A number of evidence-based treatments for heart failure reduce hospital admissions and increase survival, particularly for patients with heart failure with reduced ejection fraction (HFREF). Typically these trials use fixed doses and thus their recommendations apply to the average population rather than any particular individual. Objective tests such as measurement of biomarkers and imaging could potentially also be used to inform management decisions and optimise treatment for individuals. The aim of this review was to examine the clinical and cost-effectiveness of biomarker measurement or imaging in the management of patients with HF. Chronic Heart Failure Monitoring NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 8.1.2 Review question: What is the clinical and cost effectiveness of biomarker-based monitoring, monitoring with cardiac MRI, and monitoring with repeated echocardiography in people with heart failure? For full details see review protocol in Appendix A. Table 78: PICO characteristics of review question Population People diagnosed with heart failure in a community or outpatient setting. 