Cal. Code Regs. Tit. 8, § 9792.26 - Medical Evidence Evaluation Advisory Committee
(a) The Medical Director shall create a
Medical Evidence Evaluation Advisory Committee (MEEAC) to provide
recommendations to the Medical Director on matters concerning the MTUS. The
recommendations are advisory only and shall not constitute scientifically based
evidence.
(1) If the Medical Director position
becomes vacant, the Administrative Director shall appoint a competent person to
temporarily assume the authority and duties of the Medical Director as set
forth in this section, until such time that the Medical Director position is
filled.
(2) The members of the
MEEAC shall be appointed by the Medical Director, or his or her designee, and
shall consist of 19 members of the medical community holding the following
licenses: Medical Doctor (M.D.) board certified by an American Board of Medical
Specialties (ABMS) approved specialty board; Doctor of Osteopathy (D.O.) board
certified by an ABMS or American Osteopathic Association (AOA) approved
specialty board; M.D. board certified by a Medical Board of California (MBC)
approved specialty board; Doctor of Chiropractic (D.C.); Physical Therapy
(P.T.); Occupational Therapy (O.T.); Acupuncture (L.Ac.); Psychology (PhD.);
Doctor of Podiatric Medicine (DPM); Pharmacologist (PharmD); Nurse Practitioner
(NP) or Registered Nurse (RN), and representing the following specialty fields:
(A) One member shall be from the orthopedic
field;
(B) One member shall be from
the chiropractic field;
(C) One
member shall be from the occupational medicine field;
(D) One member shall be from the acupuncture
medicine field;
(E) One member
shall be from the physical therapy field;
(F) One member shall be from the psychology
field;
(G) One member shall be from
the pain specialty field;
(H) One
member shall be from the occupational therapy field;
(I) One member shall be from the psychiatry
field;
(J) One member shall be from
the neurosurgery field;
(K) One
member shall be from the family physician field;
(L) One member shall be from the neurology
field;
(M) One member shall be from
the internal medicine field;
(N)
One member shall be from the physical medicine and rehabilitation
field;
(O) One member shall be from
the podiatrist field;
(P) One
member shall be from the pharmacology field;
(Q) One member shall be from the nursing
field;
(R) Two additional members
shall be appointed at the discretion of the Medical Director or his or her
designee.
(3) In addition
to the nineteen members of MEEAC appointed under subdivision (a)(2) above, the
Medical Director, or his or her designee, may appoint an additional three
members to MEEAC as subject matter experts for any given
topic.
(b) The Medical
Director, or his or her designee, shall serve as the chairperson of
MEEAC.
(c) Members of MEEAC shall
make advisory recommendations to the Medical Director or his or her designee to
revise, update or supplement the MTUS.
(d) The advisory MEEAC recommendations shall
be supported by the best available medical evidence found in scientifically and
evidenced-based medical treatment guidelines or peer-reviewed published studies
that are nationally recognized by the medical community.
(e) To assess the quality and methodological
rigors used to develop a medical treatment guideline, members of MEEAC shall
use a modified version of the Appraisal of Guidelines for Research &
Evaluation II (AGREE II) Instrument, May 2009. The AGREE II Instrument, May
2009, consisting of 23 key items organized within six domains followed by two
global rating items was found in the following website:
www.agreetrust.org. A copy of the AGREE
II Instrument, May 2009 version may be obtained from the Medical Unit, Division
of Workers' Compensation, P.O. Box 71010, Oakland, CA 94612-1486, or from the
DWC web site at http://www.dwc.ca.gov.
(1) Members of MEEAC shall use a modified
AGREE II that uses the same six domains and two global rating items as the
AGREE II Instrument, May 2009 version but includes two
additional domains and additional key items:
(A) Additional domain in the modified AGREE
II Instrument -- Conflict of Interest
1. Key
Item in this domain -- All conflicts of interest of each guideline development
group member were reported and discussed by the prospective group prior to the
onset of his or her work.
2. Key
Item in this domain -- Each panel member explained how his or her conflict of
interest could influence the clinical practice guideline development process or
specific recommendation.
3. Key
Item in this domain -- The chairperson of the guideline development group had
no conflicts of interest.
(B) Additional domain in the modified AGREE
II Instrument - Currency of Guideline
1. Key
Item in this domain -- The guideline is being updated in a timely fashion
(typically at least every three years and, if the guideline is more than five
years old, it should be considered to be out of
date).
(f) Recommendations in guidelines that have a
low AGREE II overall score may still be considered, provided that the evidence
supporting the recommendations is the best available medical
evidence.
(g) To determine the best
available medical evidence, members of MEEAC shall rank the medical evidence
used to support recommendations found in either guidelines or peer-reviewed
published studies by applying the MTUS Methodology for Evaluating Medical
Evidence set forth in section
9792.25.1 and shall choose the
recommendations supported by the best available medical evidence.
(h) The members of MEEAC, except for the
three subject matter experts, shall serve a two-year term, but shall remain in
that position until a successor is selected. The subject matter experts shall
serve as members of the medical evidence evaluation advisory committee until
the evaluation of the subject matter guideline is completed. The members of the
committee shall meet as necessary, but no less than three (3) times a
year.
(i) The Administrative
Director, in consultation with the Medical Director, may revise, update, and
supplement the MTUS as necessary.
Notes
2. Editorial correction of operative date in HISTORY 1 (Register 2009, No. 30).
3. Amendment filed 4-20-2015; operative 4-20-2015 pursuant to Government Code section 11343.4(b)(3) (Register 2015, No. 17).
Note: Authority cited: Sections 133, 4603.5, 5307.3 and 5307.27, Labor Code. Reference: Sections 77.5, 4600, 4604.5 and 5307.27, Labor Code.
2. Editorial correction of operative date in History 1 (Register 2009, No. 30).
3. Amendment filed 4-20-2015; operative
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