Evidence-Based Medicine Guidelines Create New Opportunities for Heath Psychologists in Occupational Medicine

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The current American College of Occupational and Environmental Medicine (ACOEM) practice guidelines and the Official Disability Guidelines (ODG), both published in 2004, agree on the importance of the role of psychology in rehabilitation. Both douments reference the influential Colorado worker's compensation guidelines. While the Colorado guidelines suggest that psychological assessments be performed on worker's compensation patients at 6-12 weeks post injury if theree is not a clear objective reason for contineud pain or disability. Employing principles of evidence based medicine, the Colorado guidelines concluded that the value of psychological assessment in the rehabilitation process the met the highest standard of evidence. The ACOEM guidelines recommended that psychological assessment of injured workers happen in the 4-6 week time frame. The ACOEM guidlines have now been given regualtory status in California, and are being considered for adoption elsewhere as well. While the ODG strongly recommends psychological assessment, it does not specifiy a time range. In the past, the North American Spine Society has published similar guidelines.

Related articles:

Evidence-Based Guidelines Help Create a Solid Foundation for Practice Decisions in Occupational Medicine.

Making the Case for Evidence-Based Medicine

Guidelines Help Emphasize Value of Psychological Evaluations in Workers’ Compensation Arena.

For more information…

• Official Disability Guidelines (ODG)

See www.disabilitydurations.com

• State of Colorado Division of Workers’ Compensation Practice Guidelines

See www.coworkforce.com/DWC/Ruleshtm/rulescontents.asp

• Occupational Medicine Practice Guidelines published by American College of Occupational and Environmental Medicine (ACOEM)

See www.acoem.org/whatsnew/pracguide.asp

• An evaluation tool designed by Kathryn Mueller, MD, MPH, to assess how providers are using ACOEM guidelines

Can be used as a medical record that providers fill out to gather quality improvement feedback; or by case managers to do chart reviews.

See www.umassmed.edu/workerscomp/Tool_Box/treatment_guide/ index.cfm or contact Kathryn.Mueller@uchsc.edu

• A report on evaluation of users’ responses to ACOEM guidelines

Mueller KL, Harris JS, Low P, Koziol-McLain J, Peplowski B. Acceptance and self-reported use of national occupational practice guidelines. Journal of Occupational and Environmental Medicine, 1999, 42:362–369.

Edward Whitney, MD, MSPH, is a graduate of the University of Colorado School of Medicine who practiced adult ambulatory medicine in Colorado and in California until 1995, when he returned to the University of Colorado Health Sciences Center to study epidemiology and public health. Since 1999, he has worked full time at the Colorado Division of Workers’ Compensation, where he has conducted studies of adherence to the division’s Medical Treatment Guidelines. To support the goal of including evidence statements in the revised guidelines, Dr. Whitney has conducted critical reviews of published medical literature.

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