What limitations did the committee consider when choosing the diagnostic accuracy study for the base case analysis?
The committee was concerned about the low proportion of HF-REF in the study, as they would have expected the proportion of HF-REF patients presenting to primary care to be higher. The diagnostic accuracy study by Verdu et al. 2012 was not considered to be appropriate for the base case analysis as it was a Spanish study and not considered to be representative of current UK practice, and therefore generalisable to a UK population. The committee discussed that Zaphiriou was a UK study, however was conducted over ten years ago and again is unlikely to represent the current UK population presenting to primary care. Additionally, the criteria for diagnosing HF-PEF patients on echocardiography were not specifically defined as they are today.