ArticleBMJ (Clinical research ed.)2014
Influence of healthy candidate bias in assessing clinical effectiveness for implantable cardioverter-defibrillators: cohort study of older patients with heart failure.
Article in BMJ (Clinical research ed.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- A Systematic Review and Meta-Analysis on the Levels of Supportive Care Needs in Adults With Cancer.Psycho-oncology · 2026Pooled it
- Clinical Risk Stratification for Primary Prevention Implantable Cardioverter Defibrillators.Circulation. Heart failure · 2015Trial
- Use of Aspirin and Initial Cardiovascular and Bleeding Risk in Patients with Chronic Kidney Disease.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Machine learning for improving high-dimensional proxy confounder adjustment in healthcare database studies: An overview of the current literature.Pharmacoepidemiology and drug safety · 2022Review
- When Can Nonrandomized Studies Support Valid Inference Regarding Effectiveness or Safety of New Medical Treatments?Clinical pharmacology and therapeutics · 2022Review
- Conducting Real-world Evidence Studies on the Clinical Outcomes of Diabetes Treatments.Endocrine reviews · 2021Article
- Facility-Level Variation and Clinical Outcomes in Use of Cardiac Resynchronization Therapy With and Without an Implantable Cardioverter-Defibrillator.Circulation. Cardiovascular quality and outcomes · 2018Observational
- Reasons for Guideline Nonadherence at Heart Failure Discharge.Journal of the American Heart Association · 2018Article
- Measuring Frailty in Medicare Data: Development and Validation of a Claims-Based Frailty Index.The journals of gerontology. Series A, Biological sciences and medical sciences · 2018Article
- Long-term Outcomes Associated With Implantable Cardioverter Defibrillator in Adults With Chronic Kidney Disease.JAMA internal medicine · 2018Article
- Automated data-adaptive analytics for electronic healthcare data to study causal treatment effects.Clinical epidemiology · 2018Review
- Use of Health Care Databases to Support Supplemental Indications of Approved Medications.JAMA internal medicine · 2018Article
- Real world effectiveness of primary implantable cardioverter defibrillators implanted during hospital admissions for exacerbation of heart failure or other acute co-morbidities: cohort study of older patients with heart failure.BMJ (Clinical research ed.) · 2015Article
- Implantable Cardioverter-Defibrillator Use in Older Adults: Proceedings of a Hartford Change AGEnts Symposium.Circulation. Cardiovascular quality and outcomes · 2015Review
- Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo assess the potential contribution of unmeasured general health status to patient selection in assessments of the clinical effectiveness of implantable cardioverter-defibrillator (ICD) therapy.
designRetrospective cohort study.
settingLinked data from an ICD registry, heart failure registry, and Medicare claims data for ICDs implanted in 2005 through 2009.
participants29,426 patients admitted to hospital with heart failure aged 66 years or older and eligible for ICD therapy for primary prevention.
main outcome measuresNon-traumatic hip fracture, admission to a skilled nursing facility, and 30 day mortality-outcomes unlikely to be improved by ICD therapy.
resultsCompared with 17,853 patients without ICD therapy, 11,573 patients with ICD therapy were younger and had lower ejection fraction and more cardiac admissions to hospital but fewer non-cardiac admissions to hospital and comorbid conditions. Patients with ICD therapy had greater freedom from unrelated events after adjusting for age and sex: hip fracture (hazard ratio 0.77, 95% confidence interval 0.64 to 0.92), skilled nursing facility admission (0.53, 0.50 to 0.55), and 30 day mortality (0.12, 0.10 to 0.15).
conclusionsLower risks of measured outcomes likely reflect unmeasured differences in comorbidity and frailty. The findings highlight potential pitfalls of observational comparative effectiveness research and support physician consideration of general health status in selecting patients for ICD therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.