In selected patients, ICDs unequivocally provide statistical benefit, but there are risks, and alternatives—as in any invasive treatment. In this way, ICDs are akin to many other expensive and invasive therapies. Cancer chemotherapies like adriamycin, with its cardiac toxicity, come to mind, for example.
He ends with a reminder of the most pervasive conflict of interest to keep in mind when reading research reports:
Most smart doctors read journal articles with a critical eye. They (should) know that the writers are passionate and convinced of their positive findings. Such is human nature.