Recent Cochrane reviews on spinal manipulative therapy (SMT) have shown that most randomized controlled trials (RCTs) lack an adequate description of the intervention. In this project entitled "Consensus on Interventions Reporting Criteria List Spinal Manipulative Therapy" (CIRCLe SMT) we want to establish a minimum set of criteria for the description of SMT in RCTs. The adequacy of reporting RCTs is necessary for accurate and critical assessment of the validity and generalizability of the results. The CONSORT statement includes recommendations on reporting of RCTs, but lacks specific recommendations on the description of the intervention. The latter is important as well in reporting and should be such that the intervention can be reproduced. This will allow studies in the future to be better compared with one another and results of studies to be better implemented in clinical practice.


The aim of this study is to identify which features of SMT should be considered in the description of this intervention.

Desired outcomes

A viable list of features to be include in the description of SMT in RCTs.

Delphi procedure

This will consist of the first two rounds (or three if necessary) of a modified-Delphi survey. Prior to distributing the list, the literature will be searched for features of SMT and their definitions, which will be used in constructing the initial list. Potential participants will be contacted and e-mailed and will be asked to determine whether each feature should be included. Answers will consist of "yes" or "no" and those scoring >70% will be considered consensus. The possibility to provide comments will be offered for each step. The second round will present participants with an overview of the first round results and then provide the adapted list for further evaluation. We anticipate that two rounds and possibly a third will be necessary to reach consensus.


A workshop will be held during the 'Odense International Forum XII' on back pain research in primary care 16-19 October 2012. The workshop will aim at consensus among a panel of international experts and be used to stimulate discussion regarding the features to be included in the description of SMT. At the workshop the final round of the Delphi process will be performed.