The cadence for the release of new AMA Guides® content has not yet been determined. The AMA anticipates consistent, periodic updates to the AMA Guides to ensure the AMA Guides always reflect the best available medicine, however the AMA is cognizant of the intricacies of adoption.

In conjunction with their combined expertise across several medical disciplines, the AMA Guides Editorial Panel has adopted a comprehensive set of standards by which content proposals will be accepted. 

Interested in submitting a proposal for updates to the AMA Guides? Please review the evidentiary and submission requirements.

A proposal for an editorial change must be supported by an evidence-based foundation when possible. When evidence-based medicine is not available, consensus-based medicine developed in a structured Delphi approach may be substituted.

In order of preference, one of the following is required to support each proposed editorial change:

  • Evidence-based medicine documented in peer reviewed articles published in medical journals indexed in PubMed, Web of Science, SCOPUS, or Google Scholar that are classified as Level of Evidence I-IV in the Oxford Centre for Evidence Based Medicine Level of Evidence Table (Appendix A)
  • Outcomes-based Real-World Evidence (RWE), meaning observational data generated during routine clinical practice and stored in EHRs, medical claims or billing databases, and registries with evidence determined to be of High or Moderate quality using the WHO’s GRADE (Grading or Recommendations, Assessment, Development, and Evaluation) framework (Appendix B)
  • Other peer-reviewed sources such as specialty society guidelines developed in accordance with the Institute of Medicine standards1
  • Consensus-based decisions developed in a Delphi process2 endorsed or overseen by a relevant stakeholder professional association of society

In some cases, evidence may take the form of data or case law that demonstrates inconsistent application of the AMA Guides or a need for clarification of some element. In these cases, evidence of the need to enhance the AMA Guides may include judicial outcomes such as:

  • State-based workers’ compensation impairment rating data that is categorized by CPT code or injury code
  • Industrial Commissioner (or similar) data on litigated case outcomes when impairment ratings are an issue
  • Judicial opinions or law journal articles that identify a specific issue of wide and inconsistent impairment ratings for similar conditions
1 Institute of Medicine. 2011. Clinical Practice Guidelines We Can Trust. Washington, DC: The National Academies Press.
2 Helmer-Hirschberg, Olaf, Analysis of the Future: The Delphi Method. Santa Monica, CA: RAND Corporation, 1967.

To submit an application to update the AMA Guides please log into the AMA Guides Submission Portal.



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