Table 6 Summary of findings about EBM tool in the workers’ compensation setting

Trust and guidance for clinicians

Automatically approval of treatment could be perceived as a sign that that the claims managers trust the clinicians’ judgement

Limiting over-servicing

Recommendations about MRIs and certain surgeries could limit over-servicing, although solicitors could still get it anyway

Patient expectations and claimant monitoring

Tool may assist with managing patient expectations, as it sets timeframes about RTW

Individual differences & psychosocial factors

Tool may inadequately consider individual differences and psychosocial factors. Most patients are not one size fits all

Clinical judgement

Clinical judgement is important. Tool should not overpass clinical judgement

Patient preference

Some patients prefer to have non evidence based treatments but in general those patients can be convinced to value EBM

Quality of evidence

For many topics the evidence is not replicated, or very specific to certain populations

Quantity of evidence

Lack of evidence should not imply denial of treatment

Timeliness and risk assessment

Tool may not adequately assess risk of prolonged recovery, and therefore not sufficiently focus on timely treatment

Critical appraisal and guideline development

Interpretation of evidence is dependent on who does the interpretation. American tool might not be applicable in Australia

Claims managers using the EBM tool

Inexperience or limited training for claims managers could lead to rigid usage and unfair denials

Tool is no solution

Tool may not assist with the 20% most problematic cases, and does not recognise employer factors that prolong return to work