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Aims: This project aims to generate real-world evidence on the effectiveness of devices and therapies for heart failure (HF) patients in Australia. It will describe HF patient demographics and clinical characteristics over time and identify disparities in treatment efficacy and access based on demographic and socioeconomic factors.

Significance: Heart failure affects nearly 144,000 Australians, with cases rising significantly between 2017 and 2022. Despite clinical advancements, HF remains a leading cause of hospitalisations and mortality. Few studies have investigated the use and outcomes of contemporary devices and therapies outside the hospital. This project addresses this gap, aiming to ensure optimal care for all HF patients and reduce disease burden.

Expected Outcome: The project will provide comprehensive data on HF treatments' effectiveness in diverse clinical settings, highlight areas for improvement, and address treatment disparities. The findings will inform healthcare policies and improve clinical practices, enhancing the outcomes of HF patients in Australia.

Aims

This research project has three primary aims:

1. Investigate the impact of specific medical technologies, such as insertable cardiac monitors, catheter ablation solutions, and heart valves, on HF diagnosis, care, and patient outcomes, highlighting their effectiveness in the Australian context.
2. Examine trends in pharmacotherapy utilisation among HF patients, focusing on temporal prescription patterns and their impact on patient outcomes, demonstrating the effectiveness of these medications in Australia. 
3. Identify disparities in HF care and outcomes by considering factors such as patient sex, socioeconomic status, rurality, health insurance status, and ethnicity. This aim seeks to uncover and address inequalities in healthcare delivery.

This project aims to address the fragmented and limited current knowledge of HF treatment in Australia, using real-world evidence to optimise access to innovative and cost-effective technologies and therapies for HF care, ultimately enhancing patient lives.

Design

This project will utilise real-world Australian population-based health data from sources including the CardiacAI Data Repository and the Medicines Intelligence (MedIntel) Data Platform.

• The CardiacAI Data Repository collects electronic medical record (EMR) data from several hospitals, established through collaboration between several Local Health Districts and the Centre for Big Data Research in Health (CBDRH). It links EMR data with various health datasets to generate real-world evidence and develop clinical decision support tools for cardiovascular healthcare.
• The MedIntel Data Platform generates evidence on prescribed medicine use, safety, costs, and cost-effectiveness, comprising Medicare-eligible people aged ≥18 years in New South Wales from 2005-2020.
• Additionally, the project will utilise existing bespoke linked data assets within CBDRH if needed for addressing specific objectives. 

A range of biostatistical methods will be applied, including descriptive, time-series, time-to-event analyses, and advanced methods for causal inference. Outcomes will include health service use, complications, readmissions, and mortality.