Clinical trials based on the Stroke Riskometer

Welcome to the Stroke Riskometer app and the RIBURST study.

RIBURST is an international collaborative study that aims to better understand the risk factors associated with stroke, heart attacks, dementia and diabetes mellitus, and to assess how much influence each risk factor has on the likelihood of developing these conditions in the future.

As at 2016, the Stroke Riskometer app already involved over 300 renowned stroke experts from 102 countries, making it the largest international collaborative mobile health project in the world.

You can contribute to this study by submitting your results through the app - this will help researchers better understand stroke, heart attacks, dementia and diabetes mellitus to improve the prevention of these devastating disorders within your own and the international community.

The study is conducted according to the internationally accepted Good Clinical Practice Guidelines and relevant regional regulatory (Ethics) Committee) requirements. Your participation is completely voluntary. Please see the research section of the Stroke Riskometer app for more information on the study and the consent form.

The study has been approved by the Auckland University of Technology Ethics Committee on 22/07/2014 – AUTEC Reference number 14/201.

We welcome you to:

  1. Join the RIBURST study as a scientific collaborator
  2. Request permission to use the Stroke Riskometer for your study
  3. Register your study based on the Stroke Riskometer

Please note: If you use the Stroke Riskometer data or app in your research you must acknowledge this in any relevant publications or presentations. Please use the following wording: “We acknowledge the use of Stroke Riskometer data /the Stroke Riskometer app in this study. The Stroke Riskometer app was developed by and is copyrighted by Auckland University of Technology, Auckland, New Zealand”.

Find a past or current study that is using the Stroke Riskometer

Find out which other studies have been or are being carried out based on the Stroke Riskometer app. For more information, contact the lead investigator.

  • Project: Assessment of stroke risk and the effectiveness of intervention in elderly individuals with hypertension in rural areas of Thai Binh Province
    Start date: 2024
    End date: 2026
    Lead Investigator: Pham Ly, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Vietnam. E= phamly2504@gmail.com
    Abstract: With the rapid increase in the elderly population and the prevalence of cardiovascular diseases, stroke is becoming a serious public health issue in Vietnam. This is particularly concerning in the rural areas of Thai Binh Province, where access to healthcare services is limited, making the risk of stroke among the elderly even more alarming. Through this study, we hope to provide valuable information for developing appropriate healthcare measures, thereby reducing the risk of stroke and improving the health of the elderly in rural communities, while also contributing to the formulation of effective public health strategies in the context of an aging population.

  • Project: Evaluation of stroke knowledge and awareness in middle-age and older individuals in the society
    Start date: March 2024
    End date: September 2024
    Lead Investigator: Professor Zeliha Tulek, Instanbul University-Cerrahpasa Florence Nightingale Faulty of Nursing, Itanbul, Turkey. E= ztulek@iuc.edu.tr
    Abstract: This study plans to evaluate the knowledge and awareness about stroke among middle-aged and elderly individuals in society. The study also aims to evaluate the participants' stroke risk level and individuals' health perceptions. The relationship between the level of knowledge about stroke and sociodemographic characteristics, individuals' stroke risk status, and health perception will also be investigated. Additionally, the relationship between individuals' risk status and health perceptions will be examined. This study is planned to be carried out between March and September 2024 in social facilities affiliated with Fatih Municipality in Istanbul. The sociodemographic information form, stroke information and awareness form, Stroke Riskometer, and Health Perception Scale will be used as data collection tools in the study.
  • Project: Study of stroke risk factors and impact of health education among nursing officers at a tertiary care center
    Start date: 2024
    End date: ongoing
    Lead investigator: Dr. Naveen Ranga, Department of Neurology, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
    Abstract: The aim of the study is to investigate various risk factors of stroke among nursing officers and the impact of health education intervention on stroke risk factors at a tertiary care centre. This is a prospective study with intervention in the form of health education regarding lifestyle modification for stroke risk factors.
  • Project: Polipill and Riskometer to prevent stroke and cognitive impairment in primary health care - PROMOTE Study
    Start date: 2023
    End date:
    Lead investigator: Prof. Sheila Martins, President of Brazilian Stroke Network, Neurology Professor of Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. E= Sheila Martins sheila@redebrasilavc.org.br
    Abstract: This is a phase III cluster randomised, place-controlled (for polypill only), multi-centre pragmatic trial for primary stroke prevention. The increased burden of stroke and dementia provides strong evidence that currently used primary prevention strategies are not enough and 80% of strokes occur in people with low to moderate risk. The purpose is to test whether a polypill used alone or in combination with lifestyle modification will reduce the incidence of stroke and cognitive impairment in a population of individuals with low to moderate risk of stroke.
    S. Martins, M. Brainin, B. Telo, F. Santos, A. Palmeira, C. Anderson, L. Sposato, P. M. Bath, R. Sacco, G. Hankey, M. Falavigna, R. Lopes, O. Berwanger, V. Feigin. Polipill and Riskometer to prevent stroke and cognitive impairment in primary health care - PROMOTE Study. International Journal of Stroke. 2021;16(25):Supplement. Abstract 142; WSCC121-870. DOI: 110.1177/17474930211041949

    • View the presentation by Prof Sheila Martins (President, World Stroke Organization) on the Polypill and Riskometer trial in Brazil. This lecture was given at the 15th World Stroke Congress on 12 October 2023.

  • Project: PERsonalised Knowledge to reduce the risk of Stroke (PERKS-International)
    Start date: 2021
    End date: 2024
    Lead Investigator: Associate Professor Seana Gall - Menzies Institute for Medical Research, University of Tasmania. Menzies Institute for Medical Research, University of Tasmania, Hobart 7005, Australia. T =+61 3 6226 4728 E= seanna.gall@utas.edu.au
    Abstract: This is a Phase III, prospective, pragmatic, open-label, single blinded endpoint 2 arm randomised controlled trial (RCT) including 790 participants across Australia and New Zealand. Participants will be adults aged >35 and ≤75 years with two or more modifiable risk factors (smoking, overweight, low physical activity, poor diet, high blood pressure, high total cholesterol or high blood glucose) measured using the Life's Simple 7 (LS7) index. Participants will be randomised using a stratified block approach to either the intervention or usual care group. Participants in the intervention group will be provided with the Stroke Riskometer App whereas those in the usual care group will not be informed about the Stroke Riskometer App. Blinded assessments will be conducted face-to-face at baseline and 6 months and by online or telephone assessment at 3 and 12 months. The primary outcome is a 0.4 point increase in the total LS7 score from baseline to 6 months post-randomisation in the intervention compared to usual care group.
  • Project: Reducing the International Burden of Stroke Using Mobile Technology): The Stroke Riskometer research project (RIBURST)
    Start date: 2014
    Lead Investigator: Professor Valery Feigin, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, New Zealand. E=valery.feigin@aut.ac.nz
    Abstract: RIBURST is an international collaborative study that aims to better understand the risk factors associated with stroke, heart attack, dementia and diabetes mellitus and to assess how much influence each risk factor has on the likelihood of having a stroke, heart attack, dementia and diabetes mellitus in the future. The Stroke Riskometer app already involves over 300 renowned stroke experts from 102 countries making it the largest  international -collaborative mobile health project in the world.
  • Project: Recalibration of a stroke prediction equation and disparities in stroke prevention in Aotearoa
    Start date: 2024
    End date: 2026
    Lead Investigator: Professor Valery Feigin, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, New Zealand. E=valery.feigin@aut.ac.nz
    Study manager: Dr Balakrishnan Nair, Auckland University of Technology, New Zealand. NISAN, AUT University, Private Bag 92006, Auckland 1142, New Zealand. E=balakrishnan.nair@aut.ac.nz
    Abstract: The five ARCOS studies (1981-2022) strongly suggest that although acute stroke management in NZ has improved, primary and secondary stroke prevention strategies are not sufficiently effective and require modification. Alongside this, the rate of recurrent strokes, the prevalence of risk factors in stroke patients, and the average age of stroke onset in Māori, Pacific, Asian/Other, and NZ Europeans have not significantly changed. While there has been good progress in developing and implementing CVD strategies in NZ practice for those at high CVD risk (PREDICT), their efficacy for stroke/CVD prevention remains unproven. They do not provide a prediction of recurrent stroke and do not include people older than 74 years or aged between 20-29 years. In addition, algorithms used for these high CVD risk prevention strategies do not identify key modifiable factors (eg, physical activity, diet, BMI, chronic stress, depression, sleep patterns, etc.) that are important for the prevention of CVD and other major NCDs. Recently developed digital technologies in stroke prevention, such as the internationally endorsed, validated, and award-winning Stroke Riskometer/PreventS-MD apps, partly address the gap in individual stroke prevention, but they are not specific to the NZ multi-ethnic population. There is also limited evidence about changes in the prevalence and management of CVD risk factors in NZ. This project, for the first time, will allow the development of NZ-specific algorithms for 5-year prediction of first-ever and recurrent stroke and identify deficiencies in primary and secondary stroke prevention to enable a combined and collaborative effort at all levels to reduce the burden of stroke and to have a significant and lasting impact on reducing persistent inequalities in stroke and other major NCDs in our country and internationally.
  • Project: Trial of an Individualised Intervention for the Prevention of Stroke (TIIPS)
    Start date: 2022
    End date: 2024
    Lead Investigator: Professor Valery Feigin, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, New Zealand. E=valery.feigin@aut.ac.nz
    Study manager: Dr Sulekha De Silva, Auckland University of Technology, New Zealand. NISAN, AUT University, Private Bag 92006, Auckland 1142, New Zealand. E=sulekha.de.silva@aut.ac.nz
    Abstract: TIA and minor stroke are at high risk of secondary vascular events including major stroke, myocardial infarction, cognitive deficits and death, as high as 25% within 90 days. Evidence suggests modifying health behaviours prevention is feasible, improves health outcomes, reduces healthcare costs, risk of stroke by about 80%, and stroke incidence about 50%. Health behaviours, lifestyle interventions, can lead to reductions in CVD and stroke. Health and wellness coaching (HWC) is a multidimensional intervention improving lifestyle and maintaining health and wellbeing. The main aim is to determine the effectiveness of HWC in improving blood pressure at 6 months post-randomisation and secondary aimsare to determine the impact of HWC on overall cardiovascular disease risk based on the LS7, use of the Stroke Riskometer app; quality of life; stroke awareness; cognition; medication adherence, adverse cardiovascular events, health service use and costs. Detect at least a 6 mm Hg clinically significant difference in systolic BP changes at 6 months from baseline, between the HWC and UC groups. Following screening for eligibility, consenting and the baseline assessment, participants will be randomised to Usual Care for HWC groups. Assessments are conducted at 3-, 6-, 9- and 12- months post-randomisation. The trial will determine HWC will lead to clinically meaningful improvements in lifestyle behaviours and reduce the risk for secondary vascular events including major stroke.
  • Project: Digital Technologies for Stroke Prevention (DigitS): A randomised controlled trial
    Start date: 2023
    End date: 2027
    Lead Investigator: Professor Rita Krishnamurthi, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, New Zealand. E=rita.krishnamurthi@aut.ac.nz
    Study manager: Dr Shabnam Jalili-Moghaddam, National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand. E=shabnam.jalili@aut.ac.nz
    Abstract: Up to 90% of recurrent strokes and TIAs are potentially preventable with effective secondary stroke prevention. Despite this, no major improvements in stroke recurrence rates have been observed over the last three decades in New Zealand (NZ) or internationally. This randomised controlled trial (RCT) aims to determine the efficacy and uptake of a web-app for clinicians combined with a mobile-app for secondary stroke prevention in adults (35-79 years) with TIA or IS.
  • Project: Health message appeal and Facebook audience engagement: Evidence from the Stroke Riskometer application
    Start date: 2022
    End date: 2022
    Lead investigator: Dr Ekaterina Volevach, International Clinical Research Centre, St Anne University Hospital,     Brno, Czech Republic. E=ekaterina.volevach@fnusa.cz
    Abstract: This is an exploratory quasi-randomized study to determine efficacy of three types of message appeals (positive, negative, rational) in the area of stroke prevention (using the free Stroke Riskometer app) on audience engagement. The comparison between message appeals will be done using the split test on Facebook users with increased risk of stroke. The study population will be defined through a special audience creator in Facebook Ad manager and the inclusion criteria for the study are: location in the Czech Republic, 20+ years old, excessive alcohol consumption or smoking, poor diet, lack of adequate physical activity.
  • Project: Pragmatic, factorial, cluster randomised controlled trial on primary stroke prevention in Brazil
    Start date: 2021
    End date: 2021
    Lead Investigator: President of Brazilian Stroke Network, Neurology Professor of Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. E= sheila.martins@hmv.org.br
    Abstract: The project aims to measure the engagement of the Stroke Riskometer app.  It will also test the feasibility of the PreventS webapp, which is built on the stroke Riskometer app.
  • Project: Influence of Stroke Riskometer Application (SRA©) on lifestyle changes: A pilot randomised controlled trial among Malaysian caregivers
    Start date: December 2018
    End date: May 2019
    Lead investigators: Dr Aznida Firzah Abdul Aziz, Dr Radhiyah Hussin, UKM Medical Center, Jalan Yaacob Latiff, 56000 Bandar Tun Razak, Kuala Lumpur
    Abstract: The burden of caregiving plus the familial stroke risk factor(s) predisposes caregivers to stroke. User-friendly health-related applications could empower caregivers to recognize their risk for stroke. This study aimed to assess the impact of primary prevention delivery via a smartphone application to influence stroke caregivers toward healthier lifestyle. A parallel, open-label, 2-arm prospective, pilot randomized controlled trial was conducted at a long-term stroke service of UKMMC Primary Care Clinic from December 2018 until May 2019. All stroke caregivers >=18 years, able to operate a smartphone and literate in either English or Malay were recruited. Calculation of stroke risk and profiling of current lifestyle practices was done using Stroke Riskometer© application (SRA) and Life’s Simple 7 (LS7) questionnaires respectively. Seventy-five participants (38 SRA, 37 conventional care) were recruited from 147 eligible caregivers.Both groups of patients received standard health counselling prior to randomisation. The intervention group (n=38) had additional SRA installed on their smartphones , which enabled self-monitoring of stroke risk. The mean age of caregivers in both groups differed slightly (46.0 ±1.3 years vs 45.6±12.8, p=0.87). The majority of participants were female, Malay and educated up to secondary level. The stroke risk at 5- and 10-years in both groups were reduced after 3 months (5-,10-years: SRA 24.5%, 7.1%; Conventional care: 16.7%, 6.7%) as well as relative risk for stroke at 5-and 10 years (5-years: 16.5%, 9.3%; 10-years:15.0%,18.4%). LS7 scores improvement within groups: SRA-53.9% vs 33.3% (p=0.021). Usage of SRA and LS7 may benefit promotion of healthy lifestyle practices.
  • Project: The feasibility and efficacy of the Stroke Riskometer™ Pro App in improving lifestyle factors and reducing stroke risk among patients with type 2 diabetes mellitus in Malaysia: A pilot study
    Start date: July 2018
    End date: July 2019
    Lead investigators: Dr Wan Asyraf Wan Zaidi, Tee Meng Kang and Prof Norlinah Mohamed Ibrahim, UKM Medical Center, Jalan Yaacob Latiff, 56000 Bandar Tun Razak, Kuala Lumpur
    Abstract: The study determined the feasibility and efficacy of SR in improving blood pressure, body mass index [BMI]), modified Life’s Simple 7 score, fasting blood glucose, fasting lipids and HbA1c among patients with type 2 diabetes mellitus (T2DM). Forty-six T2DM patients, aged of ≥20 years were non-randomly recruited into Riskometer group (RG) (n=23) and usual care group (UCG) (n=23). The RG participants were asked to download SR into their smartphone, and were required to use it regularly. The UCG study participants did not have a smartphone and received usual medical care. All outcome parameters were measured at baseline and 3 months. Results: The use ofSR in patients with T2DM is well accepted and feasible. The mean total mLS7 score improved significantly in RG compared to UCG (6.65±1.55 vs 5.43 ± 1.27), p=0.006, mean difference of 1.217). The blood pressure (BP), exercise sub-scores of mLS7, and the mean diastolic blood pressure improved significantly in RG compared to controls (0.96± 0.56 vs 0.52 ±0.59, p=0.014; 1.09±0.60 vs 0.35±0.49, p<0.001; 74mmHg vs 81mmHg, p=0.004, respectively). The 5- and 10-year stroke risks improved significantly from baseline to 3 months in RG: 4.98% to 4.75%, p=0.001; and 12.48% to 11.93%, p=0.001, respectively.Conclusion: SR is feasible and potentially effective in controlling BP, level of physical activity, cardiovascular health, and 5- and 10-year stroke risks in T2DM patients.
  • Project: Validation of the Bahasa Malaysia Version of the Stroke RiskometerTM – A Tool for stroke primary prevention
    Start date: 2017
    End date: 2018
    Lead investigators: Dr Wan Asyraf Wan Zaidi, Prof Norlinah Mohamed Ibrahim, UKM Medical Center, Jalan Yaacob Latiff, 56000 Bandar Tun Razak,Kuala Lumpur
    Abstract: This study aimed to validate the Malay version of Stroke RiskometerTM among Malay speaking subjects. Both English and Bahasa Malaysia (BM) versions of Stroke RiskometerTM were administered to the respondents at the UKM Medical Center. The validity and reliability of the 5 and 10-year risk were determined using intraclass correlation and Cronbach’s Alpha analysis. A total of 200 participants were recruited with a mean age of 39.26 ± 14.09 years. There were 54% males and 46% females. The majority was of Malay ethnicity (78%) followed by Chinese (15%), Indian (5%) and others (2%). A total of 58.5% preferred the BM-Stroke RiskometerTM.  The outcome of the test-retest reliability study showed that agreement between English-Stroke RiskometerTM and BM-Stroke RiskometerTM was strong for both 5 and 10-year stroke risk with intraclass correlation (ICC) of 0.979 (95% CI, 0.972 – 0.984) for 5-year risk and 0.983 (95% CI, 0.978 – 0.987) for 10-year risk. The Cronbach’s Alpha were 0.989 and 0.991 respectively. Conclusion: The BM-Stroke RiskometerTM is a valid and reliable tool to measure the risk of stroke in 5 and 10-year times, comparable with English-Stroke RiskometerTM version.
  • Project: Mobile Application to Reduce Risk of Stroke (MARS)
    Start date: 2016
    End date: 2019
    Lead investigator: Professor Valery Feigin, Auckland University of Technology, New Zealand. NISAN, AUT University, Private Bag 92006, Auckland 1142, New Zealand. E=valery.feigin@aut.ac.nz
    Abstract: The MARS trial was a pragmatic pilot, open-label, 2-arm prospective RCT. Consented participants were randomly assigned to the intervention arm using online minimization randomization. Usual care participants were not actively informed about the App. Changes in lifestyle behavior were measured at baseline, 3- and 6-months and assessed using Life’s Simple 7 (LS7) questionnaire as recommended by the American Heart Association. Questions about stroke symptoms and risk factors were asked to measure awareness levels. Positive feedback was received from study participants for the App as a tool to know more about stroke and take action for better health. Conclusions: The findings suggest the Stroke Riskometer is a feasible intervention for stroke awareness and prevention, and the results indicated that a full scale RCT to test the effectiveness of the app was warranted.
    Related publications: Krishnamurthi, R., Bhattacharjee, R., George, A., Parmar, P., Barker-Collo, S., & Feigin, V. (2018). Using a mobile app to improve stroke awareness and reduce the risk of stroke - the pilot randomised control MARS trial [poster]. In 11th World Stroke Congress. Montreal, Canada.

Contact us

For information about the app or the RIBURST study, contact the project manager at stroke.riskometer@aut.ac.nz

App-related resources

Downloadable posters to advertise the Stroke Riskometer

If you would like to advertise the Stroke Riskometer within your organisation, or amongst your professional networks, please feel free to download one of the posters below. These are editable so you can insert the information that is relevant to you.

Suggested layout for poster to be displayed in pharmacy, or other public place