The committee agreed that, regardless of the programme delivery format or setting, all patients should be assessed by a trained healthcare professional prior to commencement, in order to: ensure that the person can safely participate in exercise-based cardiac rehabilitation; tailor an appropriate programme for the patient. In addition, professional support should be available to patients throughout both centre and home-based programmes and patients should be advised on how to access that support. Trade-off between net clinical effects and costs One relevant economic evaluation was identified and included in this review that compared home-based rehabilitation to hospital-based rehabilitation for people with heart failure. This was a 5 year follow-up comparative costing of patients who participated in a trial by Cowie et al. 2011 included in the clinical review. The study found home-based rehabilitation to be more costly compared to hospital-based rehabilitation. When discussing this paper, the committee considered that the estimated intervention cost of home-based rehabilitation would be lower in current practice. In the study, the cost of DVD production to deliver the home-based intervention was divided by the number of patients in the study arm (n=15) to give the average cost per patient. In practice with a much larger population size, the committee considered that home-based rehabilitation would be less costly than hospital-based rehabilitation as the fixed cost of producing a DVD would be divided over a greater number of patients, and the marginal cost of providing each additional DVD would be minimal. The estimated intervention cost of hospital-based rehabilitation is unlikely to differ in current practice. The committee also noted that the admission costs were higher in the home-based rehabilitation group in this study. 