Chapter 1: Conceptual Foundations and Philosophy

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Summary of Updates to AMA Guides Sixth Edition 2022

  • Language describing the new evidence-based editorial process explains why the latest edition of the AMA Guides is rooted in science and best evidence.
  • Encourages documenting evidence and the standard used to determine the impairment rating in reports.
  • No changes to impairment ratings or methodology.

Chapter 1: Conceptual Foundations and Philosophy

  • Section 1.1 History of the AMA Guides
    • Description of changes: Insertion of paragraph to describe the evolution of the sixth edition of the AMA Guides, including the new evidence-based editorial process and panel.
  • Section 1.2a Previous Criticisms of the AMA Guides
    • Insertion: “New editions of the AMA Guides were unable to be published quickly enough to reflect emergent improvements in science and evidence-based medicine.”
  • Section 1.3b Applications of ICF Model to the AMA Guides, International Appeal and Applications
    • Insertion: “The concept of impairment evaluation as it relates to the ICF model continues to evolve. Incorporation of the biopsychosocial model of health will provide a platform for further research and exploration of these concepts into the future.”
  • Section 1.6 The Case for Simplification and Ease of Application
    • New Section title: Evidence Requirements
    • Description of changes: details the evidence requirements for updating the sixth edition.
  • Section 1.8e History of Clinical Presentation
    • Removed: “…those with minimal or intermittent moderate symptoms, in impairment class 1; and those with constant symptoms that persist despite treatment, in impairment class 4.”
    • Inserted: “...those with mild symptoms will be in class 1; and those with very severe constant symptoms that persist despite treatment will be in impairment class 4.”
  • 1.8g Objective Test Results
    • Insertion: “Each chapter will delineate the key factor of the impairment class within a given grid.”
    • Insertion: “Typically, a combination of the key factor and non-key factors will be used to determine a place within a class and grade, and the key factor may vary within chapters or between chapters.”
  • 1.9 AMA Guides Editorial Process and Digital Delivery (New Section)
    • Description of changes: additional information about the mission and goals of the AMA Guides Editorial Panel and the importance of using the most current evidence-based medicine to complete impairment ratings.
    • Sixth edition methodology will serve as the foundation for all changes to the AMA Guides moving forward.
    • Figure 1.3, AMA Guides Editorial Process is also provided.
  • Minor editorial updates throughout the chapter have been made to improve readability and for clarity.
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