News in brief - July 11, 2005

Increasing access to rapid HIV test - AMA endorses efforts to increase early identification of developmental delays - Family violence questions should be part of history - Report on food allergies released - Preventive services guide available

Increasing access to rapid HIV test

The American Medical Association will collaborate with other medical societies to increase access to the rapid HIV test, working in a manner consistent with quality assurance guidelines published by the Centers for Disease Control and Prevention in 2003, according to policy adopted at the AMA's Annual Meeting in June. Testing should also include pre- and post-test counseling.

The Association has long advocated that HIV testing should be readily available. Wider access to tests that do not require waiting days or longer for results is believed to be one way to reach the large number of people who are unaware they are infected.

A progress report will be issued at the 2006 Interim Meeting.

AMA endorses efforts to increase early identification of developmental delays

In order to increase the early identification of more children who have autism or other forms of developmental delay, the American Medical Association offered its support for efforts by medical specialty societies to educate physicians about screening and detecting these disorders. The Association is also urging doctors to assist parents in getting access to appropriate early intervention services.

The action, endorsed by AMA delegates at the June Annual Meeting, is a response to recognition that interventions at a young age can have a significant impact. "We have too many children who arrive at school who could have been picked up two or three years prior," said Joel Shulkin, MD, a pediatrician from Windham, N.H., and a member at-large of the AMA Young Physicians Section.

Family violence questions should be part of history

Physicians should assess a patient's risk for family violence as part of the routine social and medical history, according to a report issued by the American Medical Association's Council on Scientific Affairs at the Association's Annual Meeting last month.

"There's no question that screening carries with it substantial pay-off," said Robert McAfee, MD, a former AMA president who has long worked on this issue. "Violence in this country is on a downward swing, which we're pleased to see, but there's no indication that the violence that occurs in the family structure is anything but at an all-time high."

The report's recommendation stemmed from growing awareness that identification of this kind of abuse is important but that many cases are missed. Screening, however, remains controversial. The AMA has made similar recommendations before, but the U.S. Preventive Services Task Force said last year that there was insufficient evidence to recommend routine screening.

The AMA also urged increased awareness of the risk of domestic violence to pregnant women.

Report on food allergies released

An advisory committee of the Food and Drug Administration has released a draft report on food allergies, including celiac disease, that analyzes the science behind threshold measures that mark the point at which foods trigger an allergic reaction in susceptible individuals.

The report will be considered during a July 13-14 meeting of the agency's Food Advisory Committee. Developed by scientists from the Center for Food Safety and Applied Nutrition, the report represents a step toward carrying out the Food Allergen Labeling and Consumer Protection Act, which became law last year.

The draft report is available online (www.cfsan.fda.gov/~dms/alrgn.html) and public input is being accepted until Aug. 16. Additional information is available on the FDA's Web site (www.fda.gov/ohrms/dockets/98fr/05-12041.htm).

Preventive services guide available

The Agency for Healthcare Research and Quality has compiled all current recommendations of the U.S. Preventive Services Task Force in "The Guide to Clinical Preventive Services 2005" and has made it available for free on its Web site (www.ahrq.gov/clinic/pocketgd.htm). Single copies of a pocket-sized version also are available, as is an application to download it to a PDA.

The recommendations are intended for primary care physicians and cover preventive services, the early detection of cancer, heart and vascular disease, infectious diseases, mental health conditions, and injury and violence.

"This pocket-sized guide makes it easy for clinicians to use as a quick, evidence-based reference," said USPSTF Chair Ned Calonge, MD, who is also chief medical officer and state epidemiologist of the Colorado Dept. of Public Health and Environment. "The guide carries on the 20-year tradition of the Task Force in setting the standard for evidence-based prevention recommendations. I hope clinicians find it a useful tool as they care for patients."