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<p>With the growing burden of mental and behavioral disorders, the need for mental and behavioral disorder independent medical examinations (M&amp;BD IMEs) is increasing. These are conducted to furnish legal, administrative, and other claimant stakeholders with independent and unbiased medical opinions for decision-making and adjudication purposes. Current practices for M&amp;BD IMEs do not include grading of evidence to guide the strength of recommendations. To update current best practices for M&amp;BD IMEs<i>,</i> a literature review was conducted. The nature of the evidence is not suitable for GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) or for a traditional risk of bias assessment of included content. To increase methodological rigor and transparency for reaching recommendations, we constructed a novel, basic, and pragmatic grading framework for M&amp;BD IMEs. Based on the highest attainable level of evidence identified specific to M&amp;BD IMEs, the updated best practices include the categories of “required,” “strong recommendation,” “weak recommendation,” and “no recommendation.” Recommendations offered are based on the strength of evidence and range from “required,” to “strong,” to “weak.” A “no recommendation” category was included if the evidence was insufficient. Establishing minimum standards typically facilitates the implementation of relevant evidence into practice. We anticipate that creating M&amp;BD IME best practices and a minimum standards guideline will lead to a higher level of methodological rigor in translating science into practice for M&amp;BD IMEs. Special attention should be paid to disseminating the best practices and standards reported here to enable examiners to further improve competence.&#xa0;</p>

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Best Practices for the Mental and Behavioral Disorder Independent Medical Examination

  • 期刊论文

  • 发表日期：

    2025年4月30日

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  • Charl Els,
  • Barry Gelinas,
  • Sebastian Straube,
  • Douglas W. Martin

摘要

With the growing burden of mental and behavioral disorders, the need for mental and behavioral disorder independent medical examinations (M&BD IMEs) is increasing. These are conducted to furnish legal, administrative, and other claimant stakeholders with independent and unbiased medical opinions for decision-making and adjudication purposes. Current practices for M&BD IMEs do not include grading of evidence to guide the strength of recommendations. To update current best practices for M&BD IMEs, a literature review was conducted. The nature of the evidence is not suitable for GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) or for a traditional risk of bias assessment of included content. To increase methodological rigor and transparency for reaching recommendations, we constructed a novel, basic, and pragmatic grading framework for M&BD IMEs. Based on the highest attainable level of evidence identified specific to M&BD IMEs, the updated best practices include the categories of “required,” “strong recommendation,” “weak recommendation,” and “no recommendation.” Recommendations offered are based on the strength of evidence and range from “required,” to “strong,” to “weak.” A “no recommendation” category was included if the evidence was insufficient. Establishing minimum standards typically facilitates the implementation of relevant evidence into practice. We anticipate that creating M&BD IME best practices and a minimum standards guideline will lead to a higher level of methodological rigor in translating science into practice for M&BD IMEs. Special attention should be paid to disseminating the best practices and standards reported here to enable examiners to further improve competence.