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Opportunities and challenges of a novel cardiac output response to stress (CORS) test to enhance diagnosis of heart failure in primary care: Qualitative study

Lookup NU author(s): Dr Sarah Charman, Dr Nduka Okwose, Dr Gregory Maniatopoulos, Dr Sara Graziadio, Tamara Metzler, Helen Banks, Professor Luke ValeORCiD, Dr Guy MacGowanORCiD, Professor Djordje JakovljevicORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2019 Author(s) (or their employer(s)). Re-use permitted under CC BY. Published by BMJ. Objective To explore the role of the novel cardiac output response to stress (CORS), test in the current diagnostic pathway for heart failure and the opportunities and challenges to potential implementation in primary care. Design Qualitative study using semistructured in-depth interviews which were audio recorded and transcribed verbatim. Data from the interviews were analysed thematically using an inductive approach. Setting Newcastle upon Tyne, UK. Participants Fourteen healthcare professionals (six males, eight females) from primary (general practitioners (GPs), nurses, healthcare assistant, practice managers) and secondary care (consultant cardiologists). Results Four themes relating to opportunities and challenges surrounding the implementation of the new diagnostic technology were identified. These reflected that the adoption of CORS test would be an advantage to primary care but the test had barriers to implementation which include: establishment of clinical utility, suitability for immobile patients and cost implication to GP practices. Conclusion The development of a simple non-invasive clinical test to accelerate the diagnosis of heart failure in primary care maybe helpful to reduce unnecessary referrals to secondary care. The CORS test has the potential to serve this purpose; however, factors such as cost effectiveness, diagnostic accuracy and seamless implementation in primary care have to be fully explored.

Publication metadata

Author(s): Charman S, Okwose N, Maniatopoulos G, Graziadio S, Metzler T, Banks H, Vale L, MacGowan GA, Seferovic PM, Fuat A, Deaton C, Mant J, Hobbs RFD, Jakovljevic DG

Publication type: Article

Publication status: Published

Journal: BMJ Open

Year: 2019

Volume: 9

Issue: 4

Online publication date: 14/04/2019

Acceptance date: 19/03/2019

Date deposited: 02/05/2019

ISSN (electronic): 2044-6055

Publisher: BMJ Publishing Group


DOI: 10.1136/bmjopen-2018-028122


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Funder referenceFunder name
777204Commission of the European Communities