ISBN: Study Applicabilit y Limitations Other comments Costs (c) Effects (QALYs) (c) Incrementa l cost (d) Incrementa l effects (d) Cost- effectiveness (d) Uncertainty 6. Do nothing Lifetime horizon Abbreviations: ICER: incremental cost-effectiveness ratio; MICE: Male, Infarction, Crepitations, Edema; QALY: quality-adjusted life years; RCT: randomised controlled trial (a) Recent UK study from a NHS and PSS perspective. (b) The analysis used diagnostic accuracy data where the level of NT-proBNP was used as a criterion in determining whether or not the patient had heart failure, therefore introducing incorporation bias to the diagnostic accuracy results. The committee were concerned that the hospitalisation rates applied in the model were overestimated compared to current clinical practice. The model does not report the outcomes for those who do not have heart failure and no assumptions have been reported for this population (c) Incremental cost/QALYs compared to do nothing (intervention 6) (d) Incremental cost/QALYs/cost effectiveness ratio compared to next most effect treatment option that is not ruled out by dominance or extended dominance. An option is ruled out by dominance when another option has higher QALYs and lower costs. An option is ruled out by extended dominance when it has a higher ICER than the next, more effective, option and so this option can never be the most cost effective. ICERs reported rounded to the nearest 100. Chronic Heart Failure Diagnosing heart failure 5.1.5.2 Unit costs The unit costs of BNP and NT-proBNP are provided below to aid committee discussion. Test costs were sought from a range of hospital trusts. Three sites provided unit cost information for BNP, and five sites provided unit cost information for NTproBNP. The average of these are reported below. 