Project

This collaborative PhD project addresses the critical issue of cardiovascular diseases (CVD) in Australia, affecting over four million people and accounting for 25% of all deaths. The annual cost to the country is $5 billion. The project aims to improve patient access to Medtronic's advanced technologies for CVD care by leveraging the data science expertise of the UNSW Centre for Big Data Research in Health.

By analysing real-world Australian health data, the project will quantify the health and economic impact of CVD, explore how medical technologies shape CVD care and outcomes, and identify disparities based on patient sex, socioeconomic status, rurality, Indigenous status, and ethnicity.

Providing precise Australia-specific data, this project will support Medtronic in developing accurate epidemiological and economic models for reimbursement and Health Technology Assessment. It has the potential to inform government policies and create innovative clinical decision support tools, ultimately reshaping the landscape of CVD care in Australia.

Aims

This project focuses on three primary aims:

1. Quantifying the health, healthcare, and economic impact of CVDs, including atrial fibrillation, ischemic stroke, and heart failure. This will enhance our understanding of the burden these conditions place on Australians.
2. Investigating how specific medical technologies, such as insertable cardiac monitors, catheter ablation solutions, or heart valves, impact CVD diagnosis, care, and patient outcomes, highlighting their effectiveness in an Australian context.
3. Identifying disparities in CVD care and outcomes by considering factors like patient sex, socioeconomic status, rurality, Indigenous status, and ethnicity. This will help uncover and address disparities in healthcare delivery.

This project addresses the fragmented and limited current knowledge of CVD in Australia. It will generate and appropriately use real-world evidence to optimise access to innovative and cost-effective technologies for CVD care, ultimately enhancing patients' lives.

Design

This project will utilise real-world Australian population-based health data from sources including:

• The newly available National Health Data Hub (NHDH) national linked data asset. NHDH currently comprises national longitudinal data from 2010 onwards from the Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, Residential Aged Care services and the National Death Index, and data on hospital and outpatient services for all jurisdictions except WA and NT (negotiations underway).
• Linked datasets for NSW held by UNSW which additionally include detailed costing data.

A range of biostatistical methods will be applied to address the research aims, including descriptive, time-series and time-to-event analyses and advanced methods for causal inference including regression and propensity-score analyses, inverse-probability-of-treatment weighting and G methods. Outcomes investigated will include health service use and costs, harms and adverse events, readmissions and mortality, while study variables will include demographic factors, CV risk factors, comorbidities, treatment pathways and medical technologies used.