Advanced Heart Failure PSP Question Verification form

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Published: 29 April 2020

Version: 1

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The purpose of this Question Verification Form is to enable Priority Setting Partnerships (PSPs) to describe clearly how they checked that their questions were unanswered, before starting the interim prioritisation stage of the process.

The JLA requires PSPs to be transparent and accountable in defining their own scope and evidence checking process. This will enable researchers and other stakeholders to understand how individual PSPs decided that their questions were unanswered, and any limitations of their evidence checking. 

Name of the PSP

Advanced Heart Failure

Please describe the scope of the PSP

Heart failure is a clinical syndrome where the heart is unable to pump sufficient blood around the body leading to symptoms of breathlessness, ankle swelling and fatigue. We want to find out what research is needed for people with ‘advanced’ heart failure. There is no universally agreed definition of ‘advanced’ amongst professional groups. For example, specialist cardiologists may recognise ‘advanced’ as patients requiring tertiary referral for consideration of devices or transplantation whilst generalists, such as geriatricians or GPs, may consider ‘advanced’ heart failure in those patients with significant and progressive symptoms also in the context of frailty, multimorbidity and polypharmacy.

Our agreed definition is a person with a known diagnosis of heart failure who has symptoms, such as breathlessness, which impact on what they are able to do, require them to take multiple medications and may have required admission to hospital but are not currently an inpatient.

Please provide a brief overview of your approach to checking whether the questions were unanswered

The evidence was checked in two ways:

  1. Running an advanced search strategy in Medline (via Ovid) for systematic reviews of advanced heart failure with no time limit. This produced 609 hits in October 2019.
  2. Cross-referencing indicative questions with the newly published NICE guidance on chronic heart failure: diagnosis and management (published September 2018). Co-PI Clare Taylor was part of the guideline development team.

Please list the type(s) of evidence you used to verify your questions as unanswered

• Systematic review evidence
• NICE guidance evidence summaries & recommendations

Please list the sources that you searched in order to identify that evidence

• Medline database
• NICE guidance full document

What search terms did you use?

For Medline we used:
Database: Ovid MEDLINE(R) <1946 to present>
Search Strategy:
--------------------------------------------------------------------------------
1 *Health Services for the Aged/ (13552)
2 *Ambulatory Care/ (18671)
3 *Day Care, Medical/ (3287)
4 *Home Health Nursing/ (151)
5 *Intermediate Care Facilities/ (496)
6 intermediate care.mp. (1768)
7 (reablement or re-ablement).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] (63)
8 hospital care at home.mp. (16)
9 (hospital at home or hospital-at-home).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] (363)
10 home hospital.mp. (191)
11 medical day hospital care.mp. (3)
12 day hospital.mp. (3063)
13 domiciliary care.mp. (287)
14 intermediate services.mp. (12)
15 hospital in home.mp. (10)
16 hospital in the home.mp. (148)
17 medical home care.mp. (49)
18 day unit.mp. (211)
19 day centre.mp. (214)
20 substitutive care.mp. (3)
21 (home-based versus hospital-based or home based versus hospital based).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] (13)
22 home hospitalisation.mp. (29)
23 (rapid response team or rapid response nurse).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] (865)
24 Continuing health care team.mp. (0)
25 discharge coordinator.mp. (22)
26 discharge planning.mp. or Patient Discharge/ (26840)
27 rehabilitation/ (18025)
28 "Continuity of Patient Care"/ (17792)
29 (care plan or care package or care provision).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] (7530)
30 Case Management/ (9899)
31 Patient Care Planning/ (38011)
32 integrated care.mp. (3315)
33 Primary Health Care/ (69336)
34 Family Practice/ (65354)
35 Heart Failure/ (110382)
36 advanced heart failure.mp. (2620)
37 review/ (2431871)
38 review.ti,ab. (1324229)
39 (systematic or narrative or literature or evidence or integrative or meta-analysis or meta-synthesis or qualitative synthesis or thematic synthesis or mixed method).mp. or realist.ti,ab. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms] (2440533)
40 or/1-34 (275182)
41 or/35-36 (111122)
42 or/37-39 (4577022)
43 40 and 41 and 42 (690)

Please describe the parameters of the search (eg time limits, excluded sources, country/language) and the rationale for any limitations

We did not limit Medline search by time or language, however we did not extend search to individual study level due to practical time restraints

We only searched NICE guidance (England & Wales) and did not extend it wider to European or American guidance. Overall it was not considered appropriate as it was apparent that the scopes of indicative questions were not based around clinical management but more person-centred.

Names of individuals who undertook the evidence checking

Alyson Huntley – Experienced information specialist and reviewer with previous experience of searching the heart failure literature. Alyson was assisted by Anna King who also has experience of heart failure reviews.

On what date was the question verification process completed?

November 2018

Any other relevant information

None