Evidence map›Paper›PMID 34261778›Full record

ReviewOpen heart2021

Ethical issues in two parallel trials of personalised criteria for implantation of implantable cardioverter defibrillators for primary prevention: the PROFID project-a position paper.

Dick Willems, Marieke Bak, Hanno Tan, Georg Lindinger, Ayca Kocar, Alireza Seperhi Shamloo, Georg Schmidt, Gerhard Hindricks, Nikolaos Dagres

Abstract readReviewConsensus Statement
In one paragraph

Review in Open heart, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. High mortality after ST-segment elevation myocardial infarction and implications for implantable cardioverter defibrillator trials design.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025
    Article
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Dick WillemsEthics, Law, and Humanities, Amsterdam Public Health, Amsterdam UMC Locatie Meibergdreef, Amsterdam, The Netherlands d.l.willems@amsterdamumc.nl.ORCID 0000-0002-5587-2549
Marieke BakEthics, Law, and Humanities, Amsterdam Public Health, Amsterdam UMC Locatie Meibergdreef, Amsterdam, The Netherlands.
Hanno TanDepartment of Cardiology, Heart Center, Academic Medical Center, Amsterdam, The Netherlands.
Georg LindingerInstitute for Health Care Management and Health Sciences, University of Bayreuth, Bayreuth, Bayern, Germany.
Ayca KocarInstitute for Health Care Management and Health Sciences, University of Bayreuth, Bayreuth, Bayern, Germany.
Alireza Seperhi ShamlooLeipzig Heart Institute GmbH, Leipzig, Sachsen, Germany.ORCID 0000-0002-4894-8664
Georg SchmidtMedizinische Klinik und Poliklinik, Technische Universität München, München, Bayern, Germany.
Gerhard HindricksLeipzig Heart Institute GmbH, Leipzig, Sachsen, Germany.
Nikolaos DagresLeipzig Heart Institute GmbH, Leipzig, Sachsen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo discuss ethical issues related to a complex study (PROFID) involving the development of a new, partly artificial intelligence-based, prediction model to enable personalised decision-making about the implantation of an implantable cardioverter defibrillator (ICD) in postmyocardial infarction patients, and a parallel non-inferiority and superiority trial to test decision-making informed by that model.

methodThe position expressed in this paper is based on an analysis of the PROFID trials using concepts from high-profile publications in the ethical literature.

resultsWe identify ethical issues related to the testing of the model in the treatment setting, and to both the superiority and the non-inferiority trial. We underline the need for ethical-empirical studies about these issues, also among patients, as a parallel to the actual trials. The number of ethics committees involved is an organisational, but also an ethical challenge.

conclusionThe PROFID trials, and probably other studies of similar scale and complexity, raise questions that deserve dedicated parallel ethics and social science research, but do not constitute a generic obstacle. A harmonisation procedure, comparable to the Voluntary Harmonization Procedure (VHP) for medication trials, could be needed for this type of trials.

Indexed as

Artificial IntelligenceDecision MakingDefibrillators, ImplantableClinical Trials as TopicDeath, Sudden, CardiacHumansMyocardial InfarctionPrimary Preventionethicshealth careheart arrestmedicalmyocardial infarctionoutcome assessmentresearch design

Identifiers

PMID34261778
PMCPMC8280899

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.