LOWa due to risk of bias The mean SF-mental in the control groups was The mean SF-mental in the intervention groups was 0.1 lower (worse) (3.5 lower to 3.5 higher) Prescribed double therapy of ACE-I/ARB and B- blocker LOWa due to risk of bias (from 115 fewer to 144 more) Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: (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 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs. Table 125: Clinical Evidence Summary: Martensson 2005: Non-specialist case management (MDTcm) vs Primary care (1 control) > 6 months for high risk HF Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with primary care Risk difference with MDTcm (95% CI) VERY LOWa, b due to risk of bias, imprecision (from 3 fewer to 418 more) Prescribed ACE-I at target dose 130 VERY LOWa, b due to risk of bias, imprecision 574 ACE-I per 92 fewer ACE-I per 1000 (from 224 fewer to 97 more) Prescribed beta-blocker at target dose 130 VERY LOWa, b due to risk of bias, imprecision 235 B-blocker per 9 fewer B-blocker per 1000 (from 115 fewer to 188 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. 