METHODS

Data sources:

Medline (1966 to August 2004), hand searches of bibliographies of relevant articles including recent osteoporosis guidelines and 4 clinical skills textbooks, and contact with experts in the field.

Study selection and assessment:

studies that included data on the accuracy or precision of the history or physical examination signs for diagnosing osteoporosis, osteopenia, or spinal fracture and that used bone densitometry at any site or documented vertebral fracture as the gold standard. Studies with insufficient data to calculate likelihood ratios were excluded. Study quality was assessed (level 1 [highest] to level 3).

Outcomes:

sensitivity, specificity, and …