(b) Downgraded by 1 increment if the confidence interval crossed 1 MID or by 2 increments if the confidence interval crossed both MIDs. Table 107: Clinical evidence summary: Gonzalez-Guerrero 2014: Mid-length MDT clinic (MDTc) vs Primary care +/- Geriatric clinic for high risk HF Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with Control Risk difference with Gonzalez-guerrero 2014 VERY LOWa,b due to risk of bias, imprecision rate ratio (from 310 fewer to 310 more) LOWa,b due to risk of bias, imprecision (from 258 fewer to 15 more) Quality of life - not reported - - Not estimable - - (a) Downgraded by one increment as rated to be at high risk of bias (b) Downgraded by one increment as confidence interval crosses one MID or two increments as confidence interval crosses both MIDs Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Table 108: Clinical evidence summary: Nucifora 2006: Mid-length MDT clinic (MDTc) vs Primary care for high risk HF Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with primary care Risk difference with MDTc (95% CI) VERY LOWa, b due to risk of bias, imprecision rate ratio (from 217 fewer to 289 more) VERY LOWa, b due to risk of bias, imprecision (from 17 fewer to 243 more) Quality of life Minnesota LWHFQ (change score) lower=better. Scale from: 0 to 105. 