American ; seconds ; Ophthalmologist

The American Medical Association's Guides to the Evaluation of Permanent Impairment (Guides) has provided an useful guideline in interpreting information on permanent impairment based on the in-depth knowledge and experience in impairment ratings accumulated for a long period of time. Since its first publication by American Medical Association (1958), as A Guide to the Evaluation of Permanent Impairment of the Extremities and Back', 12 additional guides' has been published by the JAMA over the next 12 years. All the guides were consolidated to become the first official edition of the Guides' in 1971. The 'Guides' has been updated periodically to reflect current scientific clinical knowledge and judgment methods. It has become the best system available to evaluate permanent impairments across many disciplines. The latest sixth edition created a "paradigm shift" in the area of the impairment assessment by introducing a contemporary model of disablement. The standardized methods elaborated in the sixth edition clearly enhances the relevancy of impairment ratings, improves internal consistency of the methods and renders the application of the rating process easier. It adopts the terminology and conceptual framework from the International Classification of Functioning, Disability and Health in order to generate five impairment classes. A diagnosis-based grid has been developed for each organ system. Functional history, physical findings and objective clinical test results are integrated to determine the grade within the impairment class. The Guides' is the most widely used source for assessing and rating permanent impairments in the United States and can be considered as the best available method for the assessment of permanent impairment.
American Medical Association ; Disability Evaluation ; Extremities ; Judgment ; Publications ; United States

BACKGROUND: Complex regional pain syndrome (CRPS) is not regarded as an impairment in Korea. Guidelines for rating this impairment are under development by the Korean Academy of Medical Science based on that of the American Medical Association (AMA). However, no studies have been done on the validity of these guidelines in Korea. We therefore evaluated the validity of these guidelines using the criteria from the chapter on the central and peripheral nervous system (CNS-PNS class) and the worksheet for calculating total pain-related impairment score (TPRIS class). METHODS: TPRIS and CNS-PNS classes were calculated through interviews of 28 CRPS patients. The correlation between the two classes was calculated. RESULTS: TPRIS class and CNS-PNS class were well correlated (r = 0.593, P < 0.05). CONCLUSIONS: Both TPRIS or CNS-PNS classes were well correlated and could be used for evaluation of impairment. However, the CNS-PNS class is simpler and quicker to complete.
American Medical Association* ; Humans ; Korea ; Peripheral Nervous System

In 1992 the Korean Medical Association intended to make revised evaluation and rate of physical impairment based upon rate and evaluation of physical impairment according to National Compensation Law which was composed of 14 subdivisions with various rates of physical impairment. Committee of Evaluation of Physical Impairment in Korean Neurosurgical Society provided revised evaluation of nervous or mental impairment, peripheral never impairment and spinal column impairment. Because McBride Disability Evaluation and Guide to the Evaluation of Permanent Impairment by American Medical Association have been used widely in this field the author describe evaluation and rate of physical impairment in each method briefly and compare to revised evaluation by Korean Medical Association in subject of neurologic and spinal impairment.
American Medical Association* ; Compensation and Redress ; Disability Evaluation ; Jurisprudence ; Spine

PURPOSE: Since the medical insurance system was started in Korea, there has been an imbalance in the medical charges among the procedural items of special departments. For correcting this problem, the Resource-based Relative Value Scale (RBRVS) was introduced to determine the relative values of physician services and practices. The RBRVS is the prevailing model used today to describe, quantify and reimburse physicians for their services. In this study we attempted to clarify the relative values of the practice characteristics in vascular surgery and evaluate the propriety compared with the relative value unit (RVU) of the American Medical Association (AMA). METHOD: The classification of practice characteristics in vascular surgery was compared with that of the AMA. The propriety of physicians' work was measured according to the Korean and American physicians' work. The rate more than 70, between 50 to 69, and less than 49 were used to decide over-, proper- or under-estimation, respectively. RESULT: The ratio of the number of practice characteristics in Korean and American vascular surgery was 1:3.31 (97:321). The over-, proper- or under-estimated physicians' work among the identical American practice characteristics was 8/46 (17.4%), 19/46 (41.3%) and 19/46 (41.3%) respectively. CONCLUSION: Our results demonstrated that the practice characteristics of Korean vascular surgery are not sorted by detail and a large percentage of physicians' work (41.3%) is under-estimated. Therefore, reasonable payment for physician services or practices can not be determined for Korean vascular surgery.
American Medical Association ; Fees and Charges ; Insurance ; Korea ; Relative Value Scales

Several authors suggested that the clinical characteristics of incomplete presentation of Kawasaki disease are similar to those of complete presentation and that the 2 forms of presentation are not separate entities. Based on this suggestion, a diagnosis of incomplete Kawasaki disease in analogy to the findings of complete presentation is reasonable. Currently, the diagnosis of incomplete Kawasaki disease might be made in cases with fewer classical diagnostic criteria and with several compatible clinical, laboratory or echocardiographic findings on the exclusion of other febrile illness. Definition of incomplete presentation in which coronary artery abnormalities are included as a necessary condition, is restrictive and specific. The validity of the diagnostic criteria of incomplete presentation by the American Heart Association should be thoroughly tested in the immediate future.
American Heart Association ; Coronary Vessels ; Mucocutaneous Lymph Node Syndrome

Several authors suggested that the clinical characteristics of incomplete presentation of Kawasaki disease are similar to those of complete presentation and that the 2 forms of presentation are not separate entities. Based on this suggestion, a diagnosis of incomplete Kawasaki disease in analogy to the findings of complete presentation is reasonable. Currently, the diagnosis of incomplete Kawasaki disease might be made in cases with fewer classical diagnostic criteria and with several compatible clinical, laboratory or echocardiographic findings on the exclusion of other febrile illness. Definition of incomplete presentation in which coronary artery abnormalities are included as a necessary condition, is restrictive and specific. The validity of the diagnostic criteria of incomplete presentation by the American Heart Association should be thoroughly tested in the immediate future.
American Heart Association ; Coronary Vessels ; Mucocutaneous Lymph Node Syndrome

PURPOSE: To minimize an interruption in chest compression, reduce the hands-off time, the American Heart Association has recommended changing the ratio of chest compression to ventilation ratio to 30:2. However, current studies have shown that the hands-off time was >10 seconds with that method. For this reason, we reasoned that a chest compression to ventilation ratio of 15:1 would be a more suitable way to reduce hands-off time because this ratio will not change the total compression and ventilation count. METHODS: The subjects were asked to perform CPR for 5 cycles with a compression to ventilation ratio of 30:2. The subjects rested for 5 minutes, then performed CPR with a compression to ventilation of 15:1. The skill performance was measured and analyzed using a statistical program. RESULTS: In the group which performed CPR with a chest compression to ventilation ratio of 30:2, the average number of compressions per minute was 76+/-9, while at a chest compression to ventilation ratio of 15:1, the average number of compressions per minute was 68+/-9. Between the compression to ventilation ratios of 30:2 and 15:1, the count gap was 8.3+/-3.2. When CPR was performed at a chest compression to ventilation ratio of 30:2, the average hands-off time was 9.3+/-1.9. When CPR was performed at a chest compression to ventilation ratio of 15:1, the average hands-off time was 6.7+/-1.3. Between chest compression to ventilation ratios of 30:2 and 15:1, the time gap of the average hands-off time was 2.7+/-1.2 seconds. CONCLUSION: When the chest compression to ventilation ratio was 15:1, the hands-off time was significantly reduced, but the compressions per minute were also reduced.
American Heart Association ; Cardiopulmonary Resuscitation ; Manikins ; Thorax ; Ventilation

American Medical Association ; Humans ; Lymphoma, Mantle-Cell ; therapy ; United States

American Medical Association ; Congresses as Topic ; Hematology ; United States