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The present study attempts to explore consumer-centric reasons affecting the adoption of electric vehicles (EVs) are investigated using behavioural reasoning theory (BRT). Our study is among the first to examine consumer's EV adoption intention using BRT through the integration of the reasons "for and against" electric vehicle (EV) adoption. On data of 312 urban consumers, second order confirmatory factor analysis (CFA) revealed the existence of underlying reasons and SEM helped in testing the proposed relationships. This study also investigates the interaction effect of financial incentive policy with the consumer reasons on EV adoption. Findings revealed that "reasons for" adoption are environmental concern, perceived technology, and maintenance of knowledge and "reasons against" adoption are scepticism, price, and instrumental utility. Environmental beliefs and values influence the "reasons for" consumer intentions to approve electric vehicle adoption. Financial incentives policy was found significant in dampening the impact of reasons against adoption of electric vehicle. The study delineates the strategies for strengthening the promotion of electric vehicles.
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AIMS: This survey investigates natriuretic peptide (NP) testing in community and hospital settings, assessing awareness, accessibility, and utilization. METHODS AND RESULTS: This investigator-initiated survey, conceived within the HFA of the European Society of Cardiology, comprised 14 questions. It underwent validation and pilot testing to ensure question readability and online system functionality. The survey was accessible for 87 days, from 5 April 2023 to 1 July 2023 via a web platform. There were 751 healthcare professionals across 99 countries who responded. Of them, 92.5% had access to NPs testing in hospital whereas 34.3% had no access to NTproBNP in community settings. Access to point of care NP testing was uncommon (9.6%). Public insurance fully covered NPs testing in 31.0% of cases, with private insurance providing coverage in 37.9%. The majority (84.0%) of participants believed that the medical evidence supporting NPs testing was strong, and 54.7% considered it cost-effective. Also, 35.8% found access, awareness, and adoption to be in favour of NPs testing both in hospital and community settings. Strategies to optimize NP testing involved regular guideline updates (57.9%), prioritizing NPs testing for dyspnoea assessment (36.4%), and introducing clinician feedback mechanisms (21.2%). Notably, 40% lacked a community-based HF diagnostic pathway for referring high-NP patients for echocardiography and cardiology evaluation. CONCLUSIONS: This survey reveals NP awareness, access, and adoption across several countries. Highlighting the importance of community-based early heart failure diagnosis and optimizing HF diagnostic pathways remains a crucial, unmet opportunity to improve patient outcomes.
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There are few validated contextual measures predicting adoption of evidence-based programs. Variation in context at clinical sites can hamper dissemination. We examined organizational characteristics of Veterans Affairs hospitals implementing STRIDE, a hospital walking program, and characteristics' influences on program adoption. Using a parallel mixed-method design, we describe context and organizational characteristics by program adoption. Organizational characteristics included: organizational resilience, implementation climate, organizational readiness to implement change, highest complexity sites versus others, material support, adjusted length of stay (LOS) above versus below national median, and improvement experience. We collected intake forms at hospital launch and qualitative interviews with staff members at 4 hospitals that met the initial adoption benchmark, defined as completing supervised walks with 5+ unique hospitalized Veterans during months 5 to 6 after launch with low touch implementation support. We identified that 31% (n = 11 of 35) of hospitals met adoption benchmarks. Seven percent of highest complexity hospitals adopted compared to 48% with lower complexity. Forty-three percent that received resources adopted compared to 29% without resources. Thirty-six percent of hospitals with above-median LOS adopted compared to 23% with below-median. Thirty-five percent with at least some implementation experience adopted compared to 0% with very little to no experience. Adopters reported higher organizational resilience than non-adopters (mean = 23.5 [SD = 2.6] vs 22.7 [SD = 2.6]). Adopting hospitals reported greater organizational readiness to change than those that did not (mean = 4.2 [SD = 0.5] vs 3.8 [SD = 0.6]). Qualitatively, all sites reported that staff were committed to implementing STRIDE. Participants reported additional barriers to adoption including challenges with staffing and delays associated with hiring staff. Adopters reported that having adequate staff facilitated implementation. Implementation climate did not have an association with meeting STRIDE program adoption benchmarks in this study. Contextual factors which may be simple to assess, such as resource availability, may influence adoption of new programs without intensive implementation support.
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Benchmarking , Humanos , Estados Unidos , Hospitais de Veteranos/organização & administração , Tempo de Internação , United States Department of Veterans Affairs/organização & administração , Cultura Organizacional , Caminhada , Hospitalização , Limitação da MobilidadeRESUMO
Though the Ethiopian economy is predominantly agriculture-based, the adoption of agricultural technologies has been very low. The results of a previous study had shown that microcredit access was one of the factors affecting the adoption of agricultural technology in Ethiopia. However, its effect has not yet been analyzed at the meta-level. Therefore, this study employed meta-analysis to understand the heterogeneous effect of microcredit access among farmers adopting agricultural technologies. We used subgroup analysis and meta-regression analysis to identify the heterogeneity level of credit access on technology adoption using the random-effects (RE) model. The study observed that there was a positive effect of microcredit access on agricultural technology adoption with a log odds ratio of 1.59. The subgroup analysis revealed a 93.2 % overall variation ( I 2 ) with a p-value of 0.000, signifying a significant level of microcredit access within the between-groups heterogeneity of agricultural technology adoption studies conducted in Ethiopia. Notably, this was reflected by the adoption of improved livestock technologies, fertilizers, seed varieties, multiple agriculture, and irrigation technologies, with rates of heterogeneity of 94.9 %, 94.4 %, 94.3 %, 85 %, and 73.8 %, respectively, all with a p-value of 0.000. In addition, the meta-regression analysis results indicate that household experience, distance to the market, and income are significant moderators that affect the technology adoption decisions of farmers in rural Ethiopia. These findings suggest that policymakers should focus on improving the financial facilities and extension systems for rural farmers to enhance the adoption of agricultural technologies to increase production efficiency.
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Background: After decades of research output, it is well established that transnational adoptees-i.e., individuals who are placed for adoption outside their country of birth-exhibit an increased risk of various negative mental health outcomes. Even so, there is a lack of suggestions for preventive measures or treatment interventions targeting the transnational adoptee population in the literature. Objective: To explore experiences, opinions, and needs among adult transnational adoptees in Sweden concerning healthcare in general and mental healthcare in particular. Methods: Sixty-six adult transnational adoptees residing in Sweden, born in 15 different non-European countries, were recruited for individual in-depth interviews about their experiences and opinions regarding psychosocial support and healthcare. The interview data were analyzed employing a codebook thematic analysis approach. Results: Three overarching themes were identified: (a) barriers to adequate treatment, (b) helpful resources in dealing with health-related issues, and (c) health-related needs and suggestions for the development of adequate support. Identified barriers include a lack of insight into and interest in adoptee health, colorblindness and unwillingness to address racism, expectations of gratitude, steep financial costs, lack of support from adoptive parents, and mistrust of support structures that involve adoptive parents or adoption organizations. Participants also describe helpful resources, such as the community of fellow transnational adoptees. Health-related needs and suggestions include more well-defined and easily accessible structures of support, improved knowledge and competence, a broader psychotherapeutic repertoire that better addresses adoption-related themes, improved support in situations that can be particularly stressful for adoptees (such as during pregnancy and as new parents), routine follow-up during childhood and adolescence, and education targeting adoptive parents. The need for greater attention to the well-being of children of transnational adoptees is also highlighted. Implications: Based on these findings, a number of recommendations can be made. For example, knowledge about adoptee health should be strengthened, and psychotherapeutic competence in addressing issues related to racism should become a priority. After over 20 years of discussion, one or more national research and knowledge hubs on transnational adoption should be created. Moreover, economic resources should be made available to support transnational adoptees in accessing adequate treatment.
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Adoção , Humanos , Adoção/psicologia , Feminino , Suécia , Adulto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Entrevistas como Assunto , Necessidades e Demandas de Serviços de Saúde , Acessibilidade aos Serviços de Saúde , Internacionalidade , Adulto JovemRESUMO
Achieving blockbuster status requires more than clinical trial success. Crucial barriers often include real-world factors like patient acceptance, prescriber behavior and timely and full reimbursement. Implementation science can be used to identify such barriers, develop strategies to overcome them, as well as test their effect. Used correctly and at the right time, implementation science can amplify product value and lead to a triple win for patients, healthcare systems and pharma. Three easy steps that focus on context, strategies and outcomes, can be followed by pharma to bring implementation thinking and research into their processes. A 'what if' case study is shared to give an indication of how this might work and the impact it might have.
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BACKGROUND: Organizational adoption is a key but understudied step in translating evidence-based interventions into practice. The purpose of this study was to report recruitment strategies and factors associated with church enrollment and intervention adoption in a national implementation study of the Faith, Activity, and Nutrition (FAN) program. METHODS: We worked with partners using multiple strategies to disseminate intervention availability. Interested churches completed an online form. To enroll, the church coordinator (FAN coordinator) and pastor completed baseline surveys and then received intervention online training access. We compared enrolled vs. non-enrolled churches on how they heard about the study and church characteristics. We compared intervention-adopting vs. non-adopting churches on Consolidated Framework for Implementation Research (CFIR) constructs using Fisher's exact tests, χ2, or independent sample t-tests and reported differences where p < 0.10, d≥|0.35|, or the difference in percentage points was ≥ 10. RESULTS: We received 226 interest forms; 107 churches enrolled, and 85 churches adopted the intervention. Faith-based sources were the most, and paid media the least, effective in reaching churches, which were largely from the southeast with a Methodist or Baptist tradition (no differences by enrollment status). Enrolled churches were less likely to have 500 + worshipers and more likely to have attended a study information session than non-enrolled churches. Church (CFIR inner setting) and FAN coordinator characteristics, but not intervention characteristics, were related to intervention adoption. CONCLUSION: Partnerships, relationships, and "face time" are important for enrolling churches in evidence-based interventions. Church and church coordinator characteristics are related to intervention adoption. Further work on adoption conceptualization and operationalization is needed.
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Organizações Religiosas , Inovação Organizacional , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Promoção da Saúde/organização & administração , Adulto , Ciência da Implementação , Estados UnidosRESUMO
INTRODUCTION: Increase in health IT adoption is often driven by financial support through the state. In 2020, the German Hospital Future Law passed Parliament with a schedule to see potential effects in 2023. The research question of the present study thus was if there were differences between 2017 and 2023 in selected application areas eligible for funding by the law. METHODS: Availability and percentage of use in clinical units was measured in a panel of 172 hospitals for these areas. A linear mixed model with repeated measures yielded a significant increase in "medication management" and "discharge management". RESULTS AND DISCUSSION: In "medication management", hospitals in a group as compared to single hospitals tripled the percentage of clinical units using IT systems for this purpose. Not-for-profit hospitals doubled their IT systems for "discharge management" when compared to for-profit hospitals. CONCLUSION: Whether these changes can be attributed to the Hospital Future Law is debatable due to severe delays in various fields, particularly in making funding available. There is room for speeding up particularly the administrative funding process and finally demonstrating results that are proportional to the government money invested.
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Sistemas de Informação Hospitalar , Alemanha , Humanos , Difusão de InovaçõesRESUMO
Cryptocurrency is an attempt to create an alternative to centralized financial systems using blockchain technology. However, our understanding of the psychological mechanisms that drive cryptocurrency adoption is limited. This study examines the role of basic human values in three stages of cryptocurrency adoption-awareness, intention to buy, and ownership-using the Theory of Planned Behavior (TPB). Logistic regression analysis was conducted on a quota sample of 714 German adults, and the results showed that openness-to-change values increased the likelihood of cryptocurrency awareness, while self-enhancement values increased the likelihood of intention to buy and ownership. These findings were consistent even after controlling for demographic characteristics, attitudinal beliefs, and perceived behavioral control, which are important factors in the TPB. The results suggest that basic human values may influence an individual's decision to adopt cryptocurrency, but the transition from awareness to ownership may be influenced by socio-economic opportunities available to interested individuals.
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Telemedicine uses digital technologies to provide healthcare services remotely, greatly improving patient access, especially during crises like the COVID-19 pandemic. This systematic review investigates telemedicine's effects on patient outcomes, access to care, and its role in the evolving healthcare landscape. Relevant studies were identified using MeSH terms and keywords through electronic databases and manual reference list screenings. The selected empirical studies, both quantitative and qualitative, examined telemedicine across various patient populations. The review categorized findings into themes related to patient outcomes and access to care. Telemedicine was found to be a transformative tool in chronic disease management, particularly in diabetes care. Significant improvements in patient health outcomes and cost savings were reported with telemedicine interventions. For example, telehealth platforms enhance diabetes management by increasing patient engagement and improving clinical metrics such as HbA1c levels. Additionally, telehealth services for diabetes-related foot disease (DFD) overcome geographical barriers, providing specialized care and improving patient access and satisfaction. In conclusion, telemedicine significantly improves patient outcomes, access, and satisfaction in chronic disease management, especially diabetes care. By overcoming geographical barriers and enhancing patient engagement, telehealth platforms have the potential to transform global healthcare delivery. Implementing these insights into practice can improve the accessibility and effectiveness of diabetes care worldwide, ensuring equitable and patient-centered healthcare solutions.
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OBJECTIVE: Our objective was to ascertain likely reasons for explaining variation in coverage rates for hearing aids (HAs) among various countries around the world. DESIGN: A retrospective analysis of past coverage rates and their association to demographic and economic variables of apriori logical consideration. STUDY SAMPLE: Data was obtained on macroeconomic conditions from 37 countries in the OECD and estimated coverage rates for HAs using recent actual sales data. RESULTS: Two variables were identified with a very strong correlation (R = 0.97, R2 = 0.95) to coverage rates. The first variable was the level of subsidy provided for the citizens to obtain HAs. The second variable was the GNI/capita which reflects the income available to citizens to make the purchase of HAs. CONCLUSION: In countries where subsidy for HAs are made available through either public or private health service/insurance, an increase in coverage rates is likely to occur. The effect of subsidy is likely to surpass any effect of OTC HAs that has been demonstrated to date. Where and when feasible, subsidy presence and encouraging income generation among able citizens of a country should be sought in tandem - a complex interplay of improving coverage rates for HAs with economics.
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mHealth apps can especially benefit older adults with chronic conditions, but their usage rates remain often low. This study examines how older adults' self-perceived technical skills and confidence affect their use of a mHealth app. It was conducted in southern Germany and included older adults (65 years and older) with and without age-related chronic conditions. Results indicate that perceived self-efficacy does not always match actual capability. This discrepancy raises concerns about how it might impact the use and prescription of these apps.
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Aplicativos Móveis , Autoeficácia , Telemedicina , Humanos , Idoso , Alemanha , Masculino , Feminino , Doença Crônica/terapia , Idoso de 80 Anos ou maisRESUMO
Current research on technophobia and readiness to adopt new technology in the aging population is often limited to the context of specific technologies and treats technophobia as a unidimensional construct. In this study, we investigate the role of demographic variables and various aspects of technophobia in determining Slovenian aging adults' readiness to adopt new technology. Partial least squares structural equation modeling revealed that age and educational level generally significantly predicted technophobia and indirectly contributed to readiness to adopt new technology via the human versus machine ambiguity dimension of technophobia. Moreover, age and human versus machine ambiguity were significant direct negative predictors of readiness to adopt new technology. Findings obtained specifically in the health sub-domain were similar. Our results have important implications for addressing the low adoption of new technology among aging adults as they provide guidance on whom should be targeted with interventions and which aspects need to be addressed.
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The rapid evolution of artificial intelligence (AI) in healthcare, particularly in radiology, underscores a transformative era marked by a potential for enhanced diagnostic precision, increased patient engagement, and streamlined clinical workflows. Amongst the key developments at the heart of this transformation are Large Language Models like the Generative Pre-trained Transformer 4 (GPT-4), whose integration into radiological practices could potentially herald a significant leap by assisting in the generation and summarization of radiology reports, aiding in differential diagnoses, and recommending evidence-based treatments. This review delves into the multifaceted potential applications of Large Language Models within radiology, using GPT-4 as an example, from improving diagnostic accuracy and reporting efficiency to translating complex medical findings into patient-friendly summaries. The review acknowledges the ethical, privacy, and technical challenges inherent in deploying AI technologies, emphasizing the importance of careful oversight, validation, and adherence to regulatory standards. Through a balanced discourse on the potential and pitfalls of GPT-4 in radiology, the article aims to provide a comprehensive overview of how these models have the potential to reshape the future of radiological services, fostering improvements in patient care, educational methodologies, and clinical research.
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Background The Family Adoption Programme (FAP) has been introduced under the competency-based medical education curriculum wherein each medical student adopts families. The objective of this study was to determine the stakeholders' perspective and to suggest measures to make it relevant for Indian medical graduates. Methodology A mixed-method study was conducted among the faculty, undergraduate students, and community using prestructured, validated instruments. The quantitative data were entered into Microsoft Excel (Microsoft Corp., Redmond, WA) and analysed, while the qualitative data were coded and analysed thematically. Results All faculty members (12, 100%), the majority of students (49, 44.30%), and the community members strongly agreed that the policy decision to introduce the FAP was 'right'. The benefits mentioned were that FAP helps improve knowledge, psychomotor skills, attitudes and communication, attitude and behaviour skills, understanding of the social structures, health status of the community, and health-seeking behaviour of the families and provides an appropriate early clinical exposure. The challenges mentioned were selecting a site, gaining cooperation from family, communication, arrangement of logistics and transportation, getting support from teachers, difficulties in managing students in the community and coordinating among faculty, staff and students. Most faculty members recommended that the FAP should be started later in the curriculum and there should be restrictions on the number of families to be adopted. The students suggested that adequate logistics be provided as well as a reduction in the number of family visits. Conclusion The programme has been welcomed by most stakeholders. It requires the necessary support from the institution authorities, prior planning of visits, judicious utilization of social media, and coordination with government field-level health workers e.g. Accreditated Social Health Activists (ASHA). A comprehensive program evaluation and formulation of a standard operating module will further strengthen the programme.
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An interview-based questionnaire survey was done in 2021 to assess the socio-economic conditions, farming practices adopted, and problems faced by fish farmers and to analyze the cost and benefits of fish farming in the Fish super zone area of Pachrauta Municipality, Bara district. A simple random sampling technique was used to select 60 respondents for the study and the information collected was analyzed and processed by MS-Excel and SPSS. The majority of respondents were male, belonged to the age group of 25-36 years, and had a secondary level of school education. The mean total land holding size was found to be 3.65 ± 2.57 bigha with a total pond area of 1.38 ± 1.08 bigha and a small minority (18 %) practiced contract farming. Most of the farmers were found to have experience of 6-11 years (40 %). The farming system was polyculture and mostly Intensive (60 %). While the use of modern equipment was low (25 %), the majority of farmers (>90 %) practiced regular drying and liming of ponds. Mid-April to Mid-July was the most preferred time of stocking and the big fraction of feed used was locally prepared (70 %). Fertilizer use and Multiple harvesting were also common. Fish farming in the study area was found to fetch an average annual income of 0.95 million NRs. The major problems faced by farmers were Expensive feed (0.67), Lack of quality seeds (0.60), and Lack of proper marketing channels (0.55). Despite the constraints, Economic analysis revealed fish production in the study area as a profitable business with a BC ratio of 2.20 and a high gross margin value (Rs. 1330341.6 per hectare).
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Hyb-blended learning is a novel method that can serve as a substitute for conventional classroom-based learning activities, demonstrating effectiveness in both pandemics like COVID-19 and other crises, as well as in non-pandemic situations. The successful application of this method in the field of education depends on the users' intentions to adopt it. Therefore, this study aims to understand the behavioral intentions of teachers and students at Bangladeshi universities toward the adoption of the hyb-blended learning method. A correlational, cross-sectional, and sample survey-based research design was employed. Two structured questionnaires, one for teachers and one for students, were used to collect data from 171 teachers and 713 students from 11 public and 8 private universities in Bangladesh. The conceptual model of the study was developed on the theoretical underpinnings of the "Unified Theory of Acceptance and Use of Technology (UTAUT)." The study used a structural equation modeling technique to test the hypotheses. The results of the study revealed that the proposed learning method would increase teaching and learning opportunities for both teachers and students in Bangladeshi universities. They would adopt this method without relying on the experiences of others or what others think or say. Unlike teachers, the study also found that students would use it if they received support and influence from friends, fellow students, university authorities, and other external factors. However, their intentions toward adopting this method depend on the availability of resources and support for adopting it, as well as adequate and necessary understanding and talent to use it effectively. Results also revealed that they would adopt the method if it was found to be simple to use. The study has a notable practical implication, as it has proposed an alternative learning and teaching method that would be effective in Bangladeshi universities during the COVID-19 pandemic or other crises and in non-pandemic situations as well.
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Frequent climate variability and change had the strongest direct influences on the availability and accessibility of food through reducing agricultural productivity and cropping patterns. Despite the Ethiopian government having made substantial efforts to boost production and productivity through the introduction of Climate Smart Agriculture Practices (CSAPs), the implementation of these practices by smallholder wheat farmers has remained low. This study, therefore, tried to investigate the determinants of the adoption of CSAPs in Northwestern Ethiopia. The primary data were gathered from 385 randomly selected wheat producers (including 702 plot-level observations). The CSAPs considered in this investigation were wheat row planting, crop rotation, and improved wheat varieties. The factors that influence the adoption of CSAPs were determined using a multivariate probit (MVP) model. The results revealed that the age of the sampled wheat producer farmers, education level of sampled wheat farmers, livestock holding, contact with development agents, credit access, off-farm activities participation, distance to input supply institution, slope of the plot, and soil fertility status of the plot were the major determinants of the adoption of CSAPs. The study suggested that policy-makers and stakeholders should strengthen farmers' skills by providing sufficient and effective short-term training. Moreover, encouraging mixed crop-livestock production systems, strengthening credit access, development agents, and access to near-input supply institutions are required to scale-up the adoption of CSAPs.
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Rice production is inherently risky and volatile, and farmers in Bangladesh face a wide range of risks, including weather, pest and disease attacks, interruptions to input supply, and market-associated risks. Moreover, poor farm households often perceive risks in adopting new technology, even though it could improve productivity and food security. Such households are thus caught in a "risk-induced trap" that precludes them from realizing the benefits of technological innovation. Extension service is one way to help farmers improve risk management skills and escape risk-induced traps, but there is limited empirical analysis of its impact in Bangladesh. The objective of the study is to measure the nexus between agricultural extension services, technology adoption, and production risks as well as women empowerment in agriculture index. IFPRI utilized stratified random sampling to determine the 5603 households in 2018 (which is nationally called the BIHS-2018 dataset) from rural and pre-urban areas of Bangladesh. Out of these 5603 households, 2663 households were specifically selected for the study related to rice farming to achieve the main objective of the study. Focusing on rice farming, a moment-based Poisson regression model is estimated with 2SLS and identifies risks associated with key technologies and potential productivity and risk-reducing effects. The results revealed that wealthier households are more likely to adopt technology for minimizing production risk and women's empowerment which can positively affect productivity by mitigating risk. The result revealed a positive and significant difference in WEAI between the AES participant and non-participant group. We find that engagement in agricultural extension services was associated with technology adoption and production risk reduction. The agricultural extension services increased, technology adoption by 4.2 % and decreased production risk by 2.4 %. Based on the findings, it is concluded that more comprehensive extension services can enhance rice production and ameliorate farmers' risk in rice production to some extent.
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INTRODUCTION: Conventional implantable cardioverter-defibrillators (ICDs) and pacemakers carry a risk of pocket- and lead-related complications in particular. To avoid these complications, extravascular devices (EVDs) have been developed, such as the subcutaneous ICD (S-ICD) and leadless pacemaker (LP). However, data on patient or centre characteristics related to the actual adoption of EVDs are lacking. OBJECTIVE: To assess real-world nationwide trends in EVD adoption in the Netherlands. METHODS: Using the Netherlands Heart Registration, all consecutive patients with a de novo SICD or conventional single-chamber ICD implantation between 2012-2020, or de novo LP or conventional single-chamber pacemaker implantation between 2014-2020 were included. Trends in adoption are described for various patient and centre characteristics. RESULT: From 2012-2020, 2190 SICDs and 10,683 conventional ICDs were implanted; from 2014-2020, 712 LPs and 11,103 conventional pacemakers were implanted. The general use has increased (S-ICDs 8 to 21%; LPs 1 to 8%), but this increase seems to have reached a plateau. SICD recipients were younger than conventional ICD recipients (pâ¯< 0.001) and more often female (pâ¯< 0.001); LP recipients were younger than conventional pacemaker recipients (pâ¯< 0.001) and more often male (pâ¯= 0.03). Both SICDs and LPs were mainly implanted in high-volume centres with cardiothoracic surgery on-site, although over time SICDs were increasingly implanted in centres without cardiothoracic surgery (pâ¯< 0.001). CONCLUSION: This nationwide study demonstrated a relatively quick adoption of innovative EVDs with a plateau after approximately 4 years. SICD use is especially high in younger patients. EVDs are mainly implanted in high-volume centres with cardiothoracic surgery back-up, but SICD use is expanding beyond those centres.