22 To maintain consistency with the clinical review these have also been reported according to the clinical categories specified above. One health economic study was identified for the high risk, mid-length intervention, MDT clinic category; 2 health economic studies were identified for the high risk, long intervention, MDT clinic category; 1 health economic study was identified for the high risk, long intervention, nurse led MDT; and 1 health economic study was identified for the high risk, long intervention, case management MDT. No economic evaluations were identified for the remaining categories. These are summarised in the health economic evidence profiles below (Table 126, Table 127, Table 128 and Table 129) and the health economic evidence tables in Appendix G. One economic evaluation was selectively excluded due to the availability of more applicable evidence. This is listed in appendix J, with reasons for exclusion given. See also the health economic study selection flow chart in Appendix D. Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Table 126: Health economic evidence profile: Home-based MDT clinic (mid-length intervention) vs usual care in high risk patients Study Applicability Limitations Other comments Incremental cost Incremental effects Cost- effectiveness Uncertainty Sahlen [Sweden] Partially applicable (a) Potentially serious limitations (b) Cost-utility analysis (health outcome: QALYs) Within-trial analysis of a RCT Population: adults with chronic heart failure with NYHA class III-IV symptoms and a marker of severity Interventions: 1. Usual care 2. MDT - consisting of a heart failure nurse, palliative care nurse, cardiologist, palliative care physician, physiotherapist and occupational therapist 6 month follow-up saving of QALYs (more effective and less costly) Uncertainty not reported for cost effectiveness Conclusions robust to sensitivity analyses. 