(b) Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both. 9.2.3.2 High risk, Long, MDT clinic Table 113: Clinical Evidence Summary: Auckland-HF (Doughty 2002): Long MDT clinic (MDTc) vs Primary +/- Secondary care in high risk HF Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with primary +/- secondary care Risk difference with MDTc (95% CI) LOWa, b due to risk of bias, imprecision rate ratio 0.76 (from 64 fewer to 635 fewer) VERY LOWa, b due to risk of bias, imprecision (from 136 fewer to 77 fewer) Quality of life Minnesota LWHFQ (change score) lower=better. Scale from: 0 to 105. LOWa due to risk of bias The mean change in MLWHFQ in the control groups was The mean change in the intervention groups was 7 lower (greater improvement) Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with primary +/- secondary care Risk difference with MDTc (95% CI) Prescribed ACE-I 154 LOWa,b due to risk of bias, imprecision (from 29 fewer to 254 more) (a) Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias. (b) Downgraded by one increment as confidence interval cross 1 MID or 2 increments as confidence interval crosses both MID. 