| 153 6 involved. Interviewers had a diverse range of backgrounds and experiences, all had prior experience in conducting qualitative research. The appendix provides extensive interviewer characteristics. Analysis Ethical regulations prohibited the sharing of raw data across countries. The Netherlands collected summaries of each country’s demographic data and led the development of an analysis protocol that allowed for open coding on a country level to elucidate experiences with the diagnostic process and post-diagnostic support within each country’s context and identify barriers and facilitators (41, 42). Seventeen researchers coded national data (Word, NVivo, Atlas.ti). MH and IL carried out a multi-step qualitative cross-country analysis using an inductive qualitative content analysis following the approach by Kerpershoek and Wolfs (31) in Atlas.ti (Mac Version 22). Figure 1 represents the analytical steps. Each country was involved in coding national data, discussing preliminary cross-country themes and finalizing the results. If the preliminary analysis did not accurately reflect local data or context, countries could perform an additional data check in which researchers who had access to the raw data compared the cross-country themes against their local data and checked whether each cross-country theme and subtheme could be identified. Within each theme, cross-country similarities and differences were evaluated. Findings were checked by researchers in each country and not checked by participants. If something is not observed in a specific country it doesn’t necessarily mean that this issue is not relevant to that country, rather it means that it was not identified within the analysis.
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