AHCPR GUIDELINE ON MANAGEMENT OF CANCER-RELATED

AHCPR GUIDELINE ON MANAGEMENT OF CANCER-RELATED PAIN in clinical practice is currently targeted for release this autumn, HHS' Agency for Health Care Policy and Research said. The agency has 15 clinical practice guidelines on its schedule for dissemination in 1993 and 1994. Guidelines on the initial evaluation and early treatment of HIV-positive individuals, and on the treatment and diagnosis of benign prostatic hyperplasia are anticipated to be out this summer. Farthest along is a guide on sickle cell disease in newborns and infants, which is scheduled for release April 27. Among the documents to be unveiled in 1993 is a guideline for primary care physicians covering otitis media in children. There has been some debate about the effectiveness of current treatments for otitis media, which include antibiotics, tubal insertions and surgery. Critics of current treatment practices include Erdem Cantekin, PhD, University of Pittsburgh, while other experts defend the use of the therapies. The panel creating the otitis media guideline held a public hearing in May 1992 ("The Pink Sheet" June 1, 1992, T&G-14). Other guides targeted for release some time this year cover the care and evaluation of heart failure; lower back problems (anticipated to be ready in the late summer/early fall); post- stroke rehabilitation; screening for Alzheimer's and related dementias; treatment of pressure ulcers in adults; and quality determinants of mammography. Next year, the HHS agency hopes to have ready clinical practice guidelines on chest pain due to unstable angina; cardiac rehabilitation services; anxiety and panic disorders in primary care; and smoking prevention and cessation. The agency recently released its fifth guideline, which covers depression in the primary care setting ("The Pink Sheet" April 19, p. 8).