AMA Guides® Newsletter - Issue Archive

Articles

1. Determining Injury-Relatedness, Work-Relatedness, and Claim-Relatedness

   Robert J Barth

   Pages 1–10

   DOI: 10.1001/amaguidesnewsletters.2012.MayJun01

   Abstract

   The American Medical Association's Guides to the Evaluation of Disease and Injury Causation (Causation) is an important component of the AMA Guides library and delineates a type of evaluation that is distinctly different from a diagnostic evaluation, a treatment planning evaluation, a prognosis evaluation, or an impairment evaluation. Causation provides a protocol for determining whether a clinical presentation, in the context of a legal or administrative claim, may be credibly attributed to a claimed cause. This article presents the evaluation protocol from Causation, provides self-assessment questions (so users can check how well they complied with the protocol), highlights the protocol's value as a model for scientifically credible practice in general, and clarifies that the protocol is relevant to claims that involve issues related to forensic causation. Courts and administrative systems have an extremely unfortunate emphasis on opinions from experts rather than on facts. The protocol from Causation is a good example of how clinicians can focus on facts and avoid surrendering to the court or administrative system's emphasis on opinions. The protocol is standardized, objective, fact-based, and scientifically credible and involves the following: establish a diagnosis; apply relevant findings; obtain and assess evidence of exposure; consider other relevant factors; scrutinize the validity of the evidence; and evaluate results and generate conclusions.
   Show more

2. Evaluating Causation for the Opposite Lower Limb

   Christopher R. Brigham, Charles N. Brooks, James B. Talmage

   Pages 10–12

   DOI: 10.1001/amaguidesnewsletters.2012.MayJun02

   Abstract

   Causation analysis always should be based on current scientific evidence and the facts of a specific case rather than common opinions or beliefs, eg, the myth that “favoring” one lower extremity often results in injury or illness of the opposite lower limb. Temporal sequence does not prove causation, and in causation analysis one also must consider temporal disparity: Was an injury or exposure likely to cause the condition in question, or is there another, more probable, cause? To conclude that a given cause and effect are etiologically associated with a reasonable degree of medical probability or certainty (ie, more than 50% probability), all three of the following criteria must be met: the cause is medically probably; the effect is medially probably; and the cause and effect probably are etiologically related. That is, causation analysis must be based on an analytical approach and not patient history alone. The medical literature reveals no generally accepted studies that support a causal relationship based on an individual's “favoring” one extremity. Rather, evaluators must base conclusions on scientific evidence and facts of the case at hand rather than relying solely on patient history or false logic such as the post hoc propter hoc fallacy.
   Show more