Literature Review: Disability Evaluation

1996 ◽  
Vol 1 (1) ◽  
pp. 4-4
Author(s):  
James B. Talmage

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Third Edition, exclusively used the Range of Motion (ROM) Model to rate motion of the spine. The fourth edition requires the additional use of an inclinometer and also indicates that the Injury Model is the primary method for evaluating the spine; the ROM Model can be used as the differentiator or tie breaker. The ROM and the Injury Models cannot be used interchangeably, and the final rating always should be based on the Injury Model, not the ROM Model. One of the goals of changing the evaluation method is to create a more reproducible rating system. Because the Injury Model uses only objective findings present at the time of examination or found in the record, it is more reproducible. A further difference between the Injury and ROM Models is that in the former the examining physician rates the results of the injury, not the results of the treatment. The AMA Guides also requires that the patient's condition be stable—ie, not likely to change for one year. In the spine, the results of the injury, not the treatment, are rated, and often this can be done within several days of the injury.

2002 ◽  
Vol 7 (4) ◽  
pp. 8-10
Author(s):  
Christopher R. Brigham ◽  
Leon H. Ensalada

Abstract Recurrent radiculopathy is evaluated by a different approach in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, compared to that in the Fourth Edition. The AMA Guides, Fifth Edition, specifies several occasions on which the range-of-motion (ROM), not the Diagnosis-related estimates (DRE) method, is used to rate spinal impairments. For example, the AMA Guides, Fifth Edition, clarifies that ROM is used only for radiculopathy caused by a recurrent injury, including when there is new (recurrent) disk herniation or a recurrent injury in the same spinal region. In the AMA Guides, Fourth Edition, radiculopathy was rated using the Injury Model, which is termed the DRE method in the Fifth Edition. Also, in the Fourth Edition, for the lumbar spine all radiculopathies resulted in the same impairment (10% whole person permanent impairment), based on that edition's philosophy that radiculopathy is not quantifiable and, once present, is permanent. A rating of recurrent radiculopathy suggests the presence of a previous impairment rating and may require apportionment, which is the process of allocating causation among two or more factors that caused or significantly contributed to an injury and resulting impairment. A case example shows the divergent results following evaluation using the Injury Model (Fourth Edition) and the ROM Method (Fifth Edition) and concludes that revisions to the latter for rating permanent impairments of the spine often will lead to different results compared to using the Fourth Edition.


1997 ◽  
Vol 2 (4) ◽  
pp. 1-3
Author(s):  
James B. Talmage

Abstract The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, uses the Injury Model to rate impairment in people who have experienced back injuries. Injured individuals who have not required surgery can be rated using differentiators. Challenges arise when assessing patients whose injuries have been treated surgically before the patient is rated for impairment. This article discusses five of the most common situations: 1) What is the impairment rating for an individual who has had an injury resulting in sciatica and who has been treated surgically, either with chemonucleolysis or with discectomy? 2) What is the impairment rating for an individual who has a back strain and is operated on without reasonable indications? 3) What is the impairment rating of an individual with sciatica and a foot drop (major anterior tibialis weakness) from L5 root damage? 4) What is the rating for an individual who is injured, has true radiculopathy, undergoes a discectomy, and is rated as Category III but later has another injury and, ultimately, a second disc operation? 5) What is the impairment rating for an older individual who was asymptomatic until a minor strain-type injury but subsequently has neurogenic claudication with severe surgical spinal stenosis on MRI/myelography? [Continued in the September/October 1997 The Guides Newsletter]


2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.


2021 ◽  
Vol 13 (11) ◽  
pp. 5982
Author(s):  
Carlos-Alberto Domínguez-Báez ◽  
Ricardo Mendoza-González ◽  
Huizilopoztli Luna-García ◽  
Mario Alberto Rodríguez-Díaz ◽  
Francisco Javier Luna-Rosas ◽  
...  

The objective of this paper was to propose a methodological process for the design of frameworks oriented to infotainment user interfaces. Four stages comprise the proposed process, conceptualization, structuring, documentation, and evaluation; in addition, these stages include activities, tasks, and deliverables to guide a work team during the design of a framework. To determine the stages and their components, an analysis of 42 papers was carried out through a systematic literature review in search of similarities during the design process of frameworks related to user interfaces. The evaluation method by a panel of experts was used to determine the validity of the proposal; the conceptual proposal was provided to a panel of 10 experts for their analysis and later a questionnaire in the form of a Likert scale was used to collect the information on the validation of the proposal. The results of the evaluation indicated that the methodological process is valid to meet the objective of designing a framework oriented to infotainment user interfaces.


2005 ◽  
Vol 11 (5) ◽  
pp. 218-220 ◽  
Author(s):  
Kendall Ho ◽  
Zena Sharman

The Universitas 21 (U21) organization funded a one-year project to examine global e-health. An e-health steering committee surveyed the opinions of e-health researchers at U21 member schools and conducted a literature review. Information about key themes was analysed and the findings were summarized. The steering committee recommended an eight-step strategy to establish a sustainable endeavour in global e-health. This included implementing a dissemination strategy within the U21 organization to engage a progressively larger community of faculty members and others, and translating e-health knowledge into global practice in those areas in which the U21 has special expertise. While the recommendations in the discussion paper are specific to the U21 organization, the e-health steering committee believes they can be generalized and applied to any globally minded educational or research institutions seeking to contribute to e-health.


2021 ◽  
Vol 7 (2) ◽  
pp. 13086-13099
Author(s):  
Mário Jorge Souza Ferreira Filho ◽  
Kimberly Cibelle Ferreira Porfirio ◽  
Gisely Barros Trindade ◽  
Luciene Alemão Silvestre ◽  
Lívia Coutinho Varejão ◽  
...  

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S115-S115
Author(s):  
Ciara Clarke ◽  
Clodagh Rushe ◽  
Fintan Byrne

ObjectiveWe report a case of a 58-year-old gentleman who was hospitalised intermittently for one year due to treatment resistant schizophrenia. Prior to hospitalisation he had been prescribed standard antipsychotics for decades without full resolution of positive psychotic symptoms. During his final admission lasting six months he was guarded, suspicious, irritable, constantly paced the corridor and displayed thought block and paranoid persecutory delusions. He would not enter the assessment room or allow any blood or ECG monitoring, however, he was compliant with oral medication. He was successfully treated with high dose olanzapine (40mg/day) and was discharged to the community. The aim of this study is to bring awareness and add to the body of evidence for the use of high-dose olanzapine in patients with treatment resistant schizophrenia in whom a trial of clozapine is not possible.Case reportThe patient gave written consent for this case report to be written and presented. An extensive literature review was performed and key papers were identified. Discussion focuses on the key areas in the literature.DiscussionThis case demonstrates that high-dose olanzapine can be used effectively as an alternative to clozapine in treatment resistant schizophrenia.ConclusionThis case highlights the need for further evaluation of high-dose olanzapine as an alternative to clozapine in patients with treatment-resistant schizophrenia.


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