Evidence map›Paper›PMID 28283487›Full record

ArticleBMJ open2017

From breathless to failure: symptom onset and diagnostic meaning in patients with heart failure-a qualitative study.

C J Taylor, F D R Hobbs, T Marshall, F Leyva-Leon, N Gale

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Conceptualising diagnostic liminality: a qualitative exploration of the journey to heart failure diagnosis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
  3. Review
  4. Review
  5. Article
  6. Article
  7. Natriuretic peptide testing and heart failure diagnosis in primary care: diagnostic accuracy study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
    Article
  8. Earlier heart failure diagnosis in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
    Article
  9. Article
  10. Observational
  11. Article
  12. Observational
  13. Article
  14. Understanding the management of heart failure with preserved ejection fraction: a qualitative multiperspective study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
    Article
  15. Article
  16. Article
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

C J TaylorNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-8926-2581
F D R HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
T MarshallInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
F Leyva-LeonAston Medical Research Insitutue, Aston Medical School, Birmingham, UK.
N GaleHealth Services Management Centre, University of Birmingham, Birmingham, UK.
University of Birmingham · GBUniversity of Oxford · GBAston University · GB

Funding

Department of Health DRF-2012-05-407Department of Health WMCLAHRC-2014-1Medical Research Council MC_PC_11004
6 · The paper itself

Abstract

objectivesTo explore 2 key points in the heart failure diagnostic pathway-symptom onset and diagnostic meaning-from the patient perspective.

designQualitative interview study.

settingParticipants were recruited from a secondary care clinic in central England following referral from primary care.

participantsOver age 55 years with a recent (<1 year) diagnosis of heart failure confirmed by a cardiologist following initial presentation to primary care.

methodsSemistructured interviews were carried out with 16 participants (11 men and 5 women, median age 78.5 years) in their own homes. Data were audio-recorded and transcribed. Participants were asked to describe their diagnostic journey from when they first noticed something wrong up to and including the point of diagnosis. Data were analysed using the framework method.

resultsParticipants initially normalised symptoms and only sought medical help when daily activities were affected. Failure to realise that anything was wrong led to a delay in help-seeking. Participants' understanding of the term 'heart failure' was variable and 1 participant did not know he had the condition. The term itself caused great anxiety initially but participants learnt to cope with and accept their diagnosis over time.

conclusionsGreater public awareness of symptoms and adequate explanation of 'heart failure' as a diagnostic label, or reconsideration of its use, are potential areas of service improvement.

Indexed as

AwarenessHealth Knowledge, Attitudes, PracticePatient Acceptance of Health CareActivities of Daily LivingAdaptation, PsychologicalAgedAged, 80 and overAnxietyDyspneaEnglandFemaleHeart FailureHumansMaleMiddle AgedPrimary Health CareQUALITATIVE RESEARCH

Identifiers

PMID28283487
PMCPMC5353318
OpenAlexW2593968558

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.