Thank you for inviting me to review the article "Reliability of the AMA Guides to the Evaluation of Permanent Impairment," which appears in this issue of JOEM. Overall, I appreciate the authors' willingness to tackle the important question of this study, and I am pleased to see it published primarily because of the timeliness and relevance of the general issues it tries to address. Nevertheless, a substantial number of significant inherent limitations of their study remain and deserve mention, some of which cannot be overcome with a pilot effort of this kind. Perhaps the usefulness of this article will be to initiate a broader scientific dialogue and hopefully to stimulate more thorough and meaningful comparisons of this kind.
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