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

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

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

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

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

PURPOSE: In the evaluation of visual field defect, Goldmann kinetic perimetry is the preferred method. However, in many cases, Humphrey static perimetry is performed for visual disability evaluation in Korea. In the present study we investigated the correlation between Goldmann kinetic perimetry and Humphrey static perimetry for disability evaluation using visual field score (VFS). METHODS: This study included 126 eyes, classified into the following groups: 60 eyes, normal group; 11 eyes, contraction of central visual field group; 42 eyes, irregular visual field group; 13 eyes, hemianopsia group. All subjects were examined with Goldmann kinetic perimetry and Humphrey static perimetry. We studied the correlation of the VFS between Goldmann kinetic perimetry and Humphrey static perimetry according to the Korean Academy of Medical Science Guides for Impairment Evaluation (KAMS Guides) and American Medical Association Guides for the Evaluation of Permanent Impairment (AMA Guides). RESULTS: Regarding contraction of central visual field group, Goldmann VFS, Humphrey VFS and extended Humphery VFS showed no statistical significance (AMA: p = 0.50, p = 0.30, KMAS: p = 0.36, p = 0.18. respectively). In the irregular visual field and hemianopsia groups, Goldmann VFS and Humphrey VFS showed statistical significance (AMA: p = 0.00, p = 0.00, KMAS: p = 0.00, p = 0.00. respectively). Goldmann VFS and extended Humphrey VFS showed no statistical significance (AMA: p = 0.13, p = 0.12, KMAS: p = 0.08, p = 0.99. respectively). CONCLUSIONS: The contraction of central visual field based on Humphrey static perimetry can be applied to visual disability evaluation. However, in the majority of cases, there is a difference between the two tests and Goldmann kinetic perimetry should be used first in the evaluation of visual field disability evaluation.
American Medical Association ; Disability Evaluation* ; Hemianopsia ; Korea ; Methods ; Visual Field Tests* ; Visual Fields

OBJECTIVES: The internet has become an important source of medical information and a great amount of information related to allergic rhinitis (AR) is available on the internet. However, the quality of this information is still a matter of debate. Therefore, this study was conducted to assess the AR-related information on Korean websites. METHODS: The key word "allergic rhinitis" was entered into 4 popular search engines, and this led to identifying 40 websites. After being categorized according to authorship, the informational value of these websites was evaluated using 4 different assessment tools such as the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire, the Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 Update and the Health On the Net (HON) code. RESULTS: The 40 websites containing AR-related information were categorized according to their authorship as Western physician: 20, Oriental physician: 14, commercial: 1, and others: 5. The mean citation frequencies of the JAMA benchmarks and the ARIA 2008 Update concepts was 1.23 out of 4 and 4.33 out of 8, respectively, while the mean DISCERN score was 1.92 out of 5. When the websites were evaluated based on the type of authorship, the mean citation frequencies of the ARIA 2008 Update concepts were Western physician: 5.35, Oriental physician: 2.64. Additionally, three websites authored by Western physicians and 13 authored by Oriental physicians contained unreliable information. Among these 16 websites, only 3 websites met the requirements for the HON code "Justification". CONCLUSION: AR-related information available on Korean websites is of variable quality and not all of the information provided is justifiable. Thus, performing surveillance of the medical information on these websites is necessary. Furthermore, common criteria that can be used to evaluate the websites created by both Western and Oriental physicians are also needed.
American Medical Association ; Asthma ; Authorship ; Internet ; Korea ; Rhinitis ; Rhinitis, Allergic, Perennial ; Search Engine ; Surveys and Questionnaires

Since the implementation of workers' compensation, accurately and consistently rating impairment has been a concern for the employee and employer, as well as rating physicians. In an attempt to standardize and classify impairments, the American Medical Association (AMA) publishes the AMA Guides ("Guides"), and recently published its 6th edition of the AMA Guides. Common critiques of the AMA Guides 6th edition are that they are too complex, lacking in evidence-based methods, and rarely yield consistent ratings. Many states mandate use of some edition of the AMA Guides, but few states are adopting the current edition due to the increasing difficulty and frustration with their implementation. A clearer, simpler approach is needed. Some states have begun to develop their own supplemental guides to combat problems in complexity and validity. Likewise studies in Korea show that past methods for rating impairment are outdated and inconsistent, and call for measures to adapt current methods to Korea's specific needs. The Utah Supplemental Guides to the AMA Guides have been effective in increasing consistency in rating impairment. It is estimated that litigation of permanent impairment has fallen below 1% and Utah is now one of the least costly states for obtaining workers' compensation insurance, while maintaining a medical fee schedule above the national average. Utah's guides serve as a model for national or international impairment guides.
American Medical Association ; *Disability Evaluation ; Guidelines as Topic ; Humans ; United States ; Utah ; *Workers' Compensation

PURPOSE: The author evaluated the impact of vitreoretinal surgery for proliferative diabetic retinopathy (PDR) on bilateral visual function. METHODS: Anatomic and visual acuity outcomes were reviewed by author for patients who underwent bilateral surgery for PDR. Bilateral visual function was evaluated using the American Medical Association (AMA) Guidelines for Disability scale to quantitate the impact of surgery on visual system disability. RESULTS: There were 18 patients (36 eyes) who underwent vitrectomy for complications of PDR, and the overall anatomic success rate was 100%. Mean visual impairment of the study eyes and visual system according to AMA Guidelines for Disability decreased postoperatively by 22.4% points, and 25.7% points, respectively. A higher functional level of the bilateral visual system resulted postoperatively in 83.2% of all patients, according to eyes with better visual acuity. CONCLUSIONS: Vitreoretinal surgery was associated with a reduction in bilateral visual disability and improved bilateral visual function in patients with PDR.
American Medical Association ; Diabetic Retinopathy* ; Humans ; Vision Disorders ; Visual Acuity ; Vitrectomy* ; Vitreoretinal Surgery