardiovascular disease and their implications for digital health technologies: a UK-based qualitative study

ABDULLAYEV, Kamilla, GORVETT, Olivia, SOCHIERA, Anna, LAIDLAW, Lynn, CHICO, Timothy, MANKTELOW, Matthew, BUCKLEY, Oliver, CONDELL, Joan, VAN ARKEL, Richard, DIAZ, Vanessa and MATCHAM, Faith (2024). Stakeholder perspectives on contributors to delayed and inaccurate diagnosis of cardiovascular disease and their implications for digital health technologies: a UK-based qualitative study. BMJ Open, 14 (5): e080445.

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Abstract

Objective: The aim of this study is to understand stakeholder experiences of diagnosis of cardiovascular disease (CVD) to support the development of technological solutions that meet current needs. Specifically, we aimed to identify challenges in the process of diagnosing CVD, to identify discrepancies between patient and clinician experiences of CVD diagnosis, and to identify the requirements of future health technology solutions intended to improve CVD diagnosis. Design: Semistructured focus groups and one-to-one interviews to generate qualitative data that were subjected to thematic analysis. Participants: UK-based individuals (N=32) with lived experience of diagnosis of CVD (n=23) and clinicians with experience in diagnosing CVD (n=9). Results: We identified four key themes related to delayed or inaccurate diagnosis of CVD: symptom interpretation, patient characteristics, patient–clinician interactions and systemic challenges. Subthemes from each are discussed in depth. Challenges related to time and communication were greatest for both stakeholder groups; however, there were differences in other areas, for example, patient experiences highlighted difficulties with the psychological aspects of diagnosis and interpreting ambiguous symptoms, while clinicians emphasised the role of individual patient differences and the lack of rapport in contributing to delays or inaccurate diagnosis. Conclusions: Our findings highlight key considerations when developing digital technologies that seek to improve the efficiency and accuracy of diagnosis of CVD.

Item Type:	Article
Additional Information:	** Embargo end date: 20-05-2024 ** From BMJ via Jisc Publications Router ** Licence for this article starting on 20-05-2024: https://creativecommons.org/licenses/by/4.0/ ** Peer reviewed: TRUE ** Acknowledgements: We would like to thank the two patient and public involvement groups that helped to inform the design of this study: the NIHR Maudsley Biomedical Research Centre’s Race, Ethnicity and Diversity (READ) advisory group and the Sheffield-based Cardiology Patient group. We would also like to thank Dr Valerie de Angel for sharing her R code to help us create figure 2 (see online supplemental file 4) and to thank Helen Denney and Amber Ford for convening the Sheffield patient group and for administrative assistance. **Journal IDs: eissn 2044-6055 **Article IDs: publisher-id: bmjopen-2023-080445 **History: published_online 20-05-2024; published 01-05-2024; accepted 05-04-2024; submitted 02-10-2023
Uncontrolled Keywords:	health services accessibility, qualitative research, patient satisfaction, patient-centered care, cardiology
Identification Number:	https://doi.org/10.1136/bmjopen-2023-080445
SWORD Depositor:	Colin Knott
Depositing User:	Colin Knott
Date Deposited:	31 May 2024 15:45
Last Modified:	31 May 2024 15:45
URI:	https://shura.shu.ac.uk/id/eprint/33763

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