Experimental design of the survey (Modified from Nayak et al9).

Research conducted at the time of providing healthcare	Hospitals that integrate research as part of care provision Patients informed that studies are conducted through letters, posters and brochures All studies are reviewed and approved by a REC, which comprises researchers, clinicians, ethicists, patient representatives and community members
High blood pressure	Affects millions of persons in Spain Can lead to stroke, heart attack and/or kidney disease if untreated
Pragmatic RCT scenario	Scenario 1: Drug ‘CTD’ or ‘TRT’? Two health authorities‐approved medicines Both effective in lowering high blood pressure; similar adverse effects Unknown which is more effective		Scenario 2: Dose timing, ‘morning’ or ‘night’? Patients told to take medicine at same time each day Unknown whether morning or night more effective
Trial proposal	Random assignment to CTD or TRT Patient's medicine can be changed at any time by patient or physician		Random assignment of whether told to take medicine at morning or night Patient's medicine can be changed at any time by patient or physician
Debate	REC is debating the best way to get consent for this study
Consent options	Written consent vs. verbal consent	Written consent vs. general notification	Written consent vs. verbal consent	Written consent vs. general notification
Written consent	• Some members argue that patients should give study‐specific written consent
	• Consent form would include purpose, risks and benefits, alternatives, method of maintaining privacy, and contact information; participation would be voluntary
	• Written consent would require extra time and effort
	• In some cases, if written consent is required, studies may not be conducted
Alternative option	General notification
	• Other members argue that because the risks are low, general notification through posters, brochures and letters is enough
	• Eligible patients would be automatically enrolled without being informed
	Verbal consent
	• Other members argue that because the risks are low, verbal consent is enough
	• Patient's physician would briefly explain the study

Shows the 2 × 2 factorial design and information presented to respondents. Half received a drug RCT scenario comparing two first‐line drugs; the others received a dose‐timing RCT scenario comparing morning vs. night dosing. Half of participants in each group chose between written consent and general notification; the rest chose between written consent and verbal consent. CTD, chlorthalidone; RCT, randomized, controlled trial; REC, research ethics committee; TRT = hydrochlorothiazide.