31 3.3.1 What this guideline covers 31 3.3.2 What this guideline does not cover 32 3.3.3 Relationships between the guideline and other NICE guidance 33 4.1 Developing the review questions and outcomes 34 4.2 Searching for evidence 41 4.2.1 Clinical literature search 41 4.2.2 Health economic literature search 42 4.3 Identifying and analysing evidence of effectiveness 42 4.3.1 Inclusion and exclusion criteria 43 4.3.2 Type of studies 44 4.3.3 Methods of combining clinical studies 44 4.3.4 Appraising the quality of evidence by outcomes 48 4.3.5 Publication bias 57 4.3.6 Assessing clinical importance 57 Chronic Heart Failure Contents NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 4.3.7 Clinical evidence statements 57 4.3.8 Appendix D-Practical notes 57 4.4 Identifying and analysing evidence of cost effectiveness 58 4.4.2 Undertaking new health economic analysis 60 4.4.4 In the absence of health economic evidence 61 4.5.1 Research recommendations 62 4.5.3 Updating the guideline 62 5 Diagnosing heart failure 64 5.1 BNP and NT-proBNP in diagnosing heart failure 64 5.1.2 Review question: In people with suspected heart failure, what thresholds of pro-B-type natriuretic peptide (NT-proBNP) and B-type natriuretic peptide (BNP) are most accurate in identifying heart failure (as indicated by the reference standard)? 64 5.1.3 Review question: In people with suspected heart failure, what is the clinical and cost effectiveness of N-terminus pro-B-type natriuretic peptide (NT- proBNP) compared to B-type natriuretic peptide (BNP), when each is followed by the appropriate patient pthway, in order to improve patient 5.2 BNP and NT-proBNP in diagnosing heart failure in people with atrial fibrillation 84 5.2.1 Review question: In people with suspected heart failure who also have atrial fibrillation, what thresholds of N-terminus pro-B-type natriuretic peptide (NT- proBNP) and B-type natriuretic peptide (BNP) are most accurate in identifying heart failure (as indicated by the reference standard)? 