Keywords: learning health systems, hyperlipidaemia, AI, wearables, adherence, prevention

Background:

Hyperlipidaemia is a major modifiable risk factor for cardiovascular disease, yet its management is strongly influenced by patients’ cultural backgrounds, including health beliefs, dietary practices, technology acceptance, and trust in data-driven care. Learning Health Systems (LHS), particularly those integrating wearable technologies and artificial intelligence (AI), offer new opportunities for personalised and adaptive care. However, insufficient consideration of culturally shaped prior experiences may limit their effectiveness, equity, and adoption.
This study would aim to identify and systematically analyse culturally embedded prior experiences that should be considered when designing and implementing AI-enabled wearable LHS for the management of hyperlipidaemia.

Research questions:

Which culturally shaped prior experiences influence the management of hyperlipidaemia and should be considered in the design of AI-enabled wearable LHS?

Method:

The proposed research strives for a mixed-methods design. First, a scoping review should synthesise existing evidence on cultural determinants affecting hyperlipidaemia care, self-management behaviours, and digital health use. Second, qualitative interviews and focus groups with patients from diverse cultural backgrounds, as well as healthcare professionals, should explore experiences, expectations, and concerns related to lipid management, wearables, and AI-supported decision-making. Third, findings could be mapped onto LHS design principles to discover culturally sensitive requirements for data collection, feedback mechanisms, and adaptive AI models.

Results:

The study is expected to identify key cultural dimensions, such as dietary norms, perceptions of chronic risk, health literacy, attitudes toward continuous monitoring, and trust in algorithmic recommendations that significantly influence engagement with AI-enabled wearables in hyperlipidaemia care.

Conclusions:

By explicitly integrating cultural prior experiences into the design of AI-driven LHS, this research seeks to enhance patient involvement and equity in hyperlipidaemia management. The findings could optimize digital health interventions and contribute to the responsible implementation of AI in chronic disease care.

Points for discussion:

What are common challanges in shared decision making in European countries in hyperlipidaemia management?

Do we "believe" that hyperlipidaemia patients can profit from AI-driven wearable LHS?