Rice M J, Kaplan E L
Am J Public Health. 1979 Aug;69(8):767-71. doi: 10.2105/ajph.69.8.767.
We studied the hospital records of 124 patients with a discharge diagnosis of acute rheumatic fever who were hospitalized in 21 Minneapolis-St. Paul hospitals during 1975 and 1976. After careful review of the hospital records, we found that 83 (67 per cent) of these patients did not have an acute illness. Seventeen (41 per cent) of the 41 cases with an acute illness were thought to adequately fulfill the Jones' Criteria for acute rheumatic fever. Upon review of the rheumatic fever registry of the Minnesota State Health Department, we found that less than one-half of the hospitalized patients had been reported to the registry. Cases that fulfilled and did not fulfill the Jones' Criteria were reported with equal frequency, indicating significant underreporting and overreporting of rheumatic fever. Evaluation of secondary rheumatic fever prophylaxis, both in those patients with acute rheumatic fever as well as in those with rheumatic heart disease, indicated that many patients who, in theory, should be receiving prophylaxis were not receiving it. These studies indicate a need for more thorough evaluation of the current epidemiology of rheumatic fever and the role of a rheumatic fever registry, and imply a need for reevaluation of these programs. (Am J Public Health 69:767-771, 1979).
我们研究了1975年至1976年间在明尼阿波利斯 - 圣保罗市21家医院住院、出院诊断为急性风湿热的124例患者的医院记录。在仔细查阅医院记录后，我们发现其中83例（67%）患者并无急性疾病。41例患有急性疾病的患者中，有17例（41%）被认为充分符合急性风湿热的琼斯标准。在查阅明尼苏达州卫生部的风湿热登记处记录时，我们发现住院患者中向登记处报告的不到一半。符合和不符合琼斯标准的病例报告频率相同，这表明风湿热存在严重的漏报和错报情况。对急性风湿热患者以及风湿性心脏病患者的继发性风湿热预防措施的评估表明，许多理论上应接受预防的患者并未接受。这些研究表明需要对当前风湿热的流行病学以及风湿热登记处的作用进行更全面的评估，并意味着需要重新评估这些项目。（《美国公共卫生杂志》69:767 - 771, 1979年）
