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Our research

Addressing the causes of chronic disease
Our aim is to create, evaluate and apply innovative clinical and digital health approaches to reduce the burden of cardiometabolic and other chronic conditions.

Combining expertise in research and telecommunications technologies has resulted in what is now known as digital health interventions. By using these health interventions, the centre will cultivate research collaborations in order to develop new approaches to disease prevention and treatment.

To date, our research has demonstrated positive outcomes affecting behavioural and lifestyle changes by utilising digital therapeutics.

Director Professor Clara Chow believes the centre’s unique offering is its location within the Westmead Hospital precinct and its commitment to foster innovative research and ideas.

Our focus is on clinical translational research in the delivery of simple and effective health services to address the causes of chronic diseases affecting the population of western Sydney. Some research projects will be applied to a broader population and has the potential for global application.

WARC is committed to supporting innovative projects, excellence in research, leadership in digital health intervention and evaluation.

Current research projects

Catheter Ablation versus Anti-arrhythmic Drugs for Ventricular Tachycardia (CAAD-VT): A Randomised Trial Summary

Comparing in patients with structural heart disease, the optimal treatment of ventricular tachycardia by either medical therapy with anti-arrhythmic drugs or catheter ablation.

Contact mary.wong@sydney.edu.au for more information.

Funding: Ministry of Health Early-Mid Career Fellowship

Standard care or Rapid early invasive management approach to patients with life threatening heart rhythm disorders

Comparing in patients with acute ventricular tachycardia storm, the optimal treatment by either medical therapy by anti-arrhythmic drugs or early catheter ablation <96hrs after diagnosis. A pilot study to generate data for use in a multi-centre trial.

Contact mary.wong@sydney.edu.au for more information.

Funding: NSW Health Early Mid-Career Researcher Grant

Understanding the influence of COVID-19 and related restrictions on people with cardiovascular disease

Australian COVID-19 prevention strategy and policies have averted many infections but may have caused unintended harm, particularly in people with cardiovascular disease. We are collecting patient reported experiences from across Australia from people with cardiovascular disease.  

Contact warc.cvdincovid@sydney.edu.au for more information.

Funding: Investigator initiated

An opportunistic educational intervention to improve health in people with atrial fibrillation

Atrial fibrillation (AF) is the most common cardiac arrhythmia globally. Patient knowledge of AF and approaches to medical therapy for AF is poor. This study aims to test the utility and scalability of an AF educational program developed by staff at Westmead Hospital.

Contact daniel.mcintyre@sydney.edu.au for more information.

Funding: WSLHD REN Research Grant

Evaluation of Rapid Access Clinic

Evaluation of the rapid access cardiology clinic model of care to understand patient characteristics, health utilisation and cost-benefit, and demonstrate user satisfaction.

Contact warc.racc@sydney.edu.au for more information.

Funding: MRFF Rapid Applied Research Translation Grant

Improving health outcomes for people suffering out of hospital cardiac arrest

FirstCPR is a targeted health education intervention study designed to increase training, confidence, and willingness among community members to respond to a cardiac arrest emergency. Contact: warc.firstcpr@sydney.edu.au for more information.

Funding: NHMRC Partnership Project Grant

Coordinating Healthcare with Artificial intelligence-supported Technology for Atrial Fibrillation patients

 CHAT-AF is a 6-month randomised controlled trial of adult patients with atrial fibrillation (AF) aiming to evaluate the feasibility and potential efficacy of a digital intervention (‘AF-Support’) that is designed to support AF patients self-manage their condition and coordinate primary and secondary care follow-up.

‘AF-Support’ has been co-designed with clinicians, researchers, information technologists and consumers and comprises of a pre-programmed set of automated phone calls (artificial intelligence conversational technology), text messages and emails, and an semi-personalised educational website.

Automated calls occur 7 times throughout the program and follow a standard flow but are customised to vary depending on patient responses. Calls assess AF symptoms and based on protocols identify red flags requiring escalation.

By supporting patients, the program aims to improve their AF management and quality of life.

Contact warc.chat-af@sydney.edu.au for more information.

Funding: Digital Health CRC

Can we mass screen for Atrial Fibrillation (AF) among those aged over 75 in Australia?

This study aims to evaluate the feasibility of implementing an AF screening program using a smart mobile phone ECG device in community-dwelling older people. 

This is a national, two-arm, randomised, wait-list controlled trial in community-dwelling people aged 75 years or older. Participants will be randomised to the intervention group (receiving immediate daily ECG monitoring with the AliveCor Kardia device) and the wait-list controlled group (receiving monitoring post 6 months).

Contact warc.af@sydney.edu.au / 0466 055 962 for more information.

Funding: Heart Foundation Vanguard Grant

My Intelligent Cardiac Assistant - Primary prevention of cardiovascular disease with a mobile health intervention optimised with artificial intelligence

WARC has already developed and supported patients with mHealth text-message programs with basic algorithms to semi-personalise our programs.

MICArdiac aims to improve customisation of our existing digital health interventions by utilising data collected by wireless monitoring devices (such as step count, blood pressure) and machine learning (artificial intelligence) algorithm to deliver personalised education and remote health monitoring with the goal of improving cardiovascular risk factors.

The MICArdiac program will be delivered as in-app notifications through the smartphone MICArdiac app.

Contact: warc.micardiac@sydney.edu.au for more information. 

Funding: Tides Foundation (Google AI Impact Challenge)

Trial: Programmed Ventricular Stimulation to Risk Stratify for Early Cardioverter-Defibrillator (ICD) Implantation to Prevent Tachyarrhythmias following Acute Myocardial Infarction

The PROTECT-ICD study is a multi-centre randomised controlled trial targeting prevention of sudden cardiac death in patients who have reduced cardiac function following a myocardial infarct (MI).

The primary objective of the trial is to assess whether electrophysiologic study to guide prophylactic implantation of an implantable cardioverter-defibrillator (ICD) early following MI (first 40 days) will lead to a significant reduction in sudden cardiac death.

The secondary objective is to assess the utility of cardiac MRI (CMR) in assessing early myocardial viability, and its predictive value for both inducible and spontaneous ventricular tachyarrhythmias post-MI. 

Quadruple UltrA-low-dose tReamenT for hypErTension

High blood pressure is common and a major cause of heart disease and stroke. While many people with hypertension are on some treatment, in more than half of the people, blood pressure targets are not reached and their high blood pressure is uncontrolled.

In this research we investigate whether an approach that combines four types of blood pressure lowering medications at quarter doses into one pill, is a more effective way of controlling blood pressure than standard traditional therapy.

Contact: warc.quartet@sydney.edu.au for more information.

Funding: NHMRC Project Grant

Improving diagnosis and treatment for Spontaneous Coronary Artery Dissection (SCAD)

This Australian New Zealand national SCAD registry will recruit and follow patients with SCAD-related heart attacks over 5 years. It is designed to improve our understanding of this poorly recognised heart condition that predominantly affects younger women.

Contact: anzscadregistry.study@sydney.edu.au for more information regarding research opportunities. 

Funding: NSW Health and CSANZ-Bayer Grants. 

Preventing Type 2 diabetes among women with glucose intolerance during pregnancy

A digital health intervention to reduce diabetes risk for women with recent gestational diabetes, via customised mobile phone text messages for diabetic risk factors and additional data captured through activity monitor watch, with the aim of promoting the adoption of healthier lifestyle and improve weight management.

Contact WSLHD-SmartMums2@health.nsw.gov.au for more information.

Funding: MRFF Rapid Applied Research Translation Grant

Accuracy and Utility of Smartphone/Smartwatch-based ECG Monitors for Diagnosis of Cardiac Arrhythmias

A comparison of smartphone or watch based heart rate monitors vs electrophysiology procedures for diagnosis of cardiac arrhtyhmias. Utilises an Apple watch, Fitbit and alivecor single ECG lead device for detection of cardiac arrhythmias during an electrophysiology study. 

Contact mary.wong@sydney.edu.au for more information.

Funding: Heart Foundation Vanguard Grant

The role of Speckle Tracking Strain Echocardiography in detection of arrhythmogenic substrates that lead to ventricular arrhythmias and sudden cardiac death

Comparison of a non-invasive imaging method - strain echocardiography- to detect and predict arrhythmogenic substrate in patients with ventricular tachycardia and sudden cardiac death identified by electro-anatomic mapping during an electrophysiology study.

Funding: Westmead Charitable Trust Early Mid-career researcher grant

The SoundScar Study: UltraSOUND-based Characterization of Ventricular Tachycardia SCAR and Arrhythmogenic Substrate

In a multi-centre study, comparing if an invasive imaging technology can detect arrhythmogenic substrate in patients with ventricular tachycardia and sudden cardiac death identified by electro-anatomic mapping during an electrophysiology study.

Contact mary.wong@sydney.edu.au for more information.

Funding: Investigator Initiated

Safety and Effectiveness of TactiFlex Ablation Catheter Sensor Enabled for the treatment of Drug Refractory, Symptomatic, Paroxysmal Atrial Fibrillation (TactiFlex PAF IDE Trial)

A multicentre trial comparing the safety and efficacy of a novel ablation catheter with a flexible tip and integration of contact force for the treatment of drug refractory paroxysmal atrial fibrillation.

Text messaging support for people with chronic disease

TextCare will address the lack of availability, accessibility and effectiveness of support services for people living with chronic disease.

Support and rehabilitation programs are effective in improving health outcomes, but for many people they are not available or accessible, resulting in low patient attendance.

TextCare is based on behaviour change theory – it uses computerised algorithms to create personal messages that educate, motivate and support patients. This provides more accessible rehabilitation support services.

Contact: warc.textcare@sydney.edu.au for more information.

Funding: Tides Foundation (Google Impact Challenge)

 

Smart phone or Smart watch-based single lead ECGs vs traditional ambulatory Holter monitoring for definite diagnosis of cardiac arrhythmia in patients with palpitations: A Randomized controlled trial (The Wearable vs Holter trial)

WAHOO is a randomized controlled clinical trial comparing the AliveCor KardiaMobile  to the standard of care Holter monitor to determine whether the AliveCor provides a superior diagnostic yield to for symptomatic patients.

Contact mary.wong@sydney.edu.au for more information.

Funding: Heart Foundation Vanguard Grant

Improving prevention, early detection and timely treatment of coronary heart disease in women

Designed to target different healthcare strategies to improve heart health for Australian women.

Contact sarah.zaman@sydney.edu.au for further information. 

Funding: NSW Health and National Heart Foundation Grants.

Completed research projects

Collaborating to develop and optimise mobile ECG wearable monitoring devices for use in community settings

The accuracy of a digital ECG device, which can transmit its results via wifi to the practitioners, is assessed by applying the device on real patients in Westmead Cardiology.

The information collected from this phase 1 of the project will inform the development of phase 2 in which the device will be enhanced further for application in general practice setting.

Funding: University of Sydney Industry and Community Engagement Fund

A Pilot Randomised Controlled Trial of a Text Messaging Intervention With Customisation Using Linked Data From Wireless Wearable Activity Monitors to Improve Risk Factors Following Gestational Diabetes

A pilot study, using a digital health intervention to reduce diabetes risk for women with recent gestational diabetes, achieved through customised mobile phone text messages for diabetic risk factors and additional data captured through activity monitor watch, with the aim of promoting the adoption of healthier lifestyle and improve weight management. 

Text messaging support for patients with chronic disease

Many Australians have chronic conditions such as cardiovascular disease and diabetes. The introduction of the SupportMe program will transform the delivery of care across hospital and primary care services. The program aims to improve health outcomes for patients and reduce costs from inappropriate and fragmented care.

SupportMe is a pragmatic, randomised controlled trial to determine the effect of mobile phone text messaging interventions on blood pressure and blood glucose for patients with diabetes and cardiovascular diseases.

Funding: NSW Health Translational Research Grants Scheme

Our team has developed and evaluated cardiovascular disease support programs delivered via text messaging and found benefits with people who have established cardiovascular disease (secondary prevention).

However, it is unknown if this would work in a primary prevention cohort (those without coronary heart disease). TextMe-2 is a trial which aims to answer this question. The primary objective of the TextMe-2 study is to determine the impact of a program of lifestyle-focused text messages on multiple modifiable cardiovascular risk factors.

The study will focus on high-risk individuals who have been referred to outpatient cardiology services for chest pain but without documented coronary artery disease.

In addition, this study will look at the effect of such a program on quality of life, health literacy, medication adherence and depression/anxiety scores.

Contact: warc.textme2@sydney.edu.au for more information.

TEXT messages to improve MEDication adherence & Secondary prevention

Cardiovascular disease is the leading cause of death and disease burden globally. TextMeds is a randomised controlled study that investigates the effectiveness of sending automated mobile text messages to people with cardiovascular disease.

The intervention aims to improve adherence to medication, lifestyle and behaviour change.

Contact warc.text-meds@sydney.edu.au for more information.

Funding: NHMRC Project Grant

A waiting room-based intervention to improve cardiovascular health

Knowledge of cardiovascular disease is associated with better adherence to lifestyle changes that improve health.

However, there is not enough time in a 15-minute clinic appointment for doctors to both provide care and educate patients on cardiovascular disease.

'While you’re waiting' aims to use time spent in waiting rooms as an opportunity to deliver informative and engaging educational videos on cardiovascular disease that have been selected by health care professionals.   

In fact, patients often spend more time waiting to see the doctor than in their consultation. We are interested to see if this will improve overall satisfaction with clinic care and motivate patients to make lifestyle changes that reduce their cardiovascular disease risk.

Funding: Agency for Clinical Innovation