Revised Jones Criteria For The Diagnosis of Acute Rheumatic Fever (AHA 2015) - An Indian Perspective

Acute Rheumatic Fever (ARF) is still a major problem in some developing and low middle income countries though the incidence and prevalence has remarkably reduced in North America and Europe. Ever since T. Duckett Jones in 1944 proposed the Jones criteria, it was modified and later revised by the American Heart Association (AHA) in 1992. This was reconfirmed in and AHA sponsored Work shop in 2002 [1]. No modification or change was suggested after the introduction of Doppler Echocardiography (DE) for the diagnosis of clinical and "subclinical carditis". When a clinical diagnosis by the clinician fails to show evidence of carditis, DE may pick up cases of "subclinical carditis". Moreover, previous recommendations did not include the Classification of Recommendations (Class I, II a, II b, and III) and Levels of Evidence (Levels A, B and C). Recently, however, a scientific statement from the American Heart Association (AHA) has published an update to the Jones criteria including the use of DE in the diagnosis of ARF [2].