Mortality and hospitalisation rates were taken from Berger et al. 2010 identified in the clinical review. 34 This economic evaluation suggests that NP monitoring is more effective and less costly and therefore dominates both usual care in the community and the nurse-led MDT. The committee did not put much weight on the results of this study as the relative effect of NP monitoring was taken from only one of 13 studies included in the clinical review and therefore is unlikely to reflect the best estimate of the effect of NP monitoring, and was also not from a UK perspective. This study was assessed as being partially applicable with potentially serious limitations. One UK cost-utility analysis compared usual care in the community and/or usual care through specialist clinical assessment to natriuretic peptide monitoring. The model assessed two population groups: patients with chronic heart failure due to LVSD, and patients with heart failure from any cause, and also presented results stratified by age. This study found that NP monitoring is cost effective for patients with chronic heart failure and LVSD at any age compared to specialist management [ICER: 3,304 per QALY gained]. The probability that NP monitoring is cost effective at the 20,000 threshold was 99%. Similar results were found for patients with CHF and LVSD <75 years old [ICER: 2,871 per QALY gained] with a 98% probability of being cost effective at the 20,000 threshold. NP monitoring was also found to be cost effective in patients with CHF and LVSD 75 years old [ICER: 5,392 per QALY gained], however this is uncertain as there is only a 68% probability that NP monitoring is cost effective at the 20,000 threshold. 