title: A checklist to assess the quality of reports on spa therapy and balneotherapy trials was developed using the Delphi consensus method: the SPAC checklist.
abstract: OBJECTIVE
  The purpose of this study was to develop a checklist of items that describes and measures the quality of reports of interventional trials assessing spa therapy.
  
  
  METHODS
  The Delphi consensus method was used to select the number of items in the checklist. A total of eight individuals participated, including an epidemiologist, a clinical research methodologist, clinical researchers, a medical journalist, and a health fitness programmer. Participants ranked on a 9-point Likert scale whether an item should be included in the checklist.
  
  
  RESULTS
  Three rounds of the Delphi method were conducted to achieve consensus. The final checklist contained 19 items, with items related to title, place of implementation (specificity of spa), care provider influence, and additional measures to minimize the potential bias from withdrawals, loss to follow-up, and low treatment adherence.
  
  
  CONCLUSIONS
  This checklist is simple and quick to complete, and should help clinicians and researchers critically appraise the medical and healthcare literature, reviewers assess the quality of reports included in systematic reviews, and researchers plan interventional trials of spa therapy.
authors.affiliation: Faculty of Regional Environment Science, Tokyo University of Agriculture, Japan. h1kamiok@nodai.ac.jp
authors.forename: Hiroharu
authors.initials: H
authors.lastname: Kamioka
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kawamura
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Tsutani
authors.forename: Masaharu
authors.initials: M
authors.lastname: Maeda
authors.forename: Shinya
authors.initials: S
authors.lastname: Hayasaka
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Okuizum
authors.forename: Shinpei
authors.initials: S
authors.lastname: Okada
authors.forename: Takuya
authors.initials: T
authors.lastname: Honda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Iijima
mesh_terms: D001452:Balneology / Q000592:standards*; D035843:Biomedical Research / Q000592:standards; D057189:Checklist / Q000379:methods*; D002986:Clinical Trials as Topic / Q000379:methods / Q000592:standards*; D032921:Consensus; D006282:Health Personnel; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards*
keywords: Balneotherapy; Curative effect; Health enhancement; Interventional trials; Spa therapy