(c) Downgraded by 1 increment if the confidence interval crossed 1 MID or by 2 increments if the confidence interval crossed both MIDs. (d) Unable to calculate as the study reported the result as a mean difference. Chronic Heart Failure Advanced heart failure and palliative care NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 10.2.4 Economic evidence Published literature No relevant health economic studies were identified. See also the health economic study selection flow chart in appendix D. 10.2.5 Evidence statements Clinical One study including 114 people with severe heart failure was identified for inclusion within the review. The evidence compared long term oxygen therapy (prescribed for 15 hours per day) with best medical therapy (consisting of maximally tolerated medical management and target doses of a renin-angiotensin system inhibitor, a beta-adrenoceptor antagonist and an aldosterone antagonist). The evidence from this study was very low quality due to a risk of bias, imprecision due to wide confidence intervals and indirectness of the outcomes due to the long follow up period. The study was terminated early. No clinical effect was observed for the outcomes quality of life, breathlessness and the 6 minute walk test. A clinically important reduction in hospitalisations was observed. No evidence was found for the outcomes patient and carer satisfaction, change in NYHA class and unplanned hospitalisation (number of bed days). Economic No relevant economic evaluations were identified. 10.2.6 Recommendations and link to evidence Recommendations Do not offer long-term home oxygen therapy for advanced heart failure. Be aware that long-term home oxygen therapy may be offered for comorbidities, such as for some people with chronic obstructive pulmonary disease (see section 1.2.5 on oxygen in the NICE guidline on chronic obstructive pulmonary disease in over 16s. 