Table 2. A4R Condition 2: Publicity .

Feature	What Could Be Recommended for This Feature in General?	What Could Be Recommended for This Feature With Regard to RDs and RTs Specifically?
Transparency of criteria and evidence considered and approaches used to consider them	Should the evidence that was considered and the methods to select and synthesize the evidence be made public? • Yes, always and unconditionally • Yes, should be described adequately and justified meticulously (including all value judgments used in the process of generating and selecting evidence), then made public • Should the criteria and the deliberative approach to consider them be made public? • Yes, deliberations and advice published on the website of the HTA agency Protect individuals according to Chatham House Rule	• Additional attention to justifying the selected endpoints
Understandability of reasoning behind decision	What could be recommended to facilitate making reasons leading to the decision explicit and understandable to stakeholders, including the public? • Keep it simple and understandable. The art of good documentation and communication needs to be more valued and further developed • Communicate honestly about uncertainties and imperfection of decisions • Include a natural language account of the process, the key evidence used and the facts	• Knowledge brokers and health anthropologists can play an important role. Avoid emotion-laden communications, which are counterproductive for legitimizing decisions
Clarity of values underlying the decision	Should values underlying decisions be stated? Should there be a reference to the broader objectives and underlying mandate of the agency/institution/healthcare system? • Yes, generally. Also, the extent to which the intervention contributes to or infringes upon the mandate of the healthcare system and broader societal objectives must become explicit • Clarify the weights of the different criteria in the final decision	• Public health impact is generally low in RDs, we have to address the fact that incidence and prevalence are low

Abbreviations: A4R, accountability for reasonableness; RD, rare disease; RT, regenerative therapy; HTA, health technology assessment.