{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:02:59Z","timestamp":1771326179061,"version":"3.50.1"},"reference-count":69,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union\u2019s Horizon 2020","award":["847999"],"award-info":[{"award-number":["847999"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,12,17]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The implantable cardioverter defibrillator (ICD) is a cardiac device recommended for use to prevent the occurrence of sudden cardiac death (SCD) in post-myocardial infarction (MI) patients with reduced left ventricular ejection fraction (LVEF). The evidence informing this guidance comes from landmark trials that are now more than 20 years old. The risk-benefit profile of ICD for the contemporary target population may have changed substantially since then, which raises the question of whether there is evidence for sparing patients a procedure associated with potentially severe complications and high healthcare costs. A main part of the PRevention Of sudden cardiac death aFter myocardial Infarction by Defibrillator implantation (PROFID) project is the PROFID EHRA trial, which is supported by the European Heart Rhythm Association. PROFID EHRA is a European Union-funded, prospective, randomised, multi-centre, non-inferiority study designed to compare optimal medical therapy (OMT) alone to ICD with OMT, for post-MI patients with reduced LVEF. The study also describes economic evaluation methods to quantify the cost and health implications of using OMT alone in place of ICD implantation plus OMT in this group of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The economic evaluation has been designed to conduct a pre-trial cost-effectiveness analysis (CEA) prior to the availability of trial data, followed by a within-trial cost-consequences analysis (CCA) and a long-term post-trial CEA, conducted from the National Health Service and Personal Social Service perspective in England. The pre-trial CEA uses simulation modelling informed by available evidence to assess the lifetime costs and quality-adjusted life years of OMT alone and ICD+OMT in post-MI patients with reduced LVEF at risk of SCD, as defined in the PROFID EHRA trial. The within-trial CCA is intended to summarise the health-related quality of life (HRQoL), healthcare resource use and associated costs observed during the PROFID EHRA trial follow-up period. The post-trial CEA updates the pre-trial model by incorporating contemporary evidence about the HRQoL and costs observed during the trial and the occurrence of those events and outcomes accruing during the trial follow-up period and projecting them into the expected lifetime of the patients. Sensitivity analyses are performed to assess the robustness of the CEA results with respect to both model assumptions and uncertainty in the value of the model input parameters. Finally, a value of information analysis will identify the key drivers of uncertainty surrounding the model conclusions regarding the optimal treatment strategy, establishing if further research may be required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The PROFID EHRA trial, under legal sponsorship of Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Germany, received its first ethics approval by the Medicine Research Ethics Committee of the La Paz University Hospital in Madrid, Spain (reference number LHS-2019-0209). Before including patients, for all participating study centres, the required local, central and\/or national ethical approval has to be obtained. As of the date 13 November 2025, at least one participating study centre in the following countries has received ethical approvals from relevant ethics committees: Austria, Belgium, Czech Republic, Denmark, France, Germany, Great Britain, Hungary, Israel, the Netherlands, Poland and Spain. Results will be shared with the general public through various media channels and additionally with healthcare professionals and the scientific community through scientific meetings, conferences and publications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05665608\">NCT05665608<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-097495","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T10:04:12Z","timestamp":1771322652000},"page":"e097495","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Economic evaluation protocol for the PRevention Of sudden cardiac death aFter myocardial Infarction by Defibrillator implantation: the PROFID EHRA trial"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct05665608","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05665608","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9276-5654","authenticated-orcid":false,"given":"Yirui","family":"Qian","sequence":"first","affiliation":[{"name":"Centre for Health Economics, University of York, York, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Rojas","family":"Roque","sequence":"additional","affiliation":[{"name":"Centre for Health Economics, University of York, York, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth","family":"Woods","sequence":"additional","affiliation":[{"name":"Centre for Health Economics, University of York, York, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3426-0930","authenticated-orcid":false,"given":"Cynthia P","family":"Iglesias Urrutia","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0365-2605","authenticated-orcid":false,"given":"Vijay S","family":"Gc","sequence":"additional","affiliation":[{"name":"Centre for Health Economics, University of York, York, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Gur Arie","sequence":"additional","affiliation":[{"name":"German Heart Center of the Charit\u00e9, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Fischer","sequence":"additional","affiliation":[{"name":"German Heart Center of the Charit\u00e9, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Dagres","sequence":"additional","affiliation":[{"name":"German Heart Center of the Charit\u00e9, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerhard","family":"Hindricks","sequence":"additional","affiliation":[{"name":"German Heart Center of the Charit\u00e9, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8342-8421","authenticated-orcid":false,"given":"Andrea","family":"Manca","sequence":"additional","affiliation":[{"name":"Centre for Health Economics, University of York, York, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"2026010805401363000_16.1.e097495.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.023846"},{"key":"2026010805401363000_16.1.e097495.2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12674"},{"key":"2026010805401363000_16.1.e097495.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2021.05.005"},{"key":"2026010805401363000_16.1.e097495.4","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2020-318881"},{"key":"2026010805401363000_16.1.e097495.5","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac262"},{"key":"2026010805401363000_16.1.e097495.6","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.007497"},{"key":"2026010805401363000_16.1.e097495.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"2026010805401363000_16.1.e097495.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"2026010805401363000_16.1.e097495.9","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001063"},{"key":"2026010805401363000_16.1.e097495.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1609758"},{"key":"2026010805401363000_16.1.e097495.11","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jjcc.2019.06.001","article-title":"Declining clinical benefit of ICD in heart failure patients: Temporal trend of mortality outcomes from randomized controlled trials","volume":"75","author":"Disertori","year":"2020","journal-title":"J Cardiol"},{"key":"2026010805401363000_16.1.e097495.12","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.015139","article-title":"Time to Shock the System: Moving Beyond the Current Paradigm for Primary Prevention Implantable Cardioverter-Defibrillator Use","volume":"9","author":"Merchant","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"2026010805401363000_16.1.e097495.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.08.020"},{"key":"2026010805401363000_16.1.e097495.14","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht511"},{"key":"2026010805401363000_16.1.e097495.15","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2014-000198","article-title":"A systematic review of ICD complications in randomised controlled trials versus registries: is our \u201creal-world\u201d data an underestimation?","volume":"2","author":"Ezzat","year":"2015","journal-title":"Open Heart"},{"key":"2026010805401363000_16.1.e097495.16","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.117.007691","article-title":"Risk Factors and Temporal Trends of Complications Associated With Transvenous Implantable Cardiac Defibrillator Leads","volume":"7","author":"Koneru","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"2026010805401363000_16.1.e097495.17","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.120.018063","article-title":"Dutch Outcome in Implantable Cardioverter-Defibrillator Therapy: Implantable Cardioverter-Defibrillator-Related Complications in a Contemporary Primary Prevention Cohort","volume":"10","author":"van Barreveld","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"2026010805401363000_16.1.e097495.18","doi-asserted-by":"crossref","first-page":"4872","DOI":"10.1093\/eurheartj\/ehac496","article-title":"Device-related complications in subcutaneous versus transvenous ICD: a secondary analysis of the PRAETORIAN trial","volume":"43","author":"Knops","year":"2022","journal-title":"Eur Heart J"},{"key":"2026010805401363000_16.1.e097495.19","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1056\/NEJMe1609826","article-title":"The ICD in Heart Failure - Time for a Rethink?","volume":"375","author":"McMurray","year":"2016","journal-title":"N Engl J Med"},{"key":"2026010805401363000_16.1.e097495.20","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.122.009634","article-title":"Role of Implantable Cardioverter Defibrillator in Heart Failure With Contemporary Medical Therapy","volume":"15","author":"Butler","year":"2022","journal-title":"Circ Heart Fail"},{"key":"2026010805401363000_16.1.e097495.21","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ahj.2025.07.071","article-title":"PRevention of sudden cardiac death aFter myocardial infarction by defibrillator implantation: Design and rationale of the PROFID EHRA randomized clinical trial","volume":"291","author":"Dagres","year":"2026","journal-title":"Am Heart J"},{"key":"2026010805401363000_16.1.e097495.22","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa645"},{"key":"2026010805401363000_16.1.e097495.23","unstructured":"ClinicalTrials.gov . Prevention Of Sudden Cardiac Death After Myocardial Infarction by Defibrillator Implantation (PROFID EHRA). 2025. Available: https:\/\/clinicaltrials.gov\/study\/NCT05665608"},{"key":"2026010805401363000_16.1.e097495.24","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/j.jval.2024.03.013","article-title":"Methods for Including Adverse Events in Economic Evaluations: Suggestions for Improvement","volume":"27","author":"Ghabri","year":"2024","journal-title":"Value Health"},{"key":"2026010805401363000_16.1.e097495.25","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1093"},{"key":"2026010805401363000_16.1.e097495.26","unstructured":"Gc VS , Woods B , Iglesias U CP , et al . Conceptualisation of the cost-effectiveness model. Report for the European Commission. 2020."},{"key":"2026010805401363000_16.1.e097495.27","unstructured":"EuroQol Research Foundation . EQ-5D-5L. 2025. Available: https:\/\/euroqol.org\/information-and-support\/euroqol-instruments\/eq-5d-5l\/"},{"key":"2026010805401363000_16.1.e097495.28","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"2026010805401363000_16.1.e097495.29","unstructured":"National Institute for Health and Care Excellence . London: NICE health technology evaluations: the manual, 2022."},{"key":"2026010805401363000_16.1.e097495.30","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jhealeco.2017.06.013","article-title":"Econometric modelling of multiple self-reports of health states: The switch from EQ-5D-3L to EQ-5D-5L in evaluating drug therapies for rheumatoid arthritis","volume":"55","author":"Hern\u00e1ndez-Alava","year":"2017","journal-title":"J Health Econ"},{"key":"2026010805401363000_16.1.e097495.31","unstructured":"NHS england. national cost collection for the nhs. 2025. Available: https:\/\/www.england.nhs.uk\/costing-in-the-nhs\/national-cost-collection\/"},{"key":"2026010805401363000_16.1.e097495.32","unstructured":"R Core Team . R: A Language and Environment for Statistical Computing. 2025."},{"key":"2026010805401363000_16.1.e097495.33","unstructured":"RStudio Team . RStudio: Integrated Development for R. 2025."},{"key":"2026010805401363000_16.1.e097495.34","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.198804"},{"key":"2026010805401363000_16.1.e097495.35","doi-asserted-by":"crossref","first-page":"4616","DOI":"10.1093\/eurheartj\/ehae326","article-title":"Sudden cardiac death after myocardial infarction: individual participant data from pooled cohorts","volume":"45","author":"Peek","year":"2024","journal-title":"Eur Heart J"},{"key":"2026010805401363000_16.1.e097495.36","doi-asserted-by":"publisher","DOI":"10.3310\/hta25590"},{"key":"2026010805401363000_16.1.e097495.37","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1093\/ehjqcco\/qcad040","article-title":"Cohort profile: Evaluation of the Methods and Management of Acute Coronary Events (EMMACE) Longitudinal Cohort","volume":"9","author":"Munyombwe","year":"2023","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"2026010805401363000_16.1.e097495.38","unstructured":"PROFID EHRA Trial - PROFID PROJECT. 2025. Available: https:\/\/profid-project.eu\/profid-ehra-trial\/"},{"key":"2026010805401363000_16.1.e097495.39","doi-asserted-by":"publisher","DOI":"10.1002\/hec.584"},{"key":"2026010805401363000_16.1.e097495.40","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1812"},{"key":"2026010805401363000_16.1.e097495.41","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X12472398"},{"key":"2026010805401363000_16.1.e097495.42","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.jval.2021.10.004","article-title":"Parametric Survival Extrapolation of Early Survival Data in Economic Analyses: A Comparison of Projected Versus Observed Updated Survival","volume":"25","author":"Everest","year":"2022","journal-title":"Value Health"},{"key":"2026010805401363000_16.1.e097495.43","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1177\/0272989X231168618","article-title":"A Systematic Review of Methods to Incorporate External Evidence into Trial-Based Survival Extrapolations for Health Technology Assessment","volume":"43","author":"Bullement","year":"2023","journal-title":"Med Decis Making"},{"key":"2026010805401363000_16.1.e097495.44","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1177\/0272989X20978958","article-title":"Extrapolation of Survival Curves Using Standard Parametric Models and Flexible Parametric Spline Models: Comparisons in Large Registry Cohorts with Advanced Cancer","volume":"41","author":"Gray","year":"2021","journal-title":"Med Decis Making"},{"key":"2026010805401363000_16.1.e097495.45","unstructured":"Rutherford MJ , Lambert PC , Sweeting MJ , et al . NICE DSU Technical Support Document 21: Flexible Methods for Survival Analysis. 2020. Available: http:\/\/www.nicedsu.org.uk"},{"key":"2026010805401363000_16.1.e097495.46","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.jval.2023.12.008","article-title":"Perils of Randomized Controlled Trial Survival Extrapolation Assuming Treatment Effect Waning: Why the Distinction Between Marginal and Conditional Estimates Matters","volume":"27","author":"Jennings","year":"2024","journal-title":"Value Health"},{"key":"2026010805401363000_16.1.e097495.47","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.jval.2023.10.003","article-title":"Evaluation of Flexible Parametric Relative Survival Approaches for Enforcing Long-Term Constraints When Extrapolating All-Cause Survival","volume":"27","author":"Lee","year":"2024","journal-title":"Value Health"},{"key":"2026010805401363000_16.1.e097495.48","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/j.jval.2024.04.016","article-title":"Treatment Effect Waning Assumptions: A Review of National Institute of Health and Care Excellence Technology Appraisals","volume":"27","author":"Trigg","year":"2024","journal-title":"Value Health"},{"key":"2026010805401363000_16.1.e097495.49","doi-asserted-by":"publisher","DOI":"10.2165\/11537760-000000000-00000"},{"key":"2026010805401363000_16.1.e097495.50","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-014-0193-3"},{"key":"2026010805401363000_16.1.e097495.51","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i05"},{"key":"2026010805401363000_16.1.e097495.52","unstructured":"Drummond MF , Sculpher MJ , Claxton K , et al . Methods for the Economic Evaluation of Health Care Programmes. 4th edn. Oxford, New York: Oxford University Press, 2015."},{"key":"2026010805401363000_16.1.e097495.53","unstructured":"Department of Health & Social Care . Proposed changes to the statutory scheme to control the costs of branded health service medicines: consultation response. GOV.UK. 2023 Available: https:\/\/www.gov.uk\/government\/consultations\/proposed-update-to-the-2023-statutory-scheme-to-control-the-costs-of-branded-health-service-medicines\/outcome\/proposed-changes-to-the-statutory-scheme-to-control-the-costs-of-branded-health-service-medicines-consultation-response"},{"key":"2026010805401363000_16.1.e097495.54","unstructured":"Department for Health and Social Care . Proposals for updating Part IX of the Drug Tariff \u2013 medical devices available for prescribing in primary care. 2023."},{"key":"2026010805401363000_16.1.e097495.55","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308883"},{"key":"2026010805401363000_16.1.e097495.56","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.086728"},{"key":"2026010805401363000_16.1.e097495.57","doi-asserted-by":"crossref","unstructured":"Briggs A , Sculpher M , Claxton K . Decision Modelling for Health Economic Evaluation. Oxford: Oxford University Press, 2006.","DOI":"10.1093\/oso\/9780198526629.001.0001"},{"key":"2026010805401363000_16.1.e097495.58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2020.01.001"},{"key":"2026010805401363000_16.1.e097495.59","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.jval.2020.01.004","article-title":"Value of Information Analytical Methods: Report 2 of the ISPOR Value of Information Analysis Emerging Good Practices Task Force","volume":"23","author":"Rothery","year":"2020","journal-title":"Value Health"},{"key":"2026010805401363000_16.1.e097495.60","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X14538705"},{"key":"2026010805401363000_16.1.e097495.61","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1608029"},{"key":"2026010805401363000_16.1.e097495.62","doi-asserted-by":"publisher","DOI":"10.1023\/B:CARD.0000029034.65769.f7"},{"key":"2026010805401363000_16.1.e097495.63","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa051989"},{"key":"2026010805401363000_16.1.e097495.64","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.02.051"},{"key":"2026010805401363000_16.1.e097495.65","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eup068"},{"key":"2026010805401363000_16.1.e097495.66","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.cardfail.2010.04.009","article-title":"Cost-effectiveness of implantable cardioverter-defibrillators in children with dilated cardiomyopathy","volume":"16","author":"Feingold","year":"2010","journal-title":"J Card Fail"},{"key":"2026010805401363000_16.1.e097495.67","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.04.021"},{"key":"2026010805401363000_16.1.e097495.68","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2165\/00019053-199711050-00001","article-title":"Avoiding double-counting in pharmacoeconomic studies","volume":"11","author":"Johannesson","year":"1997","journal-title":"Pharmacoeconomics"},{"key":"2026010805401363000_16.1.e097495.69","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1007\/s40273-023-01307-1","article-title":"Moving Forward with Taking a Societal Perspective: A Themed Issue on Productivity Costs, Consumption Costs and Informal Care Costs","volume":"41","author":"Brouwer","year":"2023","journal-title":"Pharmacoeconomics"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-097495","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T10:04:17Z","timestamp":1771322657000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-097495"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":69,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,8]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bmjopen-2024-097495"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-097495","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}