Table 3 Comparison of recruiter quotes from consultations before and after feedback: tracking the changes in one Center A recruiter, S02

1. Study presentation

 A. Before feedback

S02: Now at the moment we're in a situation where we know they both work, they both help people to lose weight and they both help people to improve their life. We don't know which one of those is the best really. Some people have particular preferences for one operation or the other, but for people that don't have any particular preferences, we're running this trial. So hmm have you got, you know cast iron preferences? (Audio recording of consultation, Center A, surgeon).

 B. After feedback

S02: We're currently doing a study to try and find out if one is better than the other or if they're equivalent, 'cause you know, in the past we've had lots of people choose one, and lots of people choose another, often for no particular reason, and they've both tended to do well. So there's lots of arguments in the community now, I think this one's better and the other guy says I think this one's better, nobody really knows (Audio recording of consultation, Center A, surgeon).

2. Eliciting, exploring and addressing preferences and balancing of information

 A. Before feedback

Patient: I would prefer the gastric bypass.

S02: Okay, what is it that makes you prefer that operation? (Audio recording of consultation, Center A, Surgeon).

Patient: I think once it's done, it's done. You lose the weight quicker to begin with, but I know it equals out... to me that seems more what I want because with the band your to-ing and fro-ing, I've got a 9 year old to look after.

S02: Okay that's fine. I just want to let you know what's available and if you've got a particular preference then that's fine.

 B. After feedback

Patient: I personally think that a bypass would do me...

S02: Right, what is it that makes you think that? (Audio recording of consultation, Center A, Surgeon).

Patient: Well, once the job's done, it's done, there's no turning back unless there's an emergency right, but I think to myself that I just wanna get it done and over with, especially with the haemophilia. I want nothing rubbing or moving inside to create bleeding.

S02: Well, the band should be considered as permanent as well, once it's in, it's in, and it shouldn't rub and cause any bleeding or anything. We wouldn't expect that (laughs lightly), if we would, we wouldn't put it in anyone who had haemophilia.

Patient: Yeah, well the other thing is you're taking injections as well after that, aren't you?

S02: After bypass you'll have to have vitamin B12 injections. With the band you have to have injections into the band, so both of them involve injections.