This study was assessed as directly applicable with minor limitations. One UK cost-utility analysis compared specialist-led clinically guided therapy to specialist led NP-guided therapy in patients with heart failure who had recently been discharged from hospital following an acute episode. All heart failure patients and HF-REF patients were sub-grouped by age (less than 75 years old, 75 and older) whereas only HF-PEF patients less than 75 years of age were assessed. IPD data was used to estimate the relative effect of NP guided care on all-cause mortality and all-cause hospitalisations reported by Brunner le Rocca et al. 2006.55 The study found NP monitoring to be cost effective for all sub-groups, and even dominated specialist-led clinically- guided therapy in all heart failure patients over 75. The study also reported incremental net monetary benefit results with 95% confidence intervals. These results suggest there is uncertainty in the cost effectiveness of NP monitoring for HF-PEF patients less than 75 years of age and both all heart failure and HF-REF patients over 75 years of age, with 95% confidence intervals ranging from negative to positive. The study also carried out a sensitivity analysis using IPD meta-analysis data from a more recent health technology assessment, in which this economic evaluation was developed. However, this was only assessed for HF-REF patients less than 75 years old. The results of this suggest that NP monitoring is cost effective compared to clinically-guided therapy, however this is more uncertain than the base-case results as the 95% confidence intervals of the incremental net monetary benefit now range from negative to positive. 