Pilot Data and Feasibility: Our pilot study (AJR, 2004) found institutional true-positive reporting rates for vertebral fractures were 60%, with 100% specificity, compared with reference standard. A 1-year feasibility study of a random sample of ~5000 radiographs was then undertaken (Arch Intern Med, 2005). Based on these data, we expect to enroll 3-4 patients/week, complete recruitment in ~20 months, ascertain outcomes by 30 months, and finish the study in 3 years. The research team has generated pilot data, systematically reviewed pertinent literature, recruited opinion leaders to create guidelines, trained research staff, refined methods for outcomes ascertainment; and conducted related studies of wrist (Annals Intern Med, 2004) and hip fractures.