ArticleOpen heart2026
Defining delayed and missed diagnosis of acute and chronic coronary syndromes: a modified Delphi consensus method.
Article in Open heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesA clear definition of delayed and missed coronary artery disease (CAD) diagnosis is lacking, hampering research on the epidemiology and determinants of delayed and missed CAD diagnosis. We engaged healthcare professionals, patients and healthy citizens to develop a consensus-based definition of delayed and missed diagnosis in two CAD domains: acute coronary syndrome (ACS) and chronic coronary syndrome (CCS).
designModified Delphi method.
settingPrimary and secondary care.
participantsThe study was conducted among an expert panel consisting of cardiologists (n=19), general practitioners (n=35), patients (n=55) and healthy citizens (n=34).
results42 definitions for delayed and missed ACS and 30 definitions for delayed and missed CCS were developed during the first 2 Delphi rounds. The expert panel graded these definitions in rounds 3 and 4 by Likert scale (from 1 (strongly disagree) to 5 (strongly agree)). Useful definitions for research purposes were recommended based on predefined criteria: (1) IQR to assess consensus, (2) median to evaluate the level of support for the definition and (3) convergence of the group to assess stability of opinions across rounds. For delayed ACS, 2 definitions were classified as highly recommended, 13 as recommended and 6 as considerable. For missed ACS, none met the threshold for highly recommended; 5 were recommended and 12 were classified as considerable. For CCS, 2 definitions for delayed diagnosis were highly recommended, 13 recommended and 7 considerable. For missed CCS, 1 definition was highly recommended, 6 were recommended and 7 were considerable.
conclusionsWe were unable to establish a one-size-fits-all definition for delayed and missed ACS/CCS diagnosis, reflecting the complexity and context-dependency of CAD diagnostic pathways. However, the developed consensus-based framework and recommended definitions provide a valuable basis for future research, enabling study comparisons across different diagnostic settings. This will ultimately enhance understanding of delayed and missed ACS/CCS diagnosis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.