Comment: The quality of evidence is downgraded by study quality
A Cochrane review «»1 «Williams CM, Henschke N, Maher CG et al. Red flags...»1 included 8 studies with a total of 7378 subjects. Four of the studies were performed in primary care where the prevalence of vertebral fracture ranged from from 0.7% to 4.5%. In the remaining four studies performed in accident and emergency settings the prevalence of vertebral fracture ranged from 6.5% to 11%. Twenty-nine different tests screening for vertebral fracture were identified and their accuracy and usefulness examined: only two of tests featured in more than two studies.
Three red flags in primary care were potentially useful as single tests: significant trauma (LR+ point estimate ranging from 3 to 13), older age (LR+ from 4 to 9), corticosteroid use (LR+ from 4 to 48). The results of combined tests appeared more informative than individual red flags with LR+ estimates generally greater in magnitude and precision.
Date of latest search: 2012-04-22