basically what determines if an item is updated is we take a md5 of the fields that dont change and compare that to an md5 we have in our database. If the item's md5 is different then its updated. One way to tell if an item needs to be updated still is to run this query:
select id,name,updated from items where updated<'2003-12-19';
Note that this is fairly accurate since the 12-18 patch added a new field to items and changed the classes info.
Also note that by the time you run this query on your own db, someone might have updated the item (ie ME) :P
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