(b) Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both. 9.2.3.2.2 High risk, Long, Case Management Table 120: Clinical Evidence Summary: Berger 2010: Long Case-management (MDTcm) vs Primary +/- secondary care (1/2 control), for >6 months high risk HFREF Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with primary +/- secondary care Risk difference MDTcm (95% CI) Hospitalisations - dichotomous VERY LOWa, b, c due to risk of bias, indirectness, imprecision 75 fewer people admitted per (from 199 fewer to 66 more) LOWa, c due to risk of bias, imprecision (from 43 fewer to 249 fewer) Prescribed ACE-I or ARB 180 MODERATEa due to risk of bias (from 39 fewer to 58 more) Prescribed beta-blocker 186 LOWa, c due to risk of bias, imprecision (from 25 more to 211 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 for indirectness as "count rate" was the protocol outcome for hospitalisation, and this is proportion who were hospitalised at least once. Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: (c) Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs. 9.2.3.2.3 Low risk, Short No studies were identified in these categories. 9.2.3.2.4 Low risk, Mid-length No studies were identified in these categories. 9.2.3.2.5 Low risk, Long, Home-based MDT No studies were identified in this category. 