(b) Downgraded by one increment as confidence interval cross 1 MID or 2 increments as confidence interval crosses both MID. Table 114: Clinical Evidence Summary: Capomolla 2002: Long MDT clinic (MDTc) vs Cardiology clinic in high risk HFREF Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with cardiology clinic Risk difference with MDTc (95% CI) MODERATEa due to risk of bias rate ratio 0.18 (from 428 fewer to 575 fewer) Cardiac Death 234 LOWa, b due to risk of bias, indirectness (from 84 fewer to 164 fewer) Utility (proxy for Quality of life) higher=better. Scale from: 0 to 1. VERY LOWa, c, d due to risk of bias, indirectness, imprecision The mean utility in the control groups was The mean utility in the intervention groups was 0.09 higher (better) ACE-I dose prescribed (long acting only) MODERATEa due to risk of bias The mean ace-i dose prescribed (long acting only) in the control groups was The mean ace-i dose prescribed (long acting only) in the intervention groups was 8 mg higher Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with cardiology clinic Risk difference with MDTc (95% CI) Beta-blocker dose prescribed MODERATEa due to risk of bias The mean beta- blocker dose prescribed in the control groups was 13 mg The mean beta-blocker dose prescribed in the intervention groups was 21 mg higher (a) Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias. 