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

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: Semi-structured focus groups and 1-1 interviews to generate qualitative data that was subjected to thematic analysis 2 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. Sub-themes 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.