Pathway Clinical necessity – did MSAC identify <Yes, No> element – issues with the clinical evidence in the Assessment previous application that needs requirements addressing? Assessment modelling complexity? <Re-conduct of clinical and economic analysis required, Re-conduct of only economic analysis required > Assessment requirements comments: <Free text> Pathway Assessment report <Submission-based, Contracted> element – Name of HTA group for Assessment <name> mechanism report development or critique APR check-point – after PICO Development stage Segmentation changes occurring from the Triage stage. Associated rationale for change: <Free text> Part Component Result Pathway Clinical necessity – did MSAC identify <Yes, Maybe, No> element – issues with the clinical evidence in the Assessment previous application that needs requirements addressing? Assessment modelling complexity? <Re-conduct of clinical and economic analysis required, Re-conduct of only economic analysis required > Assessment requirements comments: <Free text> Pathway Assessment report <Submission-based, Contracted> element – Name of HTA group for Assessment <name> mechanism report development or critique APR evaluation – after Appraisal stage Final Segmentation assessment after Appraisal stage. Part Component Result Suitability MSAC direction incorporated? <Yes, Maybe, No> Suitability comments: <Free text> Pathway Pathway re-entrance – did MSAC direct a <Yes, Maybe, No> element – new PICO to be developed? PASC PASC intensity <Resubmission re-enters at PASC intensity stage, Resubmission re-enters at ESC stage> PASC intensity comments: <Free text>
Pathway element – Assessment requirements Clinical necessity – did MSAC identify issues with the clinical evidence in the previous application that needs addressing? <Yes, No> Assessment modelling complexity? <Re-conduct of clinical and economic analysis required, Re-conduct of only economic analysis required > Assessment requirements comments: <Free text> Pathway element – mechanism Assessment report <Submission-based, Contracted> Name of HTA group for Assessment report development or critique <name> APR check-point – after PICO Development stage Segmentation changes occurring from the Triage stage. Associated rationale for change: <Free text> Part Component Result Pathway element – Assessment requirements Clinical necessity – did MSAC identify issues with the clinical evidence in the previous application that needs addressing? <Yes, Maybe, No> Assessment modelling complexity? <Re-conduct of clinical and economic analysis required, Re-conduct of only economic analysis required > Assessment requirements comments: <Free text> Pathway element – mechanism Assessment report <Submission-based, Contracted> Name of HTA group for Assessment report development or critique <name> APR evaluation – after Appraisal stage Final Segmentation assessment after Appraisal stage. Part Component Result Suitability MSAC direction incorporated? <Yes, Maybe, No> Suitability comments: <Free text> Pathway element – PASC intensity Pathway re-entrance – did MSAC direct a new PICO to be developed? <Yes, Maybe, No> PASC intensity <Resubmission re-enters at PASC stage, Resubmission re-enters at ESC stage> PASC intensity comments: <Free text>