(c) Assesses structured telephone support with human to machine contact and human to human contact separately. (d) May not reflect full body of available evidence: two additional studies were included in the NMA used to determine treatment effect that were not included in the clinical review of this guideline, and five more recent studies included in the guideline review that were not included in the NMA. Utility decrement of heart failure hospitalisation considered to be overestimated. Chronic Heart Failure Monitoring NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 8.4.5 Evidence statements Clinical Overall 41 studies were included in the review. The committee discussed the potential influence of publication bias on the direction and magnitude of the study results. Funnel plots , showed publication bias which was taken into consideration when assessing the quality of the evidence. Outcomes were also downgraded if risk of bias was present or if there was imprecision due to wide confidence intervals. Structured telephone support The studies contained within the following strata compared structured telephone support to usual care. There was a high degree of heterogeneity between the interventions with both the intensity and focus varying from study to study. Recent admission This strata included studies with populations comprising of people who have recently been admitted to hospital (n=5359). For the outcome all-cause mortality, 14 studies (n=5359) were included. The quality of the evidence was low and showed a clinically important reduction in deaths. The outcome all-cause hospitalisations contained 11 studies (n=4549), was rated low quality and showed no clinical effect. For the outcome QoL the majority of the evidence was rated as moderate quality. A number of different scales were used (MLWHF, EQ-5D and SF-36). 