| Outcomes | No of Participants (studies) Follow up | Quality of the evidence (GRADE) | Relative effect (95% CI) | Anticipated absolute effects | |
|---|---|---|---|---|---|
| Risk with Control | Risk difference with Attendance at a post discharge early follow up clinic versus no post discharge early follow up clinic (95% CI) | ||||
| Mortality (heart failure patients) |
1316 (8 studies) 3-12 months |
⊕⊕⊝⊝ due to risk of bias, indirectness | RR 0.53 (0.4 to 0.7) | Moderate | |
| 180 per 1000 |
85 fewer per 1000 (from 54 fewer to 108 fewer) | ||||
| Mortality (general medical patients) |
1896 (1 study) 12 months |
⊕⊕⊕⊝ MODERATEb due to indirectness | RR 0.97 (0.84 to 1.13) | Moderate | |
| 265 per 1000 |
8 fewer per 1000 (from 42 fewer to 34 more) | ||||
| Avoidable adverse events urgent transplantations |
234 (1 study) 12 months |
⊕⊝⊝⊝ due to risk of bias, indirectness, imprecision | OR 8.08 (0.16 to 408.63) | Moderate | |
| 0 per 1000 | Not calculable | ||||
| ED attendance number of ED visits |
1823 (1 study) 12 months |
⊕⊕⊝⊝ due to risk of bias, indirectness | RR 1.02 (0.96 to 1.08) | Moderate | |
| 706 per 1000 |
14 more per 1000 (from 28 fewer to 56 more) | ||||
| Quality of life Minnesota Living With Heart Failure Questionnaire |
98 (1 study) 3 months |
⊕⊝⊝⊝ due to risk of bias, indirectness, imprecision |
The mean quality of life in the intervention groups was 11 lower (19.39 to 2.61 lower) | ||
| Quality of life time trade-off |
234 (1 study) 12 months |
⊕⊝⊝⊝ due to risk of bias, indirectness, imprecision |
The mean quality of life in the intervention groups was 0.09 higher (0.04 to 0.14 higher) | ||
| Readmission number of patients readmitted (heart failure patients readmitted for any cause) |
340 (2 studies) |
⊕⊕⊝⊝ due to risk of bias, indirectness | RR 0.38 (0.2 to 0.73) | Moderate | |
| 370 per 1000 |
229 fewer per 1000 (from 100 fewer to 296 fewer) | ||||
| Readmission number of patients readmitted (general medical patients) |
1800 (1 study) 12 months |
⊕⊕⊕⊝ MODERATEb due to indirectness | RR 1.01 (0.94 to 1.1) | Moderate | |
| 584 per 1000 |
6 more per 1000 (from 35 fewer to 58 more) | ||||
| Readmission due to heart failure number of patients readmitted due to heart failure |
870 (5 studies) 3-12 months |
⊕⊝⊝⊝ due to risk of bias, inconsistency, indirectness, imprecision | RR 0.7 (0.47 to 1.05) | Moderate | |
| 255 per 1000 |
76 fewer per 1000 (from 135 fewer to 13 more) | ||||
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.
Downgraded by 1 or 2 increments because the majority of the evidence was based on indirect comparisons.
Downgraded by 1 increment if the confidence interval crossed 1 MID or by 2 increments if the confidence interval crossed both MIDs.
Downgraded by 1 or 2 increments because Heterogeneity, I2=50%, p=0.04, unexplained by subgroup analysis.
From: Chapter 37, Post-discharge early follow-up clinics
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