Research

<p>Addressing the causes of chronic disease.</p>

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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.

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.

Themes

Digital health and technology

We're leveraging digital health technologies and methods to improve healthcare quality and deliver care that is safe, effective, patient-centred, timely, efficient and equitable.

A randomised controlled trial to evaluate the effectiveness of a personalised digital health intervention for post-discharge cardiology patients. The study aims to assess whether providing digital support in snippets across 6-months, or delivering it as a single bundle, could influence a patient’s future health and likelihood of re-hospitalisation.

Funding: NHMRC

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.

Funding: Tides Foundation (Google AI Impact Challenge)

A randomised controlled trial to evaluate the efficacy and feasibility of an artificial intelligence (AI)-supported intervention that comprises automated phone calls and text messages to improve self-management and quality of life of patients with atrial fibrillation (AF).

HeartHealth is a 6-month text message program designed to support patients in improving their heart health. Developed by clinicians at Westmead Cardiology with patient-centred input, the program delivers tailored messages aligned with evidence-based cardiovascular health guidelines. Messages include expert health tips, links to trusted resources, and video content, providing encouragement and practical advice for heart health improvement.

Funding: WSLHD

Is a 12-week text message initiative providing parents with 36 tailored oral health messages. Developed with consumer and clinician input, it aligns with WHO guidelines and offers reminders, reassurance, and video resources to support families’ oral health behaviour change.

Is a 6 month text message initiative providing patients with psoriasis with tailored content aimed at managing psoriasis and keeping a heart healthy lifestyle. Developed with consumer and clinician input, it covers the topics of diet, physical activity, and smoking.

This project aims to obtain a current granular understanding of RM technology implementation in Australia, triangulating information from clinicians/health services, consumers, and industry. We will provide localised clinical recommendations and customised patient support to assist decision making for RM identified clinical issues within a national implementation trial delivered at scale.

This program will comprise 5 studies over the 4-year period to generate evidence that will support clinically effective, safe, and cost-effective implementation of remote cardiac monitoring.

This study aims to examine the efficacy of a novel CIED remote monitoring pateinet engagement program into a community setting, focussing on patient CIED management self-efficacy and implementation feasibility.

Equity in health

Our new programs aim to address equity in healthcare access in fields such as gender, rural/remote and economic. The diversity of Western Sydney is ideal for this research.

The CAC-Women’s Trial aims to use a calcium score, measured via a simple, quick and widely available CT scan, to prompt lifestyle changes and medication use in women who are low-intermediate risk but have female-specific, risk-enhancing factors.

The study will aim to recruit a proportion of Aboriginal and/or Torres Strait Islander women who are also deemed at high CVD risk. The planned 700 patient randomised controlled trial (RCT) will evaluate the overall potential, feasibility and acceptability of a CAC-guided approach to primary prevention of CVD in women, and its impact on cardiovascular risk factor control

Funding: Heart Foundation

Improving outcomes and survivorship following SCA in the young requires a concerted multidisciplinary approach including tests to diagnose the reason for arrest, evaluation of potentially at-risk relatives, and psychological support for survivors and families. Current approaches to management are suboptimal and exacerbate health inequities with health literacy, education and resources being important indicators of access.

IMPROVE-SCA aims to design and test if optimised care pathways for young SCA survivors and families (including priority populations) improve self-reported distress following the SCA event. It will focus on diagnostics, effective management to prevent future events, support to return to life activities and psychological well-being. The intervention will include a virtual centre, website, mobile app and case worker and will be co-designed with consumers, researchers, and clinicians with relevant expertise. The care pathway will be adapted where necessary to address needs of priority populations.

Funding: 2023 MRFF Cardiovascular Health Mission

Basic life support (BLS) training uptake in the community is low, classroom-based, fee-based, usually offered in English and often taken up by people in certain professions. These factors limit wider training uptake, and novel ways are needed to complement traditional approaches that increase visibility and access to learning opportunities.

Ready2Revive is an effectiveness-implementation hybrid study conducted in partnership with Service NSW (NSW government service centres). It will examine the feasibility, acceptability and impact (on self-reported confidence) of brief opportunities to learn simplified compression-only cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use offered to customers during their visit to Service NSW centres. The pilot phase is now complete, and phase two will see the study implementation in metro and regional sites across NSW. 

Funding: Westmead Hospital Foundation Brenda Myrtle Bequest Heart Research Award 

The Twist GDM Study (TWIn STudy on parous women’s risk factors for Gestational Diabetes and Diabetes) is a prospective cohort registry study that will work with the Twins Registry Australia at the University of Melbourne to collect self-report survey information on diabetes on the participant, their female twin and their family during and after pregnancy, as well as lifestyle information. This data will be used to explore the causal pathway of gestational diabetes and future diabetes.

Funding: Diabetes Australia

New clinical approaches

We're exploring new treatments (including tailored clinical trials), new clinical pathways and new approaches, aimed at improving health outcomes, health experience and reducing health costs.

Our projects and programs are led by clinical academic researchers at the University of Sydney and are experts in their field. They address gaps in a field through developing an innovative solution and evaluation. This stream includes collaboration with academics in engineering, informatics, dentistry, and allied health.

Anticoagulation for Stroke Prevention In patients with Recent Episodes of perioperative Atrial Fibrillation after noncardiac surgery – (ASPIRE-AF trial)

Perioperative atrial fibrillation (Periop AF) is one of the most common cardiovascular complications associated with non-cardiac surgery. Patients with Periop AF are at risk of stroke, myocardial infarction and other adverse cardiovascular (CV) outcomes in the short and longer term after surgery.

In this research study we investigate among patients with periop AF whether oral anticoagulant treatment will reduce stroke and CV events. This trial has been developed through close collaboration of researchers in Australia with an international network of researchers and consumer partners.

Funding: MRFF

Safety of Continuing HER-2 Directed Therapy in Overt Left Ventricular Dysfunction: A Randomized, Controlled Trial (SCHOLAR-2).

Chemotherapy is an important treatment for patients with early-stage breast cancer but can cause injury to the heart. The Scholar-2 study investigates whether it is safe and effective to continue chemotherapy while using cardiac medications.

This is an investigator initiated multi-centre international RCT that aims to prevent sudden cardiac death through an approach that uses EPS to guide decision-making on automatic Implantable Cardioverter Defibrillator (AICD). A key sub-study will examine the role of cardiac MRI in predicting outcomes.

Funding: Biotronik, WSLHD

This program will design and evaluate improved catheters and approaches to achieve renal denervation. It builds on existing patents (6 patents in catheter ablation and thermal monitoring).

Funding: NSW EMCR research grant

This program will examine the role of stereotactic body radiation therapy (SBRT – used in treatment for solid tumours) to control ventricular arrhythmias and comprise early phase trials to examine short-term efficacy of SBRT.

Radiotherapy vs catheter ablation for ventricular tachycardia in advanced structural heart disease: a randomised controlled trial (RADIOABLATE-VT).

This study will compare stereotactic body radiation therapy (SBRT) to catheter ablation in reducing ventricular tachycardia (VT) burden in patients with structural heart disease (SHD).

TEXT messages to improve MEDication adherence & Secondary prevention (TEXTMEDS)

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.

Funding: NHMRC Projects Grant

Ketogenic Diet in Heart Failure with Reduced Ejection Fraction: A Pilot Randomised Controlled Trial (Keto-HF)

The failing heart has been found to shift to ketone bodies as a significant fuel source with resultant improvements in cardiac function. There is a strong theoretical rationale for ketosis in improving heart failure, yet clinical research of this therapeutic strategy in heart failure with reduced ejection fraction (HFrEF) is lacking. This Trial is a 6-month randomised controlled study, pilot study.

Funding: HF Vanguard Grant and WSLHD Grant

Myocardial Infarction in the Young: A Clinical Registry Study - Prospective and Retrospective (Young MI Registry)

Atherosclerotic MI is the most common form of heart attack, and occurs due to acute plaque rupture or erosion, leading to coronary thrombus and obstruction[10]. In young patients with MI, a large burden of traditional risk factors has been seen, particularly smoking and diabetes. Many non-atherosclerotic causes for MI exist.

This study is to characterise the clinical presentation, cardiovascular risk factors, coronary angiography findings and underlying aetiology of young patients with MI (defined as age <50 years).

The NHMRC Centre of Research Excellence is led by WARC's Professor Richard Lindley, and is a network of stroke clinical trialists, implementation scientists and those with lived experience. The CRE funds new pilot studies, new trial sites, organises webinars and courses and includes key stakeholders in stroke across Australia and beyond.

Funding: NHMRC CRE

Read more about the research: https://stroke-trials-cre.org.au/

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Level 5, Block K
Westmead Hospital
176 Hawkesbury Road
Westmead, NSW 2145

(Access via Block K Concierge – Wayfinding 0499 862 006)