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May 2026
A quiet revolution in heart care is underway—powered not by a new drug or device, but by data.
Supported by PHRN infrastructure, the National Echo Database of Australia and New Zealand (NEDA) has brought together nearly two million echocardiograms from more than a million people and linked them to national mortality data. The result is the world’s largest mortality-linked echocardiographic dataset—providing a powerful new lens on how heart disease develops, is detected, and should be treated.
For Professor Geoff Strange, NEDA’s Creator and Director, the breakthrough lies in combining depth with scale. Each echocardiogram contains up to 80 clinical measurements, alongside clinician notes.
“When linked to outcomes data, this level of detail enables insights that smaller, siloed datasets simply can’t reveal—it’s a fundamental shift towards a much stronger analytical foundation,” he says.
Rethinking what we thought we knew
One of NEDA’s most important contributions has been to challenge long-held clinical assumptions. By analysing full data distributions across large populations, researchers have identified that some heart conditions develop—and become dangerous—earlier than previously thought.
This has major implications for when patients should be treated. In conditions like severe aortic stenosis, where a narrowed heart valve restricts blood flow, earlier intervention can be lifesaving. Yet historically, many patients have been managed with a “watchful waiting” approach.
AI at the bedside
The dataset has also enabled the development of innovative AI tools. One example is EchoSolve, an algorithm designed to predict severe aortic stenosis in real time.
Unlike image-based systems that require time-consuming processing, EchoSolve works directly from structured numerical data already captured in clinical reports. It generates a “digital fingerprint” of risk and returns results in around three seconds—providing real-time reporting.
This speed and simplicity have driven rapid international uptake, including at leading US institutions such as Mayo Clinic, Mount Sinai and Harvard.
Crucially, the algorithm’s predictions can be validated against real-world outcomes within NEDA—linking predicted risk back to actual mortality. This creates a powerful feedback loop, strengthening clinical confidence.
Global reach, local impact
NEDA’s influence is already being felt beyond Australia. In the UK, its findings helped identify a major treatment gap—hundreds of thousands of patients eligible for intervention, with only a fraction receiving it. This evidence has informed updated European clinical guidelines, supporting earlier treatment.
Professional bodies in the United States have also updated echocardiography reporting standards based on NEDA insights, including proposed changes to better reflect differences in heart failure between men and women.
At home, the picture is similarly urgent. Research suggests that 80–90% of Australians with severe aortic stenosis who could benefit from treatment are not receiving it. Of an estimated 50,000 eligible patients each year, only around 9,000 undergo valve replacement.
Building the foundations for discovery
Creating NEDA was no small task. It required six years of collaboration across 45 specialist centres, 65 laboratories, industry partners and universities to integrate data from multiple systems.
Today, linkage with national health datasets provides access to tens of millions of hospital records and billions of medicine and emergency department records—creating a uniquely rich research environment.
This scale opens the door to new kinds of discovery, from better defining disease subtypes to identifying patients earlier in their disease trajectory.
Trust, governance and the road ahead
As with any large-scale data initiative, trust is critical. NEDA operates under strict security protocols, with identifying information protected to standards exceeding those used in banking. It also works closely with consumer groups, including Heart Valve Voice and Heart Kids Australia, to ensure community perspectives are embedded in its work.
However, Professor Strange notes that current consent requirements pose challenges for expanding this kind of research. Maintaining opt-out pathways for low-risk, high-benefit studies will be key to sustaining progress.
Looking ahead, the team aims to link echocardiographic data with pathology and other imaging modalities—moving closer to a future where structural heart disease can be detected, and even prevented, before symptoms appear.
In that future, the humble echocardiogram—once a standalone diagnostic test—becomes part of a much bigger story: one where data doesn’t just record disease but helps rewrite its course.
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Privacy and security
Privacy protection and data security lie at the heart of the Population Health Research Network. The collection, use and disclosure of personal information by government agencies and other agencies are bound by strict legislative and regulatory conditions. Researchers wishing to access linked data must also adhere to stringent conditions, including ethics approval, data custodian approval and the development of a detailed data security plan.
Researchers are typically given access to a linked data set put together to meet the specific needs of their project. This de-identified data includes only the minimum information required for the research, such as age rather than date of birth. Government agencies handle personal information in highly secure environments. Data is delivered to researchers through a secure remote access facility, ensuring no information is stored on the researcher’s personal computer or their institutional network.
Researchers cannot export raw data from this system, only their analyses, and these are checked. Researchers must only use the data for the approved purpose and are not allowed to link any other information. At the conclusion of the project, all data must be destroyed or returned. Penalties for researchers and government employees can include criminal conviction, jail time or substantial fines. In the more than ten years since the network began, there has never been a breach.
