The committee noted that evidence regarding discontinuation and adverse events and serious adverse events were graded as low and very low quality, often due to risk of bias and imprecision. Both of the adverse event outcomes were also downgraded for indirectness due to the lack of description regarding what these events consisted of, making it difficult for the committee to interpret this evidence. The committee agreed that discontinuation and adverse event rates with oral iron appeared low (difference against placebo was less than 50 per 1000 for all 3 outcomes). No evidence was identified for anaphylaxis or hypersensitivity. The evidence for peak VO2, 6 minute walk test distance and KCCQ clinical summary score were reported by the study as median and IQR. Therefore imprecision could not be assessed. It was noted that the populations in the included trials was not representative of the general HF population, being in general younger and having fewer comorbidities. The committee was unsure how the benefit seen in the trials would translate in the general HF population. It was also discussed whether the trials had been long enough to encompass the possible risks and benefits. In addition, the committee noted that the trials had only included people with reduced ejection fraction, so there was a lack of evidence in people with iron deficiency and HFPEF. Trade-off between clinical benefits and harms IV iron IV iron for people with HFREF and iron deficiency appeared to have a clinically important benefit on quality of life and haemoglobin levels (in people with anaemia). However, the impact on mortality was unclear. The committee noted that while the point estimate showed a clinically important reduction in deaths, the confidence intervals around the absolute effect were wide, reducing their confidence in the effect estimate. 