Table 4 Quotes of interview participants that illustrate their experiences and perspectives on the procedures and decision-making process

Disagreement

3A

“I never got the feeling that I couldn’t utter my disagreement or couldn’t comment on it. I found that very constructive of the whole process. It continued, without unnecessary delays leading nowhere. I think that both the personal and the interpretation of the perspectives of others played a role, but also that the process itself was helpful. For me it wasn’t a reason to hold back my comments or to ask questions for clarification.” (S7_p)

3B

“I’m not quite sure how they have dealt with everyone’s feedback, but I had the impression that it worked well.” (S10_c)

Decision-making

3C

“Well, as soon as people work together, and everyone brings in their own knowledge and skills, that causes tensions. Sure. And that is what we need to come to what matters. And we need it to understand how differences play a role in practice and why. We need it to determine a new direction with each other. I mean, you cannot change anything without some tension. Indeed, with consensus nothing will ever change. And we started this to cause change.” (S3_p)

3D

“Well, I think that questions of patients, indeed, should weight more and should be the central focus of that study.” (R141_c)

3E

“Look, you can, you cannot decide these processes by means of a majority, because, you know, then you have to be careful who is selected to be part of such sessions.” (R116_c)

3F

“The other side is that you would have hoped that very unique questions, that nobody had anticipated, would have been part of [the top 10]. And that's not the case now. These questions are, the way I read them, very aggregated questions that resonate with many people.” (R116_c).

Hurdles and enablers for decision making

3G

“Maybe the hierarchy was, you know, there are some people whom people are more responsive to or who can voice their own opinions stronger, who can express themselves well. Then the group follows easily.” (s11_p)

3H

“ Well, if I just consider the patients, then I think it’s been difficult for them to share anything in the phone meetings. That because, how should I say, the barrier is higher than in a face-to-face meeting. Before you bring in anything, you have to be certain that you say something meaningful. And I think the clinicians had less hurdles in such phone meetings.” (S7_p)

3I

“I think that if you ask for reasons why some people wanted to prioritise some of the questions, not in the larger sample, but in the top 10. Then you gain more insight in their worries and reasons and that they can explain what they consider important.” (R3_p)