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PRIZE APPLICATION TEMPLATE

Administrative Forms (Part A) Application (Part B)

Version 1.1

12 March 2015

Disclaimer:

This document is aimed at informing potential contestants for the Horizon Prize for better use of antibiotics. It

serves only as an example. The actual web forms and templates, provided in the online submission system

under the Participant Portal, might differ from this example. Applications must be prepared and submitted via

the online submission system.

http://ec.europa.eu/research/participants/portal/desktop/en/opportunities/h2020/topics/14060-hoa-01-2015.html#tab3

PRIZE APPLICATION TEMPLATE

Administrative forms (Part A)

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European Commission - Research - Participants Proposal Submission Forms

Page 1 of 7H2020-Prize-2015.pdf - Ver 1.11 20150310 Last saved 10/03/2015 14:39

Horizon 2020Call:

Topic: Type of action:

Proposal number:

Proposal acronym:

Table of contents

Section Title Action

1 General information

2 Contestants & Contacts

How to fill in the formsThe administrative forms must be filled in for each proposal using the templates available in the submission system. Some data fields in the administrative forms are pre-filled based on the previous steps in the submission wizard.

Wherever in this text the term 'proposal' is used, it shall be understood to refer to an 'application'.

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Page 2 of 7

Proposal ID Acronym

H2020-Prize-2015.pdf - Ver 1.11 20150310 Last saved 10/03/2015 14:39

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1 - General information

Topic Type of action

Call identifier Acronym

Proposal title The title should be no longer than 200 characters (with spaces) and should be understandable to the non-specialist in your field.

Note that for technical reasons, the following characters are not accepted in the Proposal Title and will be removed: < > " &

Abstract

The abstract (summary) should, at a glance, provide the reader with a clear understanding of the content of the application and its relation to the objectives of the contest. It must be short and precise and should not contain confidential information. Please use plain typed text, avoiding formulae and other special characters. The abstract must be written in English. There is a limit of 2000 characters (spaces and line breaks included).

Remaining characters 2000

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Proposal ID Acronym


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Declarations

1) In case of several contestants, the lead contestant declares to have the explicit consent of all contestants on their participation and on the content of this application.

2) The information contained in this proposal is correct and complete.

3) I hereby declare that:

- I have fully read and understood and agree to the official Rules of Contest.

- I am fully eligible and not excluded from participation in accordance with the Rules of Contest.

- All other contestants have confirmed that they are fully eligible and not excluded from participation in accordance with the Rules of Contest.

4) This application complies with ethical principles (including the highest standards of research integrity — as set out, for instance, in the European Code of Conduct for Research Integrity[1] — and including, in particular, avoiding fabrication, falsification, plagiarism or other research misconduct).

According to Article 131 of the Financial Regulation of 25 October 2012 on the financial rules applicable to the general budget of the Union (Official Journal L 298 of 26.10.2012, p. 1) and Article 145 of its Rules of Application (Official Journal L 362, 31.12.2012, p.1) contestants found guilty of misrepresentation may be subject to administrative and financial penalties under certain conditions.

Personal data protection

Your reply to the prize application will involve the recording and processing of personal data (such as your name, address and CV), which will be processed pursuant to Regulation (EC) No 45/2001 on the protection of individuals with regard to the processing of personal data by the Community institutions and bodies and on the free movement of such data. Unless indicated otherwise, your replies to the questions in this form and any personal data requested are required to assess your prize application in accordance with the specifications of the prize contest and will be processed solely for that purpose. Details concerning the processing of your personal data are available on the privacy statement at the page:

http://ec.europa.eu/dataprotectionofficer/privacystatement_publicprocurement_en.pdf

Contestants may lodge a complaint about the processing of their personal data with the European Data Protection Supervisor at any time.

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Proposal ID Acronym


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List of Contestants

# Contestants Name Country

1

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Proposal ID Acronym


Short name

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2 - Administrative data

Lead ContestantPIC Legal name

Short name: Address of the organisation

Town

Postcode

Street

Country

Webpage

Legal Status of your organisation

Research and Innovation legal statuses

Public body .................................................... no Legal person .............................. no

Non-profit ...................................................... no

International organisation .................................. no

International organisation of European interest ...... no

Secondary or Higher education establishment ....... no

Research organisation ..................................... no

Small and Medium-sized Enterprises (SMEs) ........ no

Nace code

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Proposal ID Acronym


Short name

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Person in charge of the proposal

The name and e-mail of contact persons are read-only in the administrative form, only additional details can be edited here. To give access rights and basic contact details of contact persons, please go back to Step 4 of the submission wizard and save the changes.

Town Post code

Street

Website

First name Last name

E-Mail

Position in org. Please indicate the position of the Contact Point above in the organisation.

Department Please indicate the department of the Contact Point above in the organisation

Phone 2 +xxx xxxxxxxxx Fax +xxx xxxxxxxxx

Sex Male FemaleTitle

Same as organisation address

Phone +xxx xxxxxxxxx

Country

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Validation result

Section Description

Show Error

Show Warning

The red 'Show Error' button indicates an error due to a missing or incorrect value in the form. The submission of the proposal will be blocked unless that specific field is corrected! Please complete the identified field.

The yellow 'Show Warning' button indicates a warning due to a missing or incorrect value in the form. The submission of the proposal will not be blocked, the proposal will be submitted with the missing or incorrect value, which may cause problems at a later stage when processing the proposal. Please check and correct the identified field.

The form has not yet been validated, click "Validate Form" to do so!

PRIZE APPLICATION TEMPLATE Application (Part B)

Please follow the structure of this template when preparing your application. It has been designed to ensure that the

important aspects of your work are presented in a way that will enable the experts to make an effective assessment

against the evaluation criteria.

Page limits: The entire part B should not be longer than 70 pages (if your application is positively evaluated,

you might be asked to provide additional documentation in a hearing).

All tables in these sections must be included within this limit. The minimum font size allowed is 11 points. The page

size is A4, and all margins (top, bottom, left, right) should be at least 15 mm (not including any footers or headers).

If you attempt to upload an application longer than the specified limit, you will receive an automatic warning, and will

be advised to shorten and re-upload the application. After submission, any excess pages will be overprinted with a

'watermark', indicating to evaluators that these pages must be disregarded.

Please respect the page limit and do not take it as a target either! It is in your interest to keep your text as concise as

possible, since experts rarely view unnecessarily long applications in a positive light.

[Application Acronym]

COVER PAGE

Title of the application

Acronym of the application

List of contestant(s)

Table of Contents

Contestant No * Contestant organisation name Country 1 (Coordinator)

2 3

…

* Please use the same contestant numbering as that used in the administrative application forms.


1. ABSTRACT

2. INTRODUCTION

Concept and approach

Describe and explain the overall concept underpinning the proposed solution. Describe main ideas, models or assumptions involved. Identify any trans-disciplinary considerations.

3. DETAILED DESCRIPTION OF THE PROPOSED SOLUTION

Describe the proposed solution in detail specifically addressing each of the Award Criteria set out in the Rules of Contest (see also below).

The rapid point of care test may be part of an approach that includes clinical parameters/algorithms but it cannot be limited to such clinical parameters/algorithms.

While the impact of a solution (see criteria below) naturally increases with the target population, solutions that apply only to limited target populations (e.g. children vs. adults) are also eligible.

The prize will be awarded, after closure of the contest, to the application that in the opinion of the jury demonstrates a solution that fulfils at least the minimum requirements and best addresses the following cumulative criteria.

Note that the solution should be both developed by the contestant and be novel.

1. Potential to reduce the use of antibiotics and magnitude of antibiotic use reduction: contestants should include a robust estimation of the antibiotic courses that would be avoided in cases of upper respiratory tract infections as a consequence of the application of this test;

2. Accuracy and safety: contestants should provide a risk/benefit analysis of giving or not giving antibiotics in the case of upper respiratory tract infections based on the result of this test. The test should identify with high accuracy patients with upper respiratory tract infection, who can safely be managed without antibiotics. The accuracy and safety of the solution must be confirmed by an appropriate validation. The validation must have been performed in a clinical research or routine laboratory using a number of patient samples that is justified statistically as providing reasonable validation. The validation report must include details on number of patient samples, number of targets/pathogens/markers


analysed per sample, randomisation strategy, sensitivity and specificity, gold standard used (addressing also the distinction between colonising agents and causative pathogens), time to result under 'real world' conditions and whether (and how many) samples have been analysed in parallel. Gender-specific differences should be taken into account. The validation must demonstrate a sensitivity and specificity that supports the use of the test to reduce the use of antibiotics in a safe way in patients with upper respiratory tract infections. The test should be ready for use at the time of submitting the application: as a minimum, a working device or demonstrator method should exist that is suitable for deployment to test sites (i.e. acceptable to a manufacturer for scale-up for beta-testing and then to market). Applicants may use the "STARD Checklist for the reporting of studies of diagnostic accuracy"1 indicating on which page of the application the STARD checklist items are addressed.

3. Minimal/non-invasive: it is preferred that the sampling requirements are minimal/non-invasive;

4. Low cost and affordable: cost of device, infrastructure requirements for device (water, electricity, waste disposal), cost of consumables, supply chain and storage requirements for consumables. Lower cost for device and consumables, room-temperature supply chain and storage as well as substantial tolerance for temperature excursions will be preferred.

5. Rapid: ideally the total turn-around time of the test should be less than 30 minutes.

6. Easy to use: the test must be useable by healthcare workers at primary care level. Simplicity and limited training requirements are preferred.

1 http://www.stard-statement.org/pdf%20and%20word%20documents/Checklist.PDF

http://www.stard-statement.org/pdf%20and%20word%20documents/Checklist.PDF

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