In a new review published by Qaseem et al in the Annals of Internal Medicine, the American College of Physicians (ACP) assessed current performance measures for osteoporosis. The review authors developed an algorithm to evaluate performance measures for strength and certainty of evidence, performance gaps, feasibility, and applicability—with the goal of assessing whether the measures aligned with clinical quality guidelines. Among the six performance measures relevant to internal medicine physicians, only one of them met the necessary reliability, validity, evidence, and attribution standards. Potential strategies to improve the development of these new measures and reduce the burden of performance measurement on physicians and health-care facilities were also identified. The review authors flagged a critical need to adopt new performance measures that may enhance the screening, diagnosis, and treatment of patients with osteoporosis. In a companion press release on the review from the ACP, the review authors concluded: “These performance measure reviews are important in evidence-based management of osteoporosis in our patients. We must ensure their validity in order to optimize treatment.”