The committee agreed that all-cause mortality was the appropriate outcome, rather than heart failure or cardiovascular mortality, in the context of the broad objectives of this review question. The committee also agreed that the most relevant risk tools would be those that identified patients at increased risk of mortality at 1 year, as this was an appropriate time for putting in place supportive and palliative care processes if necessary. Risk tools that identified patients at high risk of death in the very short term (for example, in hospital, or within 30 or 60 days of discharge), or in the long term (for example 2, 5 or 10 years) were not considered appropriate for this review question as they would not necessarily capture the patients who might benefit from palliative care services and processes in a timely manner. Quality of the clinical evidence The review included 7 risk tools that were validated in a range of heart failure cohorts. Overall, the quality of the evidence ranged from very low to high, and varied significantly between the tools. Many of the studies included in the review reported the area under the curve (AUC) or c-statistic as the only accuracy data. The committee noted that this metric enabled comparison of the overall accuracy of the tools, and agreed a priori that a minimum AUC of 0.70 would be necessary to consider recommending a tool, but that AUC itself was unlikely to provide enough information to make a recommendation. For those tools where multiple studies reported the AUC in different cohorts, the results were inconsistent, with some studies suggesting an AUC of greater than 0.70, and others estimating a lower accuracy. Many studies also did not report calibration data and these were downgraded for risk of bias. 