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International achievement rankings frequently appear in the media but commonly focus on total scores without referencing individual items and their corresponding content which may provide insights into differential country performance. Comparisons without analysis of performance related to content may be an invalid indication of general student knowledge resulting in uninformed reform efforts. Analysis of TIMSS item content, which indicated high or low relative performance for U.S. students, reveal important information not indicated by total scores. Specifically, U.S. students tended to outperform the international average on items dealing with visual displays and fractions, and performed poorly on items dealing with geometry and metric measurements. By disaggregating student performance according to content, more valid inferences can be made about U.S. student performance.