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