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TEXAS ORTHOPAEDIC ASSOCIATION

TEXAS ORTHOPAEDIC ASSOCIATION. AUSTIN TEXAS MAY 11 TH 2007. James Walter Simmons, Jr., M.D. International Spine & Orthopaedic Institute San Antonio, Texas Clinical Professor of Orthopaedics and Rehabilitation Clinical Professor of Neurosurgery UTMB @ Galveston, Texas. al.

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TEXAS ORTHOPAEDIC ASSOCIATION

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  1. TEXAS ORTHOPAEDIC ASSOCIATION AUSTIN TEXAS MAY 11TH 2007

  2. James Walter Simmons, Jr., M.D.International Spine & Orthopaedic Institute San Antonio, TexasClinicalProfessor of Orthopaedics and RehabilitationClinical Professor of NeurosurgeryUTMB @ Galveston, Texas al

  3. Orthopaedic Care of Workers Compensation Spinal Injuries within the Parameters of ODG and EBM

  4. ODG (Official Disability Guidelines) EBM (Evidence Based Medicine)

  5. DWC-06-0057TITLE 28. INSURANCEPart 2. Texas Department of Insurance,Division of Workers CompensationChapter 137. Disability Management

  6. ODG (TWC) Low Back Integrated Treatment / Disability Duration Guidelines Low Back, Lumbar, Thoracic (Acute Chronic) pp. 995-1535 (2,102 pages)

  7. Evidence-Based Practice:A Primer AAOS Evidence-Based Practice Committee Anthology, 2003-2005.Evidence-Based Practice “The integration of best research evidence with clinical expertise and patient values.” Sackett DL, Straus SE, Richardson WS, et al. Evidence-based medicine. How to practice and teach EBM, 2nd ed. London: Churchill Livingstone, 2000.

  8. THE RAND INSTITUTE ODG, and other four guidelines studied, scored high in the rigor of development domain by clearly describing the methods used to search for evidence and formulate recommendations (RAND, Evaluating Medical Treatment Guideline Sets for Injured Workers in California, P. 32) THE ODG ARE SCIENTIFICALLY VALID META-ANALYSIS-The Only Scientific Analysis of the Literature THE ODG GUIDELINES ARE EVIDENCE-BASED

  9. A Fair and Balanced View of Spine Fusion Surgery “EBM is not nor is it meant to be an effective cost containment tool, as it is directed toward maximizing a patient’s quality of life, which may increase or decrease the cost of care.” Errico TJ, Gatchel RJ, Schofferman J, Benzel EC, Faciszewski T, Eskay-Auerbach M, Wang JC. A Fair and Balanced View of Spine Fusion Surgery. Spine J. 2004 Sep-Oct;4 (5 Suppl):S129-38.

  10. Practice Guidelines “Practice guidelines bring order out of chaos. They allow the practitioner to develop treatment for a specific patient based not only on his/herexperienceand personalknowledge, but also on themost up-to-datescientific evidence, recently reviewed andevaluated as to the strength of this evidence. Through the process of guideline development, experts evaluate and distill the universe of information on a clinical problem down to a usable set of parameters to which the physician can apply his/her own experience and knowledge in managing a patient.Guidelines are not a substitutefor continued study, but rather represent a focus for the practitioner to provide the best care for his/her patients.Practice guidelines also serve as anexcellent referencesourcefor the physician and can function as an educational tool for the patient.” AAOS Evidence-Based Practice Committee Anthology, 2003-2005.

  11. The ODG Duration guidelines are designed for prospective case/claims management as well as retrospective benchmarking. Some of the reasons people use ODG are as follows: • To obtain the information necessary for effective management of return-to-work following illness/injury • To reduce delayed recovery rates with evidence-baseddisability duration guidelines • To provide upfront, clear targets for forecasting and reserving WC/STD/LTD/Auto claims • To identify early return-to-work opportunities with clear indications for job modification • To benchmark lost work time and cost data to measure return-to-work performance, track outliers and demonstrate the value of case management and occupational health programs • To open the lines of communication among all parties in the return-to-work process by providing a common framework based on existing and emerging medical evidence • To help injured workers get back on back to work safely, in a reasonable amount of time supported by the evidence

  12. Evidence-Based GuidelinesallowsImplementation of Evidence-Based Practice AAOS Evidence-Based Practice Committee Anthology, 2003-2005.

  13. Practice Guidelines • Evidence-Based Guidelines • Evidence-Based Practice Guidelines • Evidence-Based Practice AAOS Evidence-Based Practice Committee Anthology, 2003-2005.

  14. Thank You and God Bless America

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