Literature search and selection
The following databases were searched up to December 22, 2006: Medline, Cinahl, Embase and MANTIS. Searches of the authors' own libraries were also conducted. Finally, citation searches of relevant articles and texts were conducted manually. The following search terms were used:
Diagnosis AND "low back pain"
Diagnosis AND "neck pain"
Diagnosis AND "low back pain" AND palpation
Diagnosis AND "neck pain" AND palpation
Diagnosis AND "low back pain" AND McKenzie
Diagnosis AND "neck pain" AND McKenzie
Diagnosis AND "low back pain" AND neurodynamics
Diagnosis AND "neck pain" AND neurodynamics
Diagnosis AND "low back pain" AND radiculopathy
Diagnosis AND "neck pain" AND radiculopathy
Diagnosis AND "low back pain" AND trigger points
Diagnosis AND "neck pain" AND trigger points
Diagnosis AND "low back pain" AND muscle
Diagnosis AND "neck pain" AND muscle
Diagnosis AND "low back pain" AND instability
Diagnosis AND "neck pain" AND instability
Diagnosis AND "low back pain" AND "motor control"
Diagnosis AND "neck pain" AND "motor control"
Diagnosis AND "low back pain" AND "central sensitization"
Diagnosis AND "low back pain" AND "central pain hypersensitivity"
Diagnosis AND "neck pain" AND "central sensitization"
Diagnosis AND "neck pain" AND "central pain hypersensitivity"
Diagnosis AND "neck pain" AND oculomotor
Diagnosis AND "low back pain" AND fear
Diagnosis AND "neck pain" AND fear
Diagnosis AND "low back pain" AND catastrophizing
Diagnosis AND "neck pain" AND catastrophizing
Diagnosis AND "low back pain" AND coping
Diagnosis AND "neck pain" AND coping
Diagnosis AND "low back pain" AND depression
Diagnosis AND "neck pain" AND depression
Studies were included if they were in English and provided original, statistically analyzed data regarding the reliability and validity of clinic-based diagnostic procedures used for the identification of relevant factors in the causation or perpetuation of spinal pain. Included studies had to contain data on the assessment of patients with cervical or lumbar pain, including headache related to the cervical spine and spine-related upper or lower extremity pain. Non-English language studies were excluded, as were studies that did not present data on reliability and validity. The search focused on diagnostic procedures that are potentially useful in answering the second or third question of diagnosis. Studies that were potentially useful in answering question 1 were not considered for the purpose of this paper. Diagnostic studies that require special equipment not typically found in the clinic (such as MRI) or that require a laboratory (such as blood tests) were excluded because the purpose of the study was to evaluate clinic-based means by which the DBCDR may be applied. It is recognized that imaging or laboratory tests are often useful in the diagnosis of spinal pain, but the presentation of these procedures was beyond the scope of this paper. In cases in which systematic reviews of the literature were found, the individual studies included in the reviews were not reviewed separately, unless this was necessary to clarify information that was not readily apparent from the systematic review.
Each study was reviewed by two authors (DRM and CFN) and deemed relevant or irrelevant. A study was considered relevant if the information contained in the study indicated that it met the above inclusion/exclusion criteria.