Key issues | Findings | Changes/recommendations | Aspect of trial changed/recommendation for | Implementation |
---|---|---|---|---|
 |  | Simplified flowchart | PIS and protocol | a Amended and ethical approval obtained |
 | Difficulty in explaining the trial |  |  |  |
 |  | Easy explanation of trial | Recruiter-patient interaction | b Training session |
 | Randomisation period confusion | Opened up randomisation period | Protocol | a Amended and ethical approval obtained |
Aspects of trial design and conduct | Information overload | Two-stage information provision (chemo and post-chemo) | Recruitment and pre-recruitment interactions (also linked to streamlining of pathway) | b Training session b Recruitment appointment tips document |
 | Complex recruitment pathway | Streamlining of recruitment pathway and information provision | Recruitment pathway | b Streamlining recommendations document |
 |  |  | PIS | a Amended and ethical approval obtained |
 | Loaded terminology and unbalanced information | Use of neutral terms and equivalent information on both arms |  |  |
 |  |  | Recruiter-patient interaction | b Training session b Recruitment appointment tips document |
 | Patients' strong treatment preferences | Eliciting and addressing concerns/preferences | Recruiter-patient interaction | b Training session b Recruitment appointment tips document |
Preferences | Patient preferences influenced by recruiter, and number of people in recruitment pathway | Acknowledging and reflecting on own preferences; | Recruiter-patient interaction | b Training session |
 |  | Streamlining and limiting number of people involved in recruitment pathway | Recruitment pathway | b Streamlining recommendations document |