Appendix 4: AMSTAR2 grading of systematic reviews and meta-analyses
The quality of systematic reviews and meta-analyses used in the formulation of recommendations was assessed using AMSTAR2 (https://amstar.ca/Amstar-2.php).
| Section | Reference | Type of study | AMSTAR2 grading | Reference |
| 3. Fracture risk assessment and case finding | Bai et al 2020 | MA | Low | 59 |
| Gausden et al 2017 | SR | Medium | 101 | |
| Johannesdottir et al 2018 | SR | Low | 41 | |
| Kanis et al 2016 | SR | Medium | 78 | |
| Marshall et al 1996 | MA | Critically Low | 28 | |
| Merlijn et al 2019 | SR & MA | Critically Low | 108 | |
| Mortensen et al 2020 | SR & MA | Medium | 65 | |
| Singh-Ospina et al 2017 | SR & MA | Low | 72 | |
| Vilaca et al 2020 | SR & MA | Low | 58 | |
| Zhang et al 2020 | SR & MA | Low | 110 | |
| 4. Intervention thresholds and management strategy | Kanis et al 2016 | SR | Medium | 110 |
| 5. Non-pharmacological management of osteoporosis | Babatunde et al 2020 | SR & MA | Medium | 161 |
| El-Khoury et al 2013 | SR & MA | Medium | 167 | |
| Darling et al 2019 | SR & MA | Medium | 145 | |
| Fabiani et al 2019 | SR & MA | Medium | 142 | |
| Gillespie et al 2012 | SR & MA | High | 171 | |
| Groenendijk et al 2019 | SR & MA | Medium | 144 | |
| Iguacel et al 2018 | SR & MA | High | 147 | |
| Howe et al 2011 | SR & MA | High | 159 | |
| Jepsen et al 2017 | SR & MA | Medium | 172 | |
| Kahwati et al 2018 | SR & MA | Medium | 156 | |
| Kelley et al 2000 | SR & MA | Medium | 162 | |
| Kemmler et al 2020 | SR & MA | Low | 160 | |
| Kunutsor et al 2018 | SR & MA | Medium | 164 | |
| Min et al 2017 | SR & MA | Low | 175 | |
| Shen et al 2015 | SR & MA | Medium | 174 | |
| Sherrington et al 2017 | SR & MA | Low | 170 | |
| Sherrington et al 2019 | SR & MA | High | 168 | |
| Yao et al 2019 | SR & MA | Medium | 152 | |
| Zhao et al 2019 | SR & MA | Low | 169 | |
| 6. Pharmacological treatment options | Diez-Perez et al 2019 | SR & MA | Medium | 229 |
| Gartlehner et al 2017 | SR & MA | Medium | 216 | |
| Nayak et al 2017 | SR & MA | Low | 314 | |
| Poon et al 2018 | SR & MA | Low | 274 | |
| Simpson et al 2020 | SR & MA | Medium | 230 | |
| Zeng et al 2019 | SR & MA | Medium | 315 | |
| 7. Strategies for management of osteoporosis and fracture risk | Deng et al 2020 | SR & MA | Low | 267 |
| Dennison et al 2019 | SR | Medium | 205 | |
| Gedmintas et al 2013 | SR & MA | Medium | 260 | |
| Khan et al 2015 | SR | Medium | 253 | |
| Miyashita et al 2020 | SR & MA | Low | 279 | |
| Nayak et al 2019 | SR & MA | High | 242 | |
| Tsourdi et al 2020 | SR | Medium | 203 | |
| Wang et al 2018 | SR & MA | Critically Low | 316 | |
| Yanbeiy et al 2019 | SR & MA | Low | 317 | |
| 8. Management of symptomatic osteoporotic vertebral fractures | Al-Sari et al 2016 | SR & MA | Low | 14 |
| British Geriatric Society 2013 | SR | Medium | 282 | |
| Buchbinder et al 2018 | SR & MA | High | 290 | |
| Ebeling et al 2019 | SR & MA | Critically Low | 287 | |
| Gibbs et al 2019 | SR | Medium | 286 | |
| Hofler et al 2020 | SR | Low | 289 | |
| Knopp-Sihota et al 2012 | SR & MA | Medium | 283 | |
| Svensson et al 2017 | SR | Low | 288 | |
| 9. Models of care for fracture prevention | Ganda et al 2013 | SR & MA | Critically Low | 298 |
| Ganda et al 2019 | SR & MA | Low | 299 | |
| Martin et al 2020 | SR & MA | Medium | 307 | |
| Paskins et al 2020 | SR | Medium | 304 | |
| Wu et al 2018 | SR | Critically Low | 293 | |
| Wu et al 2018 | SR & MA | Low | 300 |