(c) Cannot be estimated as no events in control arm. (d) Absolute difference calculated by RevMan. Table 110: Clinical evidence summary: Ekman 1998: Mid-length Nurse-led clinic (MDTn) vs Primary care (1 control) 3-6 months for high risk HF Outcomes No of Participants Quality of the evidence Relative effect Anticipated absolute effects Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: (studies) Follow up (GRADE) (95% CI) Risk with primary care Risk difference with MDTn (95% CI) LOWa, b due to risk of bias, imprecision rate ratio 0.92 (from 385 fewer to 265 more) VERY LOWa due to risk of bias, imprecision (from 62 fewer to 250 more) NYHA class change (a proxy for QoL) mean level (I-IV), lower=better. Scale from: 1 to 4. LOWa, c due to risk of bias, indirectness The mean NYHA class change in the control groups was The mean NYHA class change (a proxy for qol) in the intervention groups was 0.10 higher (less improvement) (0.15 lower to 0.35 higher) Prescribed ACE-I 145 LOWa, b due to risk of bias, imprecision (from 69 fewer to 257 more) (a) Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias. (b) Downgraded by one increment as confidence interval cross one MID or downgraded by two increments as confidence interval crosses both MID. (c) Downgraded due to indirectness as a proxy measure of quality of life was reported by the study. 