Quality assessment of qualitative reviews is a subjective judgement by the reviewer based on the concerns that have been noted. A detailed explanation of how such a judgement had been made was included in the narrative summary. Table 7: Overall level of confidence for a review finding in GRADE-CERQual Level Description High confidence It is highly likely that the review finding is a reasonable representation of the phenomenon of interest. Moderate It is likely that the review finding is a reasonable representation of the phenomenon of Chronic Heart Failure Methods NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Level Description confidence interest. Low confidence It is possible that the review finding is a reasonable representation of the phenomenon of interest. Very low confidence It is not clear whether the review finding is a reasonable representation of the phenomenon of interest. 4.3.5 Publication bias Funnel plots were constructed using RevMan5(RevMan5283 software to assess against potential publication bias for outcomes containing more than 5 studies in intervention reviews (appendix F). This was taken into consideration when assessing the quality of the evidence. 4.3.6 Assessing clinical importance The committee assessed the evidence by outcome in order to determine if there was, or potentially was, a clinically important benefit, a clinically important harm or no clinically important difference between interventions. To facilitate this, binary outcomes were converted into absolute risk differences (ARDs) using GRADEpro138 software: the median control group risk across studies was used to calculate the ARD and its 95% CI from the pooled risk ratio. The assessment of clinical benefit, harm, or no benefit or harm was based on the point estimate of absolute effect for intervention studies, which was standardised across the reviews. 