Foreword

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The American Medical Association's (AMA's) Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2023 (AMA Guides Sixth 2023) updates and reinforces the international standard for the assessment of permanent impairment first published in 2008 in the AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition (AMA Guides Sixth Edition [2008]). The goal of providing physicians and qualified health care professionals with authoritative guidance based on the best available evidence and expert consensus remains unchanged. The AMA Guides Sixth 2023 is delivered via a new, transparent editorial process and a new interactive digital platform—the AMA Guides Digital. Together, the editorial process and the interactive platform will capture and communicate the best available science and medicine.

Since the sixth edition was published in 2008, medicine has evolved, and patient outcomes have changed. In 2018 the AMA convened a forum with over 50 subject matter experts representing medicine, law, and government and received consistent feedback that the AMA Guides needed to be modernized in both content and delivery. As medical science does not evolve uniformly across body systems, use of current science is critical to achieving consistent and fair impairment ratings. In response, the AMA Guides Editorial Panel (Guides Panel) was convened to oversee timely, incremental updates that incorporate the best available science and medicine into the AMA Guides.

The Guides Panel was selected through a rigorous process, which included a broad solicitation of nominations from more than 200 medical organizations across the AMA Federation and additional stakeholders with a stated objective to reflect the communities that the AMA Guides serve. The members and advisors serving on the Guides Panel bring diverse expertise and experiences across a broad range of medical topics. They also leverage their unique individualized expertise and experiences with the AMA Guides and do not advocate on behalf of their specialty or nominating organization.

The Guides Panel periodically publishes editorial priorities indicating the areas in which additional guidance is most needed. Stakeholders are invited to develop and submit change proposals to update the AMA Guides in their particular areas of expertise, regardless of whether that area has been identified as a priority by the Guides Panel. The AMA Guides Sixth Edition (2008) is considered the foundation for proposed updates to the AMA Guides, and future updates to the AMA Guides will build upon the changes that precede them (eg, AMA Guides Sixth 2023 will build on AMA Guides Sixth 2022).

The Guides Panel utilizes a public process and welcomes input from the community at large. Physicians and qualified health care professionals oversee the medical content with input from a diverse group of stakeholders who provide input on implementation considerations. The Guides Panel is committed to establishing transparency while maintaining the AMA Guides by:

  • Hosting open meetings for all public stakeholders to attend.

  • Publishing transparent objective criteria for change proposals.

  • Incorporating new medical diagnoses, validated test instruments, advances, and insights regularly.

  • Focusing on areas in which the community has indicated additional guidance is most needed.

  • Publishing content on a consistent cadence, which recognizes the needs of all stakeholders.p. v

AMA Guides Sixth 2023, AMA Guides Sixth 2022, AMA Guides Sixth 2021, AMA Guides Sixth Edition (2008), and the full archive of the AMA Guides Newsletter will be available on AMA Guides Digital. This new digital platform:

  • Enables timely content updates that reflect the most current Guides Panel decisions.

  • Reduces administrative burden by allowing easy and secure access to materials.

  • Improves the quality and consistency of evaluations.

  • Supports a reasonable transition to the most current medicine.

The AMA is committed to serving patients and physicians by providing information and resources based on the most current, evidence-based medicine. Interested parties are encouraged to reach out to guidesproposals@ama-assn.org to learn how to become involved in the new process to modernize the content and delivery of the AMA Guides®.

Douglas W. Martin, MD, Co-Chair, AMA Guides Editorial Panel (2023)

J. Mark Melhorn, MD, Co-Chair, AMA Guides Editorial Panel (2023)

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