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Table 6 Summary of findings about EBM tool in the workers’ compensation setting
| Issue | Comment |
|---|---|
| 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 |
