As I write this Foreword we are about to go to print with the 15th Anniversary hard-copy edition of Official Disability Guidelines and its related library of products. How appropriate that this milestone anniversary should commence at the close of a year when our nation’s elected leaders and citizens alike are focusing more intensely than ever on healthcare and what, if any, changes should be made to our current system. This spotlight on healthcare - among other issues - comes as a bi-product of the signing of The American Recovery and Reinvestment Act of 2009 (ARRA), in February. The debate continues, and so it should. 

        I can’t help but share with you a certain degree of satisfaction I felt in learning of one, relatively small but interesting, program that sprang forth from the ARRA, called Comparative Effectiveness Research (CER). In my mind, CER seems to define just what we at Work Loss Data Institute (WLDI) have been working towards and doing through ODG for workers’ comp conditions for the last 15 years, under the name Evidence-Based Medicine (EBM). As a matter of fact, we pride ourselves in the fact that EBM is really CER in its purest form because it is solely based on outcomes, not costs, though savings seem to be a considerable part of the end-result. 

        The American Recovery and Reinvestment Act of 2009 called on the Institute of Medicine (IOM) to recommend a list of priority topics to be the initial focus of a new national investment in comparative effectiveness research. Granted, the 100 Initial Priority Topics are for the most part group health conditions, but the theory of researching and analyzing the results of clinical trials and studies and forming recommendations as to the most effective, least invasive treatments, based on outcomes couldn’t be closer to the ODG Treatment model. Interestingly, the IOM has qualified the value of CER in stating, “Ultimately, research on these and future topics will not yield real improvements unless the results are adopted by health care providers and organizations and integrated into clinical practice.” I would agree. 

        So, in celebration of our 15th Anniversary I want to applaud our staff and our contributing editors alike who played such a major role in ODG’s development, which embodies the very best of comparative effectiveness research – long before the phrase was ever coined – and enables injured workers to enjoy the best care today’s science has to offer. 

        I would particularly like to recognize our Senior Medical Editor, Dr. Charles W. (Bud) Kennedy, who has worked with us tirelessly since early 2001. As a founding member of the Evidence Analysis Committee for the American Academy of Orthopaedic Surgeons, Bud had hands-on experience and insight into a pattern that we identified as we drilled into reported absence data to develop our best practice guidelines 15 years ago. Simply stated, the type of treatment administered and the timeliness of care can have a huge impact on the recovery and return to functionality of individuals. That plain fact led to research, compilation, analysis, and ranking of clinical trials and studies conducted on various treatment modalities, and the subsequent publication of ODG Treatment in Workers’ Comp. 

        Further, I would like to pay tribute to another visionary we had the privilege of working with as a member of ODG’s Editorial Advisory Board, Dr. Vert Mooney. Dr. Mooney passed away on October 13, 2009, but his work will live on for a long time to come. Though a spine surgeon by profession, Vert continually studied and published research on non-surgical and non-invasive interventions that would achieve the same or comparable results as operative care. He recognized the value of utilizing the least invasive, most effective procedures available to obtain the earliest return to functionality and highest quality of life for the patient. 

        Lastly, I applaud the many U.S. states and Canadian provinces that have adopted ODG. Their decision and implementation of ODG within their state workers’ comp divisions and state funds showed foresight and determination. They understood what the IOM declared above, that the benefit of all of this research would not be felt “unless the results are adopted by health care providers and organizations and integrated into clinical practice.” States like Texas, Kansas, North Dakota and Ohio, to name a few, have done their due diligence to see to it that ODG Treatment is a mainstay in the day to day care of their injured workers. 

        What began as a movement of individuals, with pioneers such as WLDI’s president and founder, Phil Denniston, and Dr. Charles W. Kennedy, who saw the need for medical evidence to be integrated with treatment decisions, has spread to become a concept embraced and recognized by academies of doctors, individual workers’ comp boards and state funds of North America, and now, finally, by the U.S. Government. Work Loss Data Institute has been instrumental to this movement from the early days, and we know that the government’s recognition of what has always been our company’s mission comes with both great potential and great responsibility – as evidence-based medicine, when properly implemented, impacts the present and future of all injured workers, their families and our society as a whole. 
       

 

Patricia Whelan

Publisher