ISBN: 978-1-4731-3093-7 Systematic reviews of RCTs 5.5.3 Clinical evidence No relevant clinical studies comparing the effectiveness of different cardiac MRI (cMRI) imaging modalities with echocardiography (echo) were identified. 5.5.4 Economic evidence Published literature No relevant health economic studies were identified. See also the health economic study selection flow chart in Appendix D. Unit Costs Table 27: Unit costs of cardiac MRI Description Unit cost Source Cardiac Magnetic Resonance Imaging Scan 264(a) NHS Reference costs 2014/15242 Simple Echocardiogram 84 NHS Reference costs 2014/15242 (a) Weighted average of RD08Z, RD09Z, RD10Z. 5.5.5 Evidence statements Clinical No clinical evidence was identified. Economic No relevant economic evaluations were identified. 5.5.6 Recommendations and link to evidence Recommendations No recommendation Research recommendations What is the optimal imaging technique for the diagnosis of heart failure? Relative values of different outcomes The committee considered the following outcomes to be critical for this review: all-cause mortality, quality of life, and all-cause hospitalisation. Data on all-cause mortality and hospitalisation were considered preferable to data limited to heart-failure related mortality and hospitalisations, primarily for consistency of methodology across the guideline, but also to take into account the potential adverse events associated with cardiac MRI or echocardiography. Adverse events related to the use of gadolinium in cardiac MRI specifically non-specific fibrosis in the presence of renal dysfunction were considered Chronic Heart Failure Diagnosing heart failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 to be important for decision-making. Given the nature of the review, namely to establish whether there was any benefit in using an additional diagnostic test, the committee also specified the following process outcomes as important for decision making: reclassification of specific heart failure aetiology, change in management, change in heart failure medication, advanced therapy use, and the need for repeat or additional testing. 