Liliana Laranjo

• MD MPH PhD
• Senior Lecturer at The University of Sydney

Objective: Our aim was to evaluate the use and effectiveness of interventions using social networking sites (SNSs) to change health behaviors. Materials and methods: Five databases were scanned using a predefined search strategy. Studies were included if they focused on patients/consumers, involved an SNS intervention, had an outcome related to...

Background: Patients with type 2 diabetes mellitus (DM) have a central role in managing their disease, but the effective adoption of self-management behaviours is often challenging. Objectives: The main objective of this study was to assess the facilitators, barriers and expectations in the self-management of type 2 DM, as perceived by patients....

Until recently, the medical record was seen exclusively as being the property of health institutions and doctors. Its great technical and scientific components, as well as the personal characteristics attributed by each doctor, have been the reasons appointed for that control. However, nowadays throughout the world that paradigm has been changing....

Background Virtual consultations represent a notable change in health care delivery following the COVID-19 pandemic. Understanding the dynamics of virtual consultations is critical in assessing health care system resilience and adaptability in times of crisis. Objective This study aimed to describe the availability and hours of use of telephone, v...

Background Conversational artificial intelligence (AI) allows for engaging interactions, however, its acceptability, barriers, and enablers to support patients with atrial fibrillation (AF) are unknown. Objective This work stems from the Coordinating Health care with AI–supported Technology for patients with AF (CHAT-AF) trial and aims to explore...

Background Virtual consultations (VC) have transformed healthcare delivery, offering a convenient and effective way to manage chronic conditions such as Type 2 Diabetes (T2D). This systematic review and meta-analysis evaluated the impact of VC on the quality of care provided to patients with T2D, mapping it across the six domains of the US National...

Aims The importance of early life factors in determining health in later adulthood is increasingly recognized. This study evaluated the association of adverse childhood experiences with cardiovascular magnetic resonance (CMR) phenotypes. Methods and Results UK Biobank participants who had completed CMR and the self-reported questionnaire on trauma...

Background Menopause is a timely opportunity to screen for cardiovascular disease (CVD) and intervene with healthier lifestyles. We investigated the association between premature/early menopause and the likelihood of CVD and whether a healthy lifestyle is associated with a lower likelihood of CVD in menopausal woman. Methods The Sax Institute’s 45...

Objective To describe the barriers to and facilitators of implementing and delivering virtual hospital (VH) services, and evidence and practice gaps where further research and policy changes are needed to drive continuous improvement. Study design Qualitative descriptive study. Setting, participants Online semi‐structured interviews and a focus g...

Objectives To identify research and development priorities for virtual care following the coronavirus disease 2019 pandemic from the perspective of key stakeholders (patients, clinicians, informaticians and academics). Design Qualitative study using a modified nominal group technique. Setting Online semi‐structured interviews and workshops held i...

Background To address the rising demand for urgent care and decrease hospital use, health systems are implementing different strategies to support urgent care patients (i.e. patients who would have typically been treated in hospital) in the community, such as general practitioner (GP) advice lines. The aims of this study were to: identify the suppo...

Introduction Cardiac implantable electronic devices (CIED) can transfer data to the healthcare team, remotely. National and international cardiac organisations recommend all patients use this technology, however patient engagement is suboptimal. Previously, in cardiovascular patients, SMS messaging services have shown improvements in patient engage...

BACKGROUND The HeartHealth program is a six-month SMS message-based support program offered to patients with a recent cardiovascular hospitalisation or recent cardiovascular clinic visit in Western Sydney, Australia. Its customised content focuses on cardiovascular risk factors, with a focus on lifestyle, treatments and general heart health informa...

BACKGROUND Virtual consultations represent a notable change in healthcare delivery following the COVID-19 pandemic. Understanding the dynamics of virtual consultations is critical in assessing healthcare system resilience and adaptability in times of crisis. OBJECTIVE (1) To describe the availability and hours of use of telephone, video and human...

BACKGROUND Conversational artificial intelligence (AI) allows for engaging interactions, however, its acceptability, barriers, and enablers to support patients with atrial fibrillation (AF) are unknown. OBJECTIVE This work stems from the Coordinating Health care with AI–supported Technology for patients with AF (CHAT-AF) trial and aims to explore...

Objectives The study explored the perceived impacts of COVID-19 and its associated policies and social restrictions on health, self-management and access to healthcare. Design Cross-sectional observational (online survey) and qualitative study (semi-structured interviews and thematic analysis). Setting Australia. Participants People with self-re...

Objectives To assess the effects of digital patient decision-support tools for atrial fibrillation (AF) treatment decisions in adults with AF. Study design Systematic review and meta-analysis. Eligibility criteria Eligible randomised controlled trials (RCTs) evaluated digital patient decision-support tools for AF treatment decisions in adults wit...

Background Chronic disease risk factors are increasing amongst adolescents, globally. Digital health prevention programs, which provide education and information to reduce chronic disease risk factors need to be equitable and accessible for all. For their success, multiple highly engaged stakeholders should be involved in development and implementa...

Background Secondary prevention lifestyle and pharmacological treatment of atherosclerotic cardiovascular disease (ASCVD) reduce a high proportion of recurrent events and mortality. However, significant gaps exist between guideline recommendations and usual clinical practice. Objectives Describe the state of the art, the roadblocks, and successful...

Artificial Intelligence (AI) is increasingly influential across various sectors, including healthcare, with the potential to revolutionize clinical practice. However, risks associated with AI adoption in medicine have also been identified. Despite the general understanding that AI will impact healthcare, studies that assess the perceptions of medic...

Background Poor oral health literacy has been proposed as a causal factor in disparities in oral health outcomes. This study aims to investigate oral health literacy (OHL) in a socially and culturally diverse population of Australian adults visiting a public dental clinic in Western Sydney. Methods A mixed methods study where oral health literacy...

Objective: This study explored factors that may influence blood pressure (BP) control in patients with atrial fibrillation (AF) with hypertension. Methods: Cross-sectional retrospective analysis of the MedicineInsight database which includes de-identified electronic health records from general practices (GPs) across Australia. BP control was ass...

Aims: To evaluate the relationship between neuroticism personality traits and cardiovascular magnetic resonance (CMR) measures of cardiac morphology and function, considering potential differential associations in men and women. Methods and results: The analysis includes 36,309 UK Biobank participants (average age= 63.9±7.7 years; 47.8% men) wit...

BACKGROUND Expanding access to self-management via Digital Health Technologies may supplement traditional care, mitigating pressures on primary care through self-management. Primary Care Physicians can play a critical role in the integration of digital health technologies into patient care, but it is unclear what factors influence Primary Care Phys...

Background: Poor oral health literacy has been proposed as a causal factor in disparities in oral health outcomes. This study aims to investigate oral health literacy (OHL) in a socially and culturally diverse population of Australian adults visiting a public dental clinic in Western Sydney. Methods: A mixed methods study where oral health literacy...

Background Dietary modification is a cornerstone of cardiovascular disease (CVD) prevention. A Mediterranean diet has been associated with a lower risk of CVD but no systematic reviews have evaluated this relationship specifically in women. Objective To determine the association between higher versus lower adherence to a Mediterranean diet and inc...

Background: Cardiovascular disease (CVD) risk prediction is important in guiding the intensity of therapy in CVD prevention. Whilst current risk prediction algorithms use traditional statistical approaches, machine learning (ML) presents an alternative method that may improve risk prediction accuracy. This systematic review and meta-analysis aimed...

Objectives: Health service providers are currently making decisions on the public funding of digital health technologies (DHTs) for managing chronic diseases with limited understanding of stakeholder preferences for DHT attributes. This study aims to understand the community, patient/carer, and health professionals' preferences to help inform a pr...

Background The extent to which digital technologies are employed to promote the delivery of high-quality healthcare is known as Digital Maturity. Individual and systemic digital maturity are both necessary to ensure a successful, scalable and sustainable digital transformation in healthcare. However, digital maturity in primary care has been scarce...

Background Adolescence presents a window of opportunity to establish good nutrition and physical activity behaviours to carry throughout the life course. Adolescents are at risk of developing cardiovascular and other chronic diseases due to poor the complex interplay of physical and mental health lifestyle risk factors. Text messaging is adolescent...

Background: The extension to which digital technologies are employed to promote the delivery of high-quality healthcare is known as Digital Maturity. Individuals and systems digital maturity are both necessary to ensure a successful, scalable and sustainable digital transformation in healthcare. Digital maturity in primary care has been scarcely ev...

Objectives To examine i) the use of mobile apps and fitness trackers in adults during the COVID-19 pandemic to support health behaviors; ii) the use of COVID-19 apps; iii) associations between using mobile apps and fitness trackers, and health behaviors; iv) differences in usage amongst population subgroups. Methods An online cross-sectional surve...

Background Smart home systems can potentially improve heart failure (HF) self-management and care. However, evidence is lacking on clinicians’ expectations and opinions about these systems. This study aimed to investigate key healthcare providers' perspectives on using smart home systems for self-management and care in people with HF. Methods Semi...

Objectives To investigate the feasibility of the be.well app and its personalization approach which regularly considers users’ preferences, amongst university students. Methods We conducted a mixed-methods, pre-post experiment, where participants used the app for 2 months. Eligibility criteria included: age 18–34 years; owning an iPhone with Inter...

With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. We explored GPs’ perspectives on the main benefits...

Background Hypertension is the most common modifiable risk factor for cardiovascular diseases in South Asia. Machine learning (ML) models have been shown to outperform clinical risk predictions compared to statistical methods, but studies using ML to predict hypertension at the population level are lacking. This study used ML approaches in a datase...

Background: Hypertension is the most common modifiable risk factor for cardiovascular diseases in South Asia. Machine learning (ML) models have been shown to outperform clinical risk predictions compared to statistical methods, but studies using ML to predict hypertension at the population level are lacking. This study used ML approaches in a datas...

Social factors play a role in e-cigarette uptake, but Australian evidence is limited. This study evaluated associations between social factors and e-cigarette intention and use. Australian participants surveyed between March 2019 and July 2019 using a cross-sectional survey design, measuring e-cigarette intentions and use, and factors including sm...

BACKGROUND Atrial fibrillation (AF) is an increasingly common chronic health condition in which integrated care, that is multidisciplinary and patient-centric, is recommended yet challenging to implement. Methods and analysis: CHAT-AF is a 6-month randomised controlled trial of adult patients with AF (n=385) allocated in a ratio 4:1 to AF-support o...

Background: Atrial fibrillation (AF) is an increasingly common chronic health condition for which integrated care that is multidisciplinary and patient-centric is recommended yet challenging to implement. Objective: The aim of Coordinating Health Care With Artificial Intelligence-Supported Technology in AF is to evaluate the feasibility and pote...

BACKGROUND Heart failure is one of the leading causes of hospitalisation, morbidity, and mortality in the world. Heart failure self-management is challenging and involves a set of self-care behaviours required to reduce the risk of deterioration, identify signs and symptoms of exacerbation, and avoid hospitalisation. Mobile applications (apps) have...

Background: Mobile apps have the potential to support patients with heart failure and facilitate disease self-management, but this area of research is recent and rapidly evolving, with inconsistent results for efficacy. So far, most of the published studies evaluated the feasibility of a specific app or assessed the quality of apps available in ap...

Background The use of telehealth interventions, such as the remote monitoring of patient clinical data (e.g. blood pressure, blood glucose, heart rate, medication use), has been proposed as a strategy to better manage chronic conditions and to reduce the impact on patients and healthcare systems. The use of algorithms for data acquisition, analysis...

BACKGROUND Heart failure is a common cause of hospitalization and patient self-management is essential to avoid decompensation and readmissions. Mobile applications (apps) seem promising in supporting heart failure self-management. OBJECTIVE This study systematically reviews the evidence on the impact of heart failure self-management apps on healt...

Background: Heart failure self-management is essential to avoid decompensation and readmissions. Mobile apps seem promising in supporting heart failure self-management, and there has been a rapid growth in publications in this area. However, to date, systematic reviews have mostly focused on remote monitoring interventions using nonapp types of mo...

BACKGROUND With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. OBJECTIVE We explored GPs’ perspective...

Background The success of electronic medical records (EMRs) is dependent on implementation features, such as usability and fit with clinical processes. The use of EMRs in mental health settings brings additional and specific challenges owing to the personal, detailed, narrative, and exploratory nature of the assessment, diagnosis, and treatment in...

Speech summarization techniques take human speech as input and then output an abridged version as text or speech. Speech summarization has applications in many domains from information technology to health care, for example improving speech archives or reducing clinical documentation burden. This scoping review maps close to 2 decades of speech sum...

Background: With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. Objective: We explored GPs' perspectiv...

BACKGROUND The success of electronic medical records (EMRs) is dependent on implementation features, such as usability and fit with clinical processes. The use of EMRs in mental health settings brings additional and specific challenges, due to the personal, detailed, narrative, and exploratory nature of assessment, diagnosis, and treatment in this...

BACKGROUND In recent decades, virtual care has emerged as a promising option to support primary care delivery. However, despite the potential, adoption rates remained low. With the outbreak of COVID-19, it has suddenly been pushed to the forefront of care delivery. As we progress into the second year of the COVID-19 pandemic, there is a need and op...

Background: In recent decades, virtual care has emerged as a promising option to support primary care delivery. However, despite the potential, adoption rates remained low. With the outbreak of COVID-19, it has suddenly been pushed to the forefront of care delivery. As we progress into the second year of the COVID-19 pandemic, there is a need and...

Given that the one-size-fits-all approach to mobile health interventions have limited effects, a personalized approach might be necessary to promote healthy behaviors and prevent chronic conditions. Our systematic review aims to evaluate the effectiveness of personalized mobile interventions on lifestyle behaviors (i.e., physical activity, diet, sm...

Objective To determine the effectiveness of physical activity interventions involving mobile applications (apps) or trackers with automated and continuous self-monitoring and feedback. Design Systematic review and meta-analysis. Data sources PubMed and seven additional databases, from 2007 to 2020. Study selection Randomised controlled trials in...

Issue addressed E‐cigarette awareness and use has increased globally, but little is known about the social factors that influence uptake in Australia. We explored the reasons why people started, continued and stopped using e‐cigarettes in Australia. Methods This was a qualitative study comprising 14 semi‐structured interviews with past and current...

Background Smartphone apps, fitness trackers, and online social networks have shown promise in weight management and physical activity interventions. However, there are knowledge gaps in identifying the most effective and engaging interventions and intervention features preferred by their users. Objective This 6-month pilot study on a social networ...

To inform the development of automated summarization of clinical conversations, this study sought to estimate the proportion of doctor-patient communication in general practice (GP) consultations used for generating a consultation summary. Two researchers with a medical degree read the transcripts of 44 GP consultations and highlighted the phrases...

Objective: The study sought to understand the potential roles of a future artificial intelligence (AI) documentation assistant in primary care consultations and to identify implications for doctors, patients, healthcare system, and technology design from the perspective of general practitioners. Materials and methods: Co-design workshops with ge...

Speech summarisation techniques take human speech as input and then output an abridged version as text or speech. Speech summarisation has applications in many domains from information technology to health care, for example improving speech archives or reducing clinical documentation burden. This scoping review maps the speech summarisation literat...

This special issue invites submissions that feature original research on designing, developing and evaluating CAs for healthcare and well-being. These CAs aim at improving healthcare outcomes and services, and satisfy unique application needs (e.g., safety, trust, and user experience). A suitable submission must also demonstrate its relevance to AC...

Background Healthy behaviors are crucial for maintaining a person’s health and well-being. The effects of health behavior interventions are mediated by individual and contextual factors that vary over time. Recently emerging smartphone-based ecological momentary interventions (EMIs) can use real-time user reports (ecological momentary assessments [...

BACKGROUND Healthy behaviors are crucial for maintaining a person’s health and well-being. The effects of health behavior interventions are mediated by individual and contextual factors that vary over time. Recently emerging smartphone-based ecological momentary interventions (EMIs) can use real-time user reports (ecological momentary assessments [...

Objective To evaluate the impact of sharing electronic health records (EHRs) with patients and map it across six domains of quality of care (ie, patient-centredness, effectiveness, efficiency, timeliness, equity and safety). Design Systematic review and meta-analysis. Data sources CINAHL, Cochrane, Embase, HMIC, Medline/PubMed and PsycINFO, from...

Background: Having patients self-manage their health conditions is a widely promoted concept, but many patients struggle to practice it effectively. Moreover, few studies have analyzed the nature of work required from patients and how such work fits into the context of their daily life. Objective: This study aimed to review the characteristics of p...

Objectives The aim of this study was to explore how e-cigarette users in Australia accessed e-cigarette information and advertising on social media platforms. Methods The mixed-methods study design included a survey and semi-structured interviews. Data were collected from March 2019 to July 2019 in Australia. Interviews were conducted following su...

Diabetes mellitus is a leading cause of concern among non-communicable diseases worldwide, with its prevalence increasing every day. Studies have shown that it is possible to prevent type 2 diabetes in high risk people if they adopt a healthy lifestyle, such as exercising regularly, eating nutritious food and maintaining an ideal weight. Mobile app...

Diabetes mellitus is a leading cause of concern among non-communicable diseases worldwide, with its prevalence increasing every day. Studies have shown that it is possible to prevent type 2 diabetes in high risk people if they adopt a healthy lifestyle, such as exercising regularly, eating nutritious food and maintaining an ideal weight. Mobile app...

UNSTRUCTURED Effective behavior change interventions may require ongoing personalized support for users. Rapid developments in digital technology and artificial intelligence are giving rise to more advanced types of personalized interventions that can analyze large amounts of data to provide real-time, contextualized support. Despite growing resear...

BACKGROUND Smartphone applications (apps), fitness trackers, and online social networks have shown promise in weight management and physical activity interventions. However, knowledge gaps remain regarding which are the most effective and engaging interventions, and what intervention features are preferred by their users. OBJECTIVE This 6-month st...

We are all together in a fight against the COVID-19 pandemic. Chatbots, if effectively designed and deployed, could help us by sharing up-to-date information quickly, encouraging desired health impacting behaviors, and lessening the psychological damage caused by fear and isolation. Despite this potential, the risk of amplifying misinformation and...

Conversational agents have increasingly been deployed in healthcare applications. However, significant challenges remain in developing this technology. Recent research in this area has highlighted that: i) patient safety was rarely evaluated; ii) health outcomes were poorly measured, and iii) no standardised evaluation methods were employed. The co...

UNSTRUCTURED Objectives: To investigate the use, impact, and performance of remote monitoring algorithms across various types of chronic conditions. Methods: A literature search of MEDLINE complete, CINHAL complete, and EMBASE was performed using search terms relating to the concepts of remote monitoring, chronic conditions, and data processing alg...

Background Bayesian modelling and statistical text analysis rely on informed probability priors to encourage good solutions. Objective This paper empirically analyses whether text in medical discharge reports follow Zipf’s law, a commonly assumed statistical property of language where word frequency follows a discrete power-law distribution. Meth...

Background: Conversational agents (CAs) are systems that mimic human conversations using text or spoken language. Their widely used examples include voice-activated systems such as Apple Siri, Google Assistant, Amazon Alexa, and Microsoft Cortana. The use of CAs in health care has been on the rise, but concerns about their potential safety risks o...

Background: The personalization of conversational agents with natural language user interfaces is seeing increasing use in health care applications, shaping the content, structure, or purpose of the dialogue between humans and conversational agents. Objective: The goal of this systematic review was to understand the ways in which personalization h...

Context: E-cigarettes were introduced to support smoking cessation, but their popularity has increased among nonsmokers, challenging current perspectives on their safety and effectiveness as a public health intervention. The objective of this systematic review was to identify and synthesize current evidence on the influence of social factors on e-...

Clinicians spend a large amount of time on clinical documentation of patient encounters, often impacting quality of care and clinician satisfaction, and causing physician burnout. Advances in artificial intelligence (AI) and machine learning (ML) open the possibility of automating clinical documentation with digital scribes, using speech recognitio...

BACKGROUND Self-management (or self-care) is widely promoted but many patients struggle to practise it effectively. Moreover, few studies have analysed the nature and volume of work required from patients in self-care and how such work fits into the context of their daily life. OBJECTIVE To review the characteristics of patient work in adult patie...

Background: Having patients self-manage their health conditions is a widely promoted concept, but many patients struggle to practice it effectively. Moreover, few studies have analyzed the nature of work required from patients and how such work fits into the context of their daily life. Objective: This study aimed to review the characteristics o...

BACKGROUND Conversational agents (CAs) are systems that mimic human conversations using text or spoken language. Their widely-used examples include voice-activated systems like Apple Siri, Google Assistant, Amazon Alexa, or Microsoft Cortana. The use of CAs in healthcare has been on the rise, but concerns about their potential safety risks often re...

BACKGROUND The personalization of conversational agents with natural language user interfaces is seeing increasing use in health care applications, shaping the content, structure, or purpose of the dialogue between humans and conversational agents. OBJECTIVE The goal of this systematic review was to understand the ways in which personalization has...

Background: Recent advances in natural language processing and artificial intelligence have led to widespread adoption of speech recognition technologies. In consumer health applications, speech recognition is usually applied to support interactions with conversational agents for data collection, decision support, and patient monitoring. However,...

BACKGROUND Recent advances in natural language processing and artificial intelligence have led to widespread adoption of speech recognition technologies. In consumer health applications, speech recognition is usually applied to support interactions with conversational agents for data collection, decision support, and patient monitoring. However, li...

Although various methods have been developed to evaluate conversational interfaces, there has been a lack of methods specifically focusing on evaluating user experience. This paper reviews the understandings of user experience (UX) in conversational interfaces literature and examines the six questionnaires commonly used for evaluating conversationa...

Objective The objective of this study is to characterize the dynamic structure of primary care consultations by identifying typical activities and their inter-relationships to inform the design of automated approaches to clinical documentation using natural language processing and summarization methods. Materials and Methods This is an observation...