The committee discussed the outcome change in haemoglobin and agreed that it was only relevant to capture this information in people who had low baseline haemoglobin levels (people with anaemia) as increasing haemoglobin levels in these people was likely to have a beneficial clinical effect. Conversely in people with normal haemoglobin levels, increasing this was less likely to have a clinical effect. The incidence of anaphylaxis/hypersensitivity was not reported in any of the included trials. Quality of the clinical evidence Four studies were identified that included an IV iron arm versus placebo; 2 small trials and 2 larger multi-centre trials. One of these studies also included an oral iron arm in addition to a further single study which looked at just oral iron versus placebo. IV iron versus placebo: For mortality, the evidence was rated very low quality due to risk of bias and imprecision. In addition to this the evidence for all-cause hospitalisation was graded as low quality for the same reasons. However, the committee noted that the confidence intervals around the absolute effect were reasonably narrow for this outcome, suggesting that the committee could have greater confidence in the result. Another study reported heart failure related hospitalisations (rather than all-cause); this outcome was downgraded for indirectness as the outcome may not have captured all of the potential hospitalisations relating to the intervention. The committee noted that quality of life measures reported by the studies, both general (EQ5D and EQ5D-VAS) and disease-specific scales (KCCQ and MLWHFQ), ranged from high quality to low quality. One study did not report quality of life, but reported change in NYHA class. This outcome was downgraded for indirectness as the committee agreed that the outcome would give some idea of overall improvement in the severity of HF symptoms. 