cliot (version 1.0.0)

jones_criteria_diagnosis: Revised Jones Criteria for Acute Rheumatic Fever (2015)

Description

Evaluates the 2015 Revised Jones Criteria to diagnose Acute Rheumatic Fever (ARF). The criteria are stratified by population risk (Low vs. Moderate/High) and differ for initial versus recurrent attacks. Diagnosis generally requires evidence of preceding Group A Streptococcal infection plus either 2 Major criteria or 1 Major + 2 Minor criteria.

Usage

jones_criteria_diagnosis(risk_population, carditis, chorea, erythema_marginatum,
                         subcutaneous_nodules, joint_manifestation, fever_c,
                         esr, crp, prolonged_pr, evidence_gas, history_recurrence)

Value

A list containing:

Diagnosis

"Positive" or "Negative/Criteria Not Met".

Major_Criteria_Met

Count of Major criteria satisfied.

Minor_Criteria_Met

Count of Minor criteria satisfied.

Arguments

risk_population

String. "low" (ARF incidence <2/100k or RHD prevalence <1/1000) or "moderate_high".

carditis

Numeric (0 or 1). Clinical or subclinical carditis. (Major).

chorea

Numeric (0 or 1). Sydenham chorea. (Major).

erythema_marginatum

Numeric (0 or 1). Erythema marginatum. (Major).

subcutaneous_nodules

Numeric (0 or 1). Subcutaneous nodules. (Major).

joint_manifestation

String. Joint symptoms. Options: "none", "monoarthralgia", "polyarthralgia", "monoarthritis", "polyarthritis". Classification depends on risk: Low Risk: Polyarthritis (Major), Polyarthralgia (Minor). Mod/High Risk: Mono/Polyarthritis (Major), Mono/Polyarthralgia (Minor).

fever_c

Numeric. Temperature in Celsius. (Low Risk cutoff >= 38.5, Mod/High >= 38.0).

esr

Numeric. Erythrocyte Sedimentation Rate (mm/hr). (Low Risk cutoff >= 60, Mod/High >= 30).

crp

Numeric. C-Reactive Protein (mg/dL). (Cutoff >= 3.0).

prolonged_pr

Numeric (0 or 1). Prolonged PR interval for age. (Minor). *Note: Cannot be counted if Carditis is counted as Major.*

evidence_gas

Numeric (0 or 1). Evidence of preceding Group A Streptococcal infection (culture, rapid antigen, or elevated ASO/DNAse B). (Required unless Chorea/Carditis is the presenting sign).

history_recurrence

Numeric (0 or 1). Patient has a history of ARF or Rheumatic Heart Disease. (1 = Yes). If Yes, diagnosis can be made with 3 Minor criteria.

References

Gewitz MH, Baltimore RS, Tani LY, et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation. 2015;131(20):1806-1818. doi:10.1161/CIR.0000000000000205

Examples

# Example 1: Positive (Low Risk)
# Polyarthritis (Major), Fever 39 (Minor), ESR 70 (Minor), GAS Positive
# Result: Positive (1 Major + 2 Minor)
jones_criteria_diagnosis("low", 0, 0, 0, 0, "polyarthritis", 39.0, 70, 1.0, 0, 1, 0)

# Example 2: Positive (High Risk)
# Monoarthritis (Major), Fever 38.2 (Minor), CRP 5.0 (Minor), GAS Positive
# Result: Positive (1 Major + 2 Minor)
jones_criteria_diagnosis("moderate_high", 0, 0, 0, 0, "monoarthritis", 38.2, 10, 5.0, 0, 1, 0)