This is the protocol for a review and there is no abstract. The objectives are as follows:
The general aim of this review is to provide information that may assist clinicians to make decisions about appropriate management in patients with LBP. More specifically, the objective of this systematic review is to assess the diagnostic performance of clinical characteristics identified by taking a clinical history and conducting a physical examination ("red flags") to screen for spinal malignancy in patients presenting with LBP.
The secondary objective of this review is to assess the influence of sources of heterogeneity on the diagnostic accuracy of "red flags", in particular, the health care setting (e.g. primary or secondary care), the study design (e.g. consecutive series or case-control), the timing of "red flag" assessment, and aspects of study quality as reflected in the assessment of the items of the QUADAS checklist (Appendix 1).