Where there was little or no overlap between at least some of the confidence intervals and the values reported by the individual studies varied across 2 areas (for example, 50 70% and 70 100%) the Advanced heart failure and palliative care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: evidence was downgraded by 1 increment, if the individual studies varied across 3 areas (for example, 0 50%, 50 70% and 70 100%) the evidence was downgraded by 2 increments. Where there was a significant degree of overlap in the confidence intervals little weight was placed on the variability of the point estimates above and below the 50% and 70% thresholds. (c) Indirectness was assessed using the PROBAST checklist items relating to applicability. (d) Imprecision was assessed according to the range of point estimates of the primary measure. The evidence was downgraded by 1 increment when there was more than 20% range of the confidence interval around the point estimate and downgraded by 2 increments when there was a range of more than 40%. Imprecision was not estimable where studies did not report confidence intervals. 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 10.4.5 Economic evidence Published literature No relevant health economic studies were identified. See also the health economic study selection flow chart in appendix D. 10.4.6 Evidence statements Clinical Evidence for 7 prognostic risk tools predicting mortality at 1 year were identified from 14 publications. The quality of the included evidence ranged from high to very low. 